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Subject:
From:
Robert Jacobs <[log in to unmask]>
Date:
Mon, 19 May 1997 19:28:08 -0400
Content-Type:
text/plain
Parts/Attachments:
text/plain (146 lines)
The following are quotes from the 7 page affidavit of William N. Hall,
M.D., M.P.H. as submitted to the Court Of Appeals.
 
para 1 - 6 are his personal credetials
 
7.  The mission of the Department is to protect human health by preventing
disease and injury.  Because of this responsibilitty, state public health
officials must take seriously any potential exposure to an essentially fatal
disease such as rabies.
 
8.  Rabies consultations by the Department with local health departments are
always based on an assessment of risk
 
9.  Public health officials are often in a difficult position of having to
choose human health over the life of an animal.  While these are not
pleasant decisions, and no one likes having to make such a choice, because
rabies is essentially fatal for people once symptoms develop, public health
officials will always choose the safest option when making decisions on
animal verses human life.
 
10.  The facts and information cited below compel our department to
recommend that the ferret in this case be immediately euthanized and tested
for rabies.
 
11.  In Michigan, there are two federal documents upon which we base our
recommendations concerning rabies control and prevention.
 
12.  The first document is titled, "Rabies Prevention - United States, 1991,
Recommendations of the Immunization Practices Advisory Committee (ACIP)"
published by the Centers for Disease Control and Prevention in Morbidity and
Mortality Weekly Report, (MMWR) March 22, 1991.
 
13.  The second document is the Compendium of Animal Rabies Control
published by the National Association o State Public Health Veterinarians on
an annual basis.  This document is also published as a supplement in MMWR.
 
14.  Michigan's Communicable Disease Rules, last updated in 1993, adopts by
reference, the 1992 version of the Compendium of Animal Rabies Control.
 
15.  Both of these documents are the products of advisory communities and
represent the consensus view on rabies prevention by experts from the
Centers for Disease Control and Prevention, academia, other government
agencies and clinical practice.
 
16 Both of these documents serve as the basis for rabies guidelines in all
species of animals, including dogs and cats.
 
17.  The 1997 version of the compendium does not differ from the 1992
version with regard to ferrets and the provision of a post-bite quarrantine
period (there is no established quarantine which would ensure a ferret is
free from rabies).  Thus the accepted standard has not changed from 1992.
 
18.  Rabies is a viral disease that attacks the neurologic system.  It is an
ivariably fatal disease.  Virus-laden saliva of a rabid animal is introduced
by a bite or scratch.
 
19.  the incubation period of rabies in humans is usually 3-8 weeks,
although there have been rare instances of incubation periods greater than
one year.  The incubation period is defined as the time interval between
initial contact with an infectious agent and the first appearance of
symptoms associated with the infection.
 
20.  Prophylactic vaccination is safe and effective in preventing rabies if
given shortly after the bite-exposure occurs.  The effectiveness of the
preventive intervention declines as time passes since the exposure, but it
is believed to be of potential value up until the time that symptoms of
rabies begin.
 
21.  Once clinical signs have begun in a person, the usual duration of
illness is 2-6 days without medical intervention.  Death is often due to
respiratory paralysis.  Diagnosis is made by specific tests of brain tissue.
 
22.  There have been between 14 and 52 exposures of people, or pets to
laboratory proven rabid animals each year in Michigan since 1990.  Michigan
did identify a laboratory confirmed rabid ferret in 1985 Ontonagon county
that involved human exposure.  Rabies positive bats and other animals are
reported throughout the state every year, thus no area of Michigan is
considered to be free of rabies.  Michigan's last case of human rabies
occurred in a six-year-old child in 1983.
 
23.  Vaccination of any animal, even dogs and cats, with a USDA approved
rabies vaccine is no guarantee that rabies will be prevented.  that is why,
if a dog or a cat bites a person, the animal is placed in 10 days of
confinement and observation whether or not it is vaccinated.
 
24.  We know from scientific studies and from many years of world wide
experience, that the virus shedding period for a dog or cat is only a few
days.
 
25 The "virus shedding period" for a particular species refers to the time
period in which the virus is available at the exit portal, such as saliva.
During this period, the animal is capable of transmitting the rabies virus
by biting a person.
 
26.  thus, when a dog or cat bites a person, it will be showing signs of
rabies at that time or within a few days.  If signs of disease occur in the
dog or cat during confinement, there is time to administer the lifesaving
post-exposure treatement to the person who has been bitten.
 
27.  In contrast to dogs and cats, the period between onset of bat variant
rabies shedding in saliva and development of recognizable signs of rabies
has not yet been established for ferrets.  We are aware that studies are
currently underway to try ot determine a virus shedding period for the bat
variant strain of rabies virus in ferrets, but these studies have not been
completed.
 
28.  This is of penultimate importance in Michigan because the overwhelming
majority of rabies positive animals in Michigan are bats presumed to be
infected with the bat variant strain.  In the last 5 years, 111 of 121 (92%)
of rabid animals were bats.  In addition, the characterization of rabies
virus isolates from rabid animals other than bats that were tested,
indicates that the vast majority are caused by the bat variant strain.
 
29.  While the ferret rabies virus shedding period for the skunk rabies
variant and the raccoon rabies variant have been studied, the ferret
shedding period for the bat rabies virus has not.
 
30.  Studies show that there are significant differences in the ferret
rabies virus shedding period between the skunk rabies variant and raccoon
rabies variant; thus we know that the virus variants are not homogeneous.
It is therefore possible that once studied, the bat rabies variant shedding
period may be lengthy.
 
31.  Information provided by the Bay County Animal Control and the exposed
individual himself imply that a true through-the-skin bite exposure to
saliva of the ferret at issue is likely to have occured.
 
32.  Our department is compelled to recommend that the ferret at issue be
immediately euthanized and tested for rabies of on the basis of the careful
consideration of: 1) the individual circumstances of this exposure incident,
2) the Michigan specific facts about rabies cited above, 3) the body of
knowledge about rabies and in particular the lack of data on the shedding of
the bat-variant strain of the rabies virus in ferrets, and 4) the current
recommendations of the national authorities responsible for forming public
health policy concerning rabies prevention as set out in the Centers for
Disease Control & Prevention in Morbidity and Mortality Weekly Report (MMWR)
March 22, 1991 and the National Association of State Ppublic Health
Veterinarians compendium of Animal Rabies Control for 1992 and 1997.
 
 
There ya go, the "official" document as submitted to the appellate court by
the attorney general of Michigan.  except for my typos it's typed over
verbatum from the document as I recieved it.  You tell me what's up with
this!!!
[Posted in FML issue 1940]

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