State Public Health Vet takes control of protecting MA animal professionals
Following a comprehensive survey of Animal Control Officers and even some veterinary professionalsacross the state, I was able to determine that most Massachusetts blood labs don’t seem to be administering rabies titer measurement tests that are in concert with those tests recommended by the Center for Disease Control’s Advisory Committee on Immunization Practices (CDC’s ACIP).
The ACIP recommends that persons who have received complete pre-exposure vaccines, should be
receiving documented rabies virus neutralizing antibody titer tests (approximately every two years), which are designed to detect the presence of a non-neutralized virus, such as the CDC’s recommended rapid flourescent focus-inhibition technique (RFFIT). According to my research, the rabies titer tests that are being administered across Massachusetts do not appear to be rabies virus neutralizing antibody titer tests. Instead, those being tested seem to be receiving an enzyme-linked immunosorbent assay (ELISA), designed only to detect rabies virus anti-glycoprotein antibodies. This means that someone who has an adequate titer as measured by an ELISA test, may not actually be protected against rabies.
During my investigation, I also realized that only a very few laboratories in the United States even perform the RFFIT titer tests, and none of these labs are in Massachusetts. In other words, unless a titer test is sent out of state, the results accumulated from the lab are not the CDC’s recommended test.
The next step: I contacted Dr. Catherine M. Brown, the State Public Health Veterinarian at the Massachusetts Department of Public Health. Her response, “I truly appreciate your (ACOAM) acting on this concern and bringing it to me in the process.” Without hesitating, Dr. Brown contacted the Massachusetts Veterinary Medical Association (MVMA) - Dr. Brown sits on the public health committee for the MVMA. She quickly turned this inquiry/concern into an agenda item for the Board’s next meeting, explaining to the Board that she had been approached by ACOAM regarding the development of an information sheet that ACOs could provide to their healthcare providers, about the recommended protocol and testing for maintaining rabies pre-exposure titers. She also suggested that since ACOAM’s research had also indicated that several veterinarians and vet techs were receiving paralleling titer tests to those being received by the ACOs, that perhaps the MVMA might consider distributing something similar to their own membership. While there is no guarantee that physicians and labs will agree to utilize these forms, as created through ACOAM and the Department of Public Health, ACOs and other animal care professionals are encourraged to provide these documents to their doctors, when having rabies titers tested. The RFFIT test is routinely available from Kansas State University for a reasonable cost. Three (3) sheets are enclosed within this newsletter email on separate PDF file pages.
1). A Rabies Pre-exposure Vaccination and Serologic Monitoring Recommendations sheet for Animal Control Officers to provide to healthcare providers
2). A Specimen Submission Instruction sheet
3). A Specimen Submission Form
Those who do utilize these forms, please contact Deni Goldman with the outcome of your doctor’s and laboratoy’s adhesion (or lack thereof) to this request. ACOAM would like to be able to provide a follow up of this project to Dr. Brown in the not -too-distant-future. On behalf of ACOAM, we thank Dr. Catherine Brown for her unhesitated interest in our concern, in the maintenance of our health and protecting us as we perform our duties ensuring the safety and health of MA residents. We are extremely greatful that she has assisted in this effort, and provided us with her full
support.
Deni Goldman
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