In the wake of Melanee Ellis' report on Alaska, last week I had about an
hour and a half worth of discussion total with two people in Alaska.
Thursday I called Dr. Mike Beller of the AK state health dept. in Anchorage,
and Friday I called Don Ritter of the state virology lab in Fairbanks (the
gentleman with whom Melanee spoke).  There is another person, John Mittal
(sp?), who might be Dr. Beller's boss, but I didn't feel it necessary to
talk to him.  Don and Mike do know each other.
 
Dr. Mike Beller said their policy is case-by-case risk analysis in bite
cases involving ferrets, and, actually, "it doesn't matter what animal",
risk analysis, in general, though the 10 day quarantine proposed by the
Compendium might be a factor for dogs and cats.  The risk analysis would
take into account (not necessarily exhaustively): whether the animal was
vaccinated or not and its vaccination history, the type of animal, the
behaviour and vital signs of the animal, whether the bite was provoked.  As
for rabies vectors, he said foxes were a "huge problem", and that every year
they get rabid foxes especially in West and North Alaska (and Don adds that
the Alaska peninsula is enzootically positive as well), with, if I remember
what he said, a 5-7 year cycle.  Mike mentioned the possibility of rabid
bats, and that he was aware of rabid bats in WA and BC (Canada).  He said
they've had no reports of rabid ferrets in Alaska.  In complicated risk
analyses, he said they might consult with the CDC.
 
Mike's policy conflicted with what Melanee reported about AK being
kill-and-test-always, so I called Don Ritter (with whom Melanee spoke) and
had about a 45 minute long chat with him.  One of Mike or Don told me the
vaccination for ferrets was approved by the Compendium, so would be
considered in the risk analysis.
 
Don Ritter told me their policy is a case-by-case risk assessment for ferret
bite incidents.  He says his office does go by the 1997 Compendium in this,
and that he considers it and the body that produces it to be a good vehicle
for their policy on this (I think that came up in a discussion about
changing policy to quarantine for ferrets, which Don said would currently
require separate regulation, since they follow the code set out by the
Compendium).  Don also listed the criteria about type of animal, whether the
bite was provoked, and added epidemiology of the area.
 
Don was aware of the recent studies of rabies strains in ferrets (including
those of skunk and raccoon strains), and part of what he cited to me as work
of which he was aware was the fox strain tests from Europe (believe he said
the W.H.O., though I haven't looked at that study for a while).  Perhaps the
fox study interests him specially, since foxes (e.g., red fox, arctic fox)
are the main rabies vector in Alaska), and he knew that in that study they
didn't shed.
 
I told him why we get emotional and bitter about this as we feel persecuted
way beyond dogs and cats and that we worry that the next study proposed will
be the aardvark one (and he laughed, so at least he thought that funny!).
He and I talked about why policymakers might be more resistant to setting
favorable policy on ferrets than they are on dogs and cats - he and I
discussed the more litigous atmosphere today (which I proposed as part of
our difficulty and he agreed it might be a factor) and I think he may feel
they were a bit more lax historically ("seat of the pants", he said) than
they are now (and we talked about whether bat strain studies done in dogs
and cats; he didn't know whether they had been done).  He did say the 10 day
cat and dog thing has been empirically found to be fairly supported now by
evidence, whatever the original studies (though he might not dispute that
shed times have been known to be longer; I didn't discuss that with him).
He says they do sometimes kill and test cats and dogs if factors suggest it,
even if they have been vaccinated (like, if they show rabies suggestive
behaviour, or suspect the vaccinations not done properly, or something).
 
We talked about the bat strain studies Rupprecht of the CDC is doing, and he
said he thought we might know something by October.  I expressed a worry
Rupprecht wouldn't have them done by October; he thinks that recent talk by
Rupprecht might indicate Rupprecht has something going on (though I don't
think he keeps that close tabs on it, since ferret rabies is only a minor
issue for them).  Don said bat strain rabies is different than other
strains, and that within the bat strains there were differences between the
risk from brown bats and silver-haired bats, the latter being feistier and
more risky empirically (if I remember what he said right).
 
Don talked of dog maulings being comparatively high in Alaska versus the
rest of the U.S.  (think he said 20-25 times higher in Alaska).  he spoke of
a 2 year old recently being killed by a female dog with pups.  He thought
proper education and care of pets very important.
 
I talked with Don about his talk to Melanee of ferrets being a risk to
babies and asked him if one source for him was the CA dept of health
publication by Constantine in 1988 or so, and he laughed and said it might
be one.  I told him briefly what I thought of that publication (though I
left out talk of toilet paper), and I will send him the PRI rebuttal of it.
My point was not that there is zero risk from ferrets, but rather that the
risk from ferrets should be put in perspective with that from dogs and cats
or any other animal with teeth.
 
At any rate, Don was very knowledgeable (good thinker, knew the studies and
latin names of animals tested, had a lot of knowledge about current and past
cases and epidemiology) and a nice person.  He knew Kodo's name without me
telling it to him.  I asked him several times directly whether he and Alaska
were always-kill-and-test, and he said no, the policy is done case by case,
with consultation (actually for any animal, though there is the 10 day
quarantine suggested for dogs and cats).
 
I asked Don if he had told Melanee they had a policy of
kill-and-test-ferrets-always, and he said he had been "too flip" with
Melanee, that "it's not that black and white".  Don said ferret bite cases
are not a major issue for them in comparison with AIDS, hepatitis, or dog
maulings.  I personally think he may have gone back over it after Melanee's
call -- as I said, I think the ferret issue is currently a small one for
them (and remember, additionally, the Compendium does change yearly).  Much
thanks to Melanee for her call to Don Ritter.
 
Todd Cromwell III, WA State
(Dors (hunter of small plastic bottles) and Seldon (hunter of dreams))
[Posted in FML issue 1981]