ORAL RABIES VACCINE TO BE PUT IN AREAS INCLUDING GLEN OAKS. In an effort to eradicate rabies in raccoons and other wild animals, the City of New York

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ORAL RABIES VACCINE TO BE PUT IN AREAS INCLUDING GLEN OAKS. In an effort to eradicate rabies in raccoons and other wild animals, the City of New York will be putting down Oral Rabies Vaccine in areas including Glen Oaks to control its spread in wild animals. This will be done between September 13 and September 26, 2006. There have been reports of rabid raccoons in Queens, Nassau and Suffolk. The full NYC Department of Health Notice is accessible below:

THE CITY OF NEW YORK DEPARTMENT OF HEALTH AND MENTAL HYGIENE Michael R. Bloomberg Thomas R. Frieden, M.D., M.P.H. Mayor Commissioner nyc.gov/health 2006 DOHMH Alert #36: Oral Rabies Vaccine (ORV) to be Distributed in Eastern Queens During Coming Weeks to Help Control Raccoon Rabies ORV Contains Live Attenuated Vaccinia Virus As part of a larger effort to prevent continuing spread of the raccoon rabies epizootic in Nassau County, NYSDOH will distribute ORV baits in a small area of eastern Queens between September 13 and September 22, 2006. This oral Rabies Vaccine (ORV) project is being conducted by the New York State Department of Health (NYSDOH) in collaboration with U.S. Department of Agriculture Wildlife Services and Nassau and Suffolk Counties. Since August 2004, 56 rabid raccoons have been confirmed in Nassau County, some very close to the Queens border. Also, three raccoons in Queens (one in 2005, and two in 2006) and two raccoons in Suffolk County have tested positive for rabies during the same time period. The ORV contains live attenuated vaccinia virus. Exposures to humans, although unlikely, could potentially occur through direct or indirect contact with the vaccine, or through accidental consumption of the ORV bait. The vaccine may rarely cause adverse events in exposed persons for whom smallpox vaccination is contraindicated, including immunocompromised persons, pregnant women, or persons with an exfoliative skin condition. Medical providers should be alert over the coming weeks for vaccinia infections among patients who may have been exposed to ORV in eastern Queens, or Nassau or Suffolk counties. All exposures or suspect cases should be reported immediately to the DOHMH Bureau of Immunization at 212-676-2289 or the NYC Poison Control Center at 212-POISONS or 1-800-222-1222. September 12, 2006 Dear Colleagues, The New York State Department of Health (NYSDOH) will conduct a rabies control program in eastern Queens during the two weeks from September 13 through September 22 to prevent the spread of rabies virus among raccoons in the area. The majority of the baiting is being conducted in Nassau and Suffolk Counties by a collaborative group including the US Department of Agriculture Wildlife Services, the NYSDOH, and the Nassau and Suffolk county health departments. This effort is in response to a growing number of rabid raccoons found in Nassau County since 2004. As Queens shares a border with Nassau County, and since a small number of rabid raccoons (one in 2005 and two in 2006) have been found in Queens, a small area of Queens that is adjacent to the Nassau County border will also be baited.

The bait will be applied in Queens by State and Federal workers on the ground during daylight hours in the neighborhoods of Little Neck, Bayside, Douglaston, Floral Park, Glen Oaks, Oakland Gardens, Bellerose, Hollis Hill and Queens Village (see map for more detail). Raccoons are attracted to the smell of the baits, which consist of a small packet of liquid vaccine about one square inch in size inside a brown fishmeal cube. The bait is labeled Rabies vaccine Live Vaccinia Vector. Do Not Disturb, Merial, Inc. US Vet Lic. No. 298 1-877-722-6725. Please see the following websites for more detailed information on ORV baiting plans: Nassau County http://www.nassaucountyny.gov/agencies/health/newsrelease/2006/09-06-2006.html Suffolk County http://www.co.suffolk.ny.us/pressreleases.cfm?id=1711&dept=6. Pictures of the bait can be found at http://www.health.state.ny.us/diseases/communicable/zoonoses/rabies/vaccpict.htm. If a person is accidentally exposed to the ORV, there is a risk, albeit extremely low, of infection with the vaccinia virus contained in the vaccine. Despite the millions of ORV doses distributed across the United States, there has only been one documented case of human infection with vaccinia virus due to exposure to ORV (Rupprecht C, at al. Human Infection Due to Recombinant Vaccinia-Rabies Glycoprotein Virus. NEJM 2001; 345(8): 582-586). In September 2000, a woman from Ohio with epidermolytic hyperkeratosis who was 15 weeks pregnant developed lesions after direct inoculation with the vaccinia virus after being bitten by her dog six days earlier. Over the course of one month she developed generalized erythroderma, mild burning sensations and complaints of tightness in her face. Thick layers of epidermis exfoliated from her palms and soles. Soon after, her symptoms resolved and she went on to deliver a healthy baby. Medical providers in New York City should be alert over the coming weeks for possible cases of vaccinia among persons who could have been exposed to ORV in Queens, Nassau or Suffolk Counties. If you see a patient who has suspected vaccinia infection, immediately contact the NYC DOHMH as follows: During business hours, contact the Bureau of Immunization at 212-676-2289. During non-business hours, or to report a human exposure to ORV bait, contact the NYC Poison Control Center at 212-POISONS or 1-800-222-1222. Medical providers may advise patients as follows: It is not possible to get rabies from the vaccine. The vaccine does not contain the rabies virus. It does contain live attenuated vaccinia virus. If residents find bait near their homes, but not in the open, leave it alone. The bait packets have a strong fishmeal smell that is not attractive to people or to most other animals such as household pets.

Direct contact with ORV bait should be avoided. Any person who needs to handle ORV bait should be instructed to wear gloves or use a plastic bag. Residents who find unopened bait on their property where pets or children are more likely to encounter it can toss it under trees or bushes. Damaged baits can be bagged and disposed of in regular trash. To avoid inadvertent contact with the baits, supervise children s outdoor activities in the areas being targeted both during and for approximately one week following the bait distribution (from now until September 29). If there is direct skin contact, particularly with the pink liquid vaccine inside the bait, wash the area with soap and water and/or an alcohol based preparation. The baits are not harmful to dogs or cats, but a pet may vomit if they eat a large number of them. Do not try to remove a packet from an animal s mouth. Keep all dogs and cats indoors or on leashes during the ORV distribution and for a week afterwards (i.e., through September 29 th ). This will allow raccoons to eat the vaccine-laden baits and become immunized and will decrease the chance of pets eating the baits. Call the NYC Poison Control Center at 212-POISONS or 1-800-222-1222 immediately in the unlikely event that a person has direct skin exposure to bait. Instruct person to wash hangs immediately with soap and water and/or an alcohol based preparation. Raccoons or other wild animals that appear sick or aggressive should be reported to 311 or a licensed trapper. Residents should NOT try to trap raccoons or other wild animals themselves. For more information about rabies in New York City, please see our website, at http://www.nyc.gov/html/doh/html/cd/cdrab.shtml. As always, we appreciate your continued collaboration with our efforts to monitor public health issues in New York City. Sincerely, Annie Fine, MD Annie Fine, MD Medical Epidemiologist Bureau of Communicable Disease Brooke Levinson, MPH Brooke Levinson, MPH Research Scientist Bureau of Communicable Disease