Rabies Policy

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Patient Care Guidelines
Rabies Exposure Mitigation Policy

Policy Number (VMT:03:01)    

Rabies Policy for the Richard A. Gillespie College of Veterinary Medicine Veterinary Medical Technology Program

 

  1. Purpose

The purpose of this rabies policy (hereinafter the “Policy”) is to decrease the chance of exposure to rabies, a fatal zoonotic disease, for personnel and students enrolled in the Richard A. Gillespie College of Veterinary Medicine Veterinary Medical Technology Program (hereinafter the “Program”) at Lincoln Memorial University (LMU). 

 

  1. Policy Statement

It is the policy of the Program to require pre-exposure rabies vaccination or evidence of a protective rabies titer within the past twenty-four (24) months for all students enrolled in the Program and personnel associated with the Program. Students who have a medical contraindication or religious exemption that prevents them from receiving the rabies vaccine must understand their increased risk of contracting rabies.  The rabies mitigation policy lays out the steps that the Program has put in place to help decrease this risk for all faculty and students enrolled in the Program. 

III.       Definitions

Fully vaccinated animal - Animals that have been held for twenty-eight (28) days after their first rabies vaccine to allow for seroconversion according to the Center for Disease Control (CDC).   Animals previously vaccinated against rabies are considered fully vaccinated immediately after their booster vaccine is given if their booster vaccine is given on schedule.

Fully vaccinated human – Humans are considered fully vaccinated after they have completed their initial rabies vaccine series (either 2-dose or 3-dose series) within the past two (2) years or have an adequate rabies titer drawn within the past two (2) years. 

  1. Audience

This policy is written for the Program including LMU personnel, students, and shareholders.

  1. Compliance

Compliance will be ensured by oversight from the Veterinary Medical Technology Program Director and Program Personnel. 

  1. Roles and Responsibilities

Animal Care Supervisor: Staff member who oversees care of canine, feline, and laboratory animals. and is the direct point of contact for students on kennel shifts regarding animal care.

 

Veterinary Medical Technology Program Director: Professor that oversees the Program, including supervision of staff and faculty. 

Program Personnel: Any staff or faculty employed by LMU with primary duties associated with the Program.  

 

VII.     Applicable Statutes, Regulations, and Related Policies (If any)

Information for guidelines regarding zoonotic disease and rabies protection:  www.cdc.gov/rabies/index.html  and What is Rabies?, World Health Organization, https://www.who.int/rabies/about/en/.

 

VIII.    Standards

CVTEA Accreditation Policies and Procedures: Appendix A

 

Rabies exposure is an occupational hazard for all members of the veterinary healthcare team, and preventive measures are necessary to protect personnel. Rabies in humans can be prevented either by eliminating exposures to rabid animals or by providing exposed persons with prompt local treatment of wounds combined with appropriate postexposure prophylaxis (including both passive antibody administration and active immunization with cell culture vaccines). According to the U.S. Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP), preexposure vaccination should be offered to persons in high-risk groups, such as veterinarians and their staff.

 

 

IX.       Components of Rabies Policy 

  1. Vaccination of mammals (excluding rodent and rabbits): 
    1. All mammals (cats, dogs, cattle, and horses) used for instruction under IACUC and USDA protocol are vaccinated against rabies by an USDA-accredited veterinarian upon intake into an LMU facility. Records for rabies vaccination will be held for each animal within their medical record in the LMU-CVM electronic medical record database. Any student who is not fully vaccinated against rabies will not handle an animal until the animal is considered fully vaccinated (see Section III for definitions).
    2. Any client owned mammals (e.g., sheep, dogs, cats, or ferrets) that are used in laboratory classes will be required to provide proof of a current rabies vaccine prior to use in a laboratory setting. Any client-owned mammal that has not been fully vaccinated will not be permitted to participate in laboratory classes (see Section III for definitions). 
  2. Vaccination of humans
    1. Pre-exposure rabies vaccination or evidence of a protective rabies titer within the past twenty-four (24) months is required for all students enrolled in the Program and personnel associated with the Program.
  3. Hold/seroconversion period post rabies vaccination 
    1. Upon intake into an LMU facility, rabies vaccination is administered to any unvaccinated animal or animal with unknown vaccination status and documented in each animal’s medical record. Animals are held for twenty-eight (28) days before they are considered fully vaccinated.
    2. Once at LMU, only fully vaccinated students or students with proof of a protective titer within the past twenty-four (24) months and fully vaccinated Program personnel will care for any animals that are not fully vaccinated against rabies (see Section III for definitions).

 

 

 

  1. Hold/observation period for vaccinated animals exposed to rabies
    1. Mammals (dogs, cats, horses, and cattle) that are exposed to rabies but current on rabies vaccination shall be given a booster vaccination immediately and are held for forty-five (45) days for observation.
    2. Only fully vaccinated employees and students or employees and students with proof of a protective titer within the past twenty-four (24) months will care for any animals not fully vaccinated against rabies on a post-exposure rabies hold (see Section III for definitions).
  2. Communication to external parties:
    1. The memorandum of understanding (MOU) signed by Student Practicum Sites states, “All students will be required to obtain Tetanus and Rabies immunizations prior to admission to the clinical educational program and shall otherwise meet those health standards required by UNIVERSITY and SITE, unless student has an Immunization Waiver on file.”  If any student is not fully vaccinated against rabies, the externship site is required to only allow them to handle animals that are fully vaccinated (see Section III for definitions). LMU will not be liable for any delays this may cause in a student’s progression through the program.
  3. Communication to internal parties:
    1. Comprehensive information about rabies is provided to the University President for review. The rabies mitigation policy, including the student vaccination policy, is reviewed and approved by the General Counsel, the Executive Dean of the LMU-CVM, and President of the University. 
  4. Communication to students:
    1. All students are informed that rabies is a fatal disease and is a serious risk to their health prior to working with any live mammals. Students will also be taught how rabies is transmitted, about the importance of the pre-exposure rabies vaccination, and the steps that should be taken after possible exposure to an animal infected with rabies.
    2. Excerpt from LMU-CVM Student Handbook detailing the rabies vaccine policy: “All students admitted to the Lincoln Memorial University Veterinary Medical Technology Program must be immunized against Rabies and Tetanus (or be exempted by a physician). This form must be completed by the attending physician as verification of coverage. Students will not be permitted to take any courses that require hands-on training with animals until this form is completed and returned to the Veterinary Medical Technology Program.”  The handbook also includes a “Rabies Notification” statement which details the risk of rabies as a fatal disease. 
    3. During a first semester course (VMT100), students are provided a paper copy of the rabies mitigation policy and the policy is discussed in class. At the end of class, students sign and submit their acknowledgement that they understand that rabies is a fatal disease and is a risk to their health and that they reviewed the rabies mitigation policy.  
    4. Students enrolled in a first semester course (VMT120) must pay a $750.00 course fee to cover the purchase and administration of a two-dose rabies vaccine series. The vaccine is administered at a local pharmacy during the initial weeks of their first semester in the Program.  Students who have insurance that will cover the rabies vaccination series may opt to be vaccinated before the start of the Program. Students who provide written documentation of rabies vaccination or protective titers within twenty-four (24) months will have the course fee waived and are considered fully vaccinated (see Section III for definitions).
    5. Contact tracing is performed for any students who worked with an unvaccinated animal in the event the animal shows signs of or is diagnosed with rabies. Any student who is not fully vaccinated against rabies will not handle an animal until the animal is considered fully vaccinated (see Section III for definitions).
    6. All client-owned animals must show proof of rabies vaccination and be fully vaccinated. All client-owned animals used for curriculum delivery will be monitored by owners for ten (10) days after student contact. At the end of the ten (10) days, program personnel will call and confirm that the animals used in laboratory are not having any symptoms of rabies. Any animal exhibiting signs of rabies will be examined by a veterinarian and testing of the animal will be required if the veterinarian examining the patient and the public health veterinarian deem it necessary.
  5. Comprehensive risk assessment considering local rabies prevalence.
    1. Before each school year begins, an audit of the confirmed rabies cases for the area is completed. This information is available through https://www.cdc.gov/rabies/location/usa/surveillance/index.html.  In addition, an audit of confirmed rabies cases is completed for any area where a student completes an externship.  This information is provided to the students before they begin live animal laboratories each academic year and before their practicum begins.
    2. Any student exposed to rabies will have immediate wound care if needed and then will be referred to their doctor to begin post-exposure prophylaxis which may include passive antibody administration and/or active immunization.
  6. Mitigating human exposure
    1. All students and personnel will have appropriate PPE available during live animal and necropsy laboratories. When working with any unvaccinated animal, fully vaccinated students and personnel will be instructed to use gloves, masks, eye protection, long sleeves, pants, and closed-toed shoes. Any student who is not fully vaccinated against rabies will not handle an animal until the animal is considered fully vaccinated (see Section III for definitions).
    2. Any student or personnel exposed to a known or suspected case of rabies will have immediate wound care and will be referred to their doctor to begin post-exposure prophylaxis, which may include passive antibody administration and/or active immunization.

 

X.        Contact Information

For more information regarding this policy, please contact Dr. Jay Miles, VMT program director at jay.miles02@lmunet.edu.  

 

XI.       Document History

Effective: 2/2022; Revised 7/2023; Revised 7/2024