I had a long, calm, polite talk with Dr. Bruce Sherman, Connecticut
Department of Health, 165 Capitol Avenue, Hartford, CT 06106, (860)
566-4268.  According to George Cooper (epidemiology, (860) 509-8000), this
is who George Cooper refers to for ferret bite advice.
 
I believe Dr. Sherman will only be ANNOYED by emotional plea and phone
calls, so we need to help him instead with calm, logical argument and
scientific study.  I don't want to inflame this person if we don't have to.
We really need to be civil here, even if we are emotionally involved.  I
think he might respond well to written inquiry and logic, as I suggest we do
below.
 
- His policy is "kill and test" for ferrets.  I asked him that directly, and
he said that was a "fair assessment".
 
- His main point is that he does not feel there are any conclusive studies
done of rabies shedding in ferrets.  He said has read one or both of the
recent ferret shedding studies, and that my phone call may prompt him to
review this evidence and other evidence again.  I told him we'd like to work
with him to decide whether the studies which have been done are adequate,
and if they aren't adequate, what we can do to make them adequate (though it
is my non-expert opinion they are adequate).  If he thinks they are
inadequate, I would like to know why, I told him (politely).  I would like
to know if any study would be adequate.
 
- I mentioned that a minimal goal of mine is trying to get him to consider
these cases on a case-by-case risk assessment, as the Compendium suggests.
 
- CT has a quarantine of 2 weeks for dogs and cats, he says.
 
- The main rabies vector in CT is far and away raccoons, and he said he
believes there was not a serious problem with rabid raccoons in CT until
1991.  The number of positive animals in CT since 1991: 2793 (!) raccoons,
390 skunks, 24 woodchucks, 5 dogs, 55 cats, 3 sheep, 21 foxes, 6 cows, 4
horses, 1 coyote, 1 deer, 1 otter, 1 ferret, 1 bobcat.
 
- I didn't press him too hard on the horse, gerbil, or guinea pig policy.
I think he was not aware of studies done on them, and he would have to
consider these on a case by case basis (he didn't disagree when I said this
as a possible policy - but we need to check him again on this; perhaps I
could have asked him more specifically about this).  I also should have
asked him if he was aware of any asymptomatic shedding dogs or cats longer
than 14 days (don't we have some sources for that?).
 
I suggest the action item we should adopt for Dr. Sherman (and this is what
I told him we'd do):
 
We need to get him a summary of all studies have been done in ferrets,
including the text of these studies.  We should send him those, along with
some questions like: is this study adequate?  If not, then what about it is
inadequate?  How do dogs, cats, horses, and other animals fare on similar
studies to the one in question?  What would it take to change your policy,
and why?  Does this study contribute positively or negatively to the risk
factors one might consider in a case-by-case analysis?  If raccoons are your
main vector, how does the recent raccoon strain study in ferrets contribute
to public safety in CT?  If the raccoon strain study is unconvincing in any
way, why?
 
Todd Cromwell (Dors and Seldon)
[Posted in FML issue 1962]