{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:08:59Z","timestamp":1787933339992,"version":"build-2784847793"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5-6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,18]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>This analysis evaluates potential reporting discrepancies of the DD2341 Form (Report of Animal Bite\u2014Potential Rabies Exposure) submitted to a forward-deployed Rabies Advisory Board to the Theater Medical Data Store (TMDS) and Reportable\u00a0Medical Event (RME) systems to identify reporting gaps that can lead to improved best practices that ensure documentation of Post Exposure Prophylaxis (PEP) of potential rabies exposures into service members (SMs) electronic medical records.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The project compares the number of Service Member animal exposure DD2341 reports submitted to the Camp Arifjan, Kuwait Rabies Advisory Board to in-theater treatment electronic records at the same forward deployed locations from January 1, 2018 to December 31, 2019 recorded in the TMDS and RME databases. Records included active duty and reserve SM deployed to six countries in the United States Central Command (USCENTCOM) area of responsibility. The analysis compared some demographic information, type of potential rabies exposure (e.g., whether a bite or scratch), and PEP to rabies with Human Rabies Immune Globulin (HRIG), Human Rabies Vaccine (HRV), or both between the reporting systems.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 44 fewer records of PEP from the TMDS data records than reported from in theater written reports. Electronic record data showed 85 coded rabies exposure diagnoses. Twenty-two received HRV and no HRIG, while four received HRIG and HRV for PEP. Only seven of the 26 SM receiving rabies PEP had a confirmed RME associated with the electronic record. There were 116 SM animal exposure written reports, with 70 reporting PEP. There were 41 records indicating the SM received HRIG and HRV as part of PEP, while 29 reports indicated that the patient received only HRV PEP. Of the 41 SM receiving HRIG, 32 of the exposures were from cat scratches or bites. Seven records specified HRIG was indicated for treatment but not available at the location; therefore, HRV was the only treatment available. The most common reason indicated on the written report for not receiving rabies PEP was that treatment was not indicated based on the risk category of animal exposure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study is the first to compare the electronic medical record data to in theater reports for potential rabies exposure in a theater of operations. The analysis suggests that some written forms generated in the USCENTCOM theater are not entered into SM Military Health System electronic medical records, indicating that electronic medical records may be a less sensitive method than in-theatre reports for rabies program surveillance in a deployed setting. There is under-reporting in electronic medical records of rabies PEP in both TMDS and RME databases. Rabies PEP is an RME according to the Armed Forces Health Surveillance Division guidelines and case definitions. There needs to be better integration of the DD2341 into the electronic medical records system.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad445","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T10:55:31Z","timestamp":1700823331000},"page":"e1166-e1173","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of\u00a0Theater Medical Data Store and\u00a0Reportable\u00a0Medical Event Records to Theater Animal Bite Reports Submissions, 2018\u20132019"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2561-2156","authenticated-orcid":false,"given":"Marc G","family":"Knobbe","sequence":"first","affiliation":[{"name":"Surgeon Directorate, 1st Special Forces Command (Airborne) , Fort Liberty, NC 28310,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5894-490X","authenticated-orcid":false,"given":"Brandon J","family":"Aden","sequence":"additional","affiliation":[{"name":"Surgeon Directorate, 804th Medical Brigade (USAR) , Fort Devens, MA 01434,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8530-0904","authenticated-orcid":false,"given":"Hayley R","family":"Ashbaugh","sequence":"additional","affiliation":[{"name":"Surgeon Directorate, U.S. Army Central Command , Camp Arifjan, APO, AE 09366","place":["Kuwait"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"2025012315141162100_R1","article-title":"International Committee on\u00a0Taxonomy of\u00a0Viruses (ICTV): Genus Lyssavirus","author":"ICTV"},{"issue":"2","key":"2025012315141162100_R2","doi-asserted-by":"publisher","first-page":"569","DOI":"10.20506\/rst.37.2.2825","article-title":"Rabies: a medical perspective: -EN- Rabies: a medical perspective -FR- Le point de vue de la m\u00e9decine sur la rage -ES- La rabia desde el punto de vista m\u00e9dico","volume":"37","author":"Jackson","year":"2018","journal-title":"Rev Sci Tech OIE"},{"issue":"4","key":"2025012315141162100_R3","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1056\/NEJM199101243240401","article-title":"Unexplained rabies in\u00a0three immigrants in\u00a0the United States: a virologic investigation","volume":"324","author":"Smith","year":"1991","journal-title":"N Engl J Med"},{"issue":"17","key":"2025012315141162100_R4","first-page":"302","article-title":"Imported human rabies in\u00a0a U.S. Army soldier \u2014 New York, 2011","volume":"61","author":"Blog","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"9","key":"2025012315141162100_R5","first-page":"12","article-title":"Animal bites, active and\u00a0reserve components, U.S. Armed Forces, 2001-2010","volume":"18","author":"AFHSC","year":"2011","journal-title":"Med Surveill Mon Rep US Army Cent Health Promot Prev 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Morb Mortal Wkly Rep Recomm Rep"},{"key":"2025012315141162100_R10","volume-title":"Army Regulation 40\u2013905 SECNAVINST 6401 1B AFI 48\u2013131 Medical Services: Veterinary Health Services","year":"2006"},{"key":"2025012315141162100_R11","article-title":"Information paper on\u00a0DoD veterinary participation in\u00a0trap neuter vaccinate return programs","author":"Office of the Chief, U.S. Army Veterinary Corps"}],"container-title":["Military 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