{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:00:08Z","timestamp":1790834408549,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T00:00:00Z","timestamp":1507852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Summary<\/jats:title>By 2013, the number of confirmed rabid animals in Ontario had decreased to unprecedented low numbers, yet the expected decrease in the number of courses of rabies post\u2010exposure prophylaxis (RPEP<\/jats:styled-content>) administered did not occur consistent with the decrease in animal rabies cases (Figure ). This prompted a review of the reasons that RPEP<\/jats:styled-content> was administered in Ontario. This study provides a descriptive analysis of the exposure incidents resulting in RPEP<\/jats:styled-content> administration in Ontario during 2013 using data obtained from the integrated Public Health Information System, a Web\u2010based disease surveillance system. Findings from the study revealed that the number of RPEP<\/jats:styled-content> courses administered could be reduced, without increased risk of rabies, through the following strategies: (i) Education and resources for public health staff and healthcare providers who assess animal exposures to improve interpretation of guidelines for RPEP<\/jats:styled-content> administration. (ii) Refinement of guidelines for public health staff and healthcare providers to ensure that they support detailed consideration of the circumstances of the exposure in order to assist with the risk assessment. Guidelines should also support completion of a risk assessment when exposures to skunks, foxes, raccoons and other wild carnivores are provoked by the victim, as opposed to automatically providing RPEP<\/jats:styled-content> as recommended by current guidelines. (iii) Public education strategies to prevent exposures to animals (e.g., do not touch unattended animals, bat proofing your house, proper removal of bats from the house). (iv) Defining the criteria to declare a jurisdiction rabies\u2010free. (v) Exploring strategies to improve surveillance for rabid animals.<\/jats:p>","DOI":"10.1111\/zph.12410","type":"journal-article","created":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T08:53:44Z","timestamp":1507884824000},"source":"Crossref","is-referenced-by-count":3,"title":["A descriptive analysis of rabies post\u2010exposure prophylaxis data: 2013, Ontario, Canada"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7586-1698","authenticated-orcid":false,"given":"D.","family":"Middleton","sequence":"first","affiliation":[{"name":"Public Health Ontario Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. J.","family":"Edwin","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto ON Canada"},{"name":"Centre for Public Health Infrastructure Public Health Agency of Canada Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. O.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. F.","family":"Warshawsky","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto ON Canada"},{"name":"Department of Epidemiology and Biostatistics Western University London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,13]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Canadian Food Inspection Agency(2016).Rabies in Canada. Retrieved fromhttp:\/\/www.inspection.gc.ca\/animals\/terrestrial-animals\/diseases\/reportable\/rabies\/rabies-in-canada\/eng\/1356156989919\/1356157139999(Accessed on November 11 2016)."},{"key":"e_1_2_8_3_1","unstructured":"Communicable Disease Prevention and Control Services(2014).British Columbia annual summary of reportable diseases 2013. Vancouver BC."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/598998"},{"key":"e_1_2_8_5_1","first-page":"359","article-title":"Laboratory diagnosis of rabies in Canada for calendar year 2006","volume":"49","author":"Fehlner\u2010Gardiner C.","year":"2008","journal-title":"Canadian Veterinary Journal"},{"key":"e_1_2_8_6_1","first-page":"1156","article-title":"Wildlife management agencies should participate in rabies control","volume":"28","author":"MacInnes C. D.","year":"2000","journal-title":"Wildlife Society Bulletin"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12155"},{"key":"e_1_2_8_8_1","first-page":"1","article-title":"Recommendations regarding the management of bat exposures to prevent human rabies","volume":"35","author":"National Advisory Committee on Immunization","year":"2009","journal-title":"Canada Communicable Disease Report"},{"key":"e_1_2_8_9_1","unstructured":"National Advisory Committee on Immunization and Health Canada(1998).Active immunization agents: Rabies vaccine. Canadian Immunization Guide."},{"key":"e_1_2_8_10_1","first-page":"1","article-title":"Compendium of animal rabies prevention and control, 2011","volume":"60","author":"National Association of State Public Health Veterinarians Inc","year":"2011","journal-title":"MMWR Recommendations and Reports"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0802.010177"},{"key":"e_1_2_8_12_1","unstructured":"Ontario Agency for Health Protection and Promotion(2007).Ontario agency for health protection and promotion act 2007 SO 2007 c. 10 Sched. K. 2013."},{"key":"e_1_2_8_13_1","unstructured":"Ontario Chief Medical Officer of Health(2008).Bat rabies post\u2010exposure prophylaxis administration policy change."},{"key":"e_1_2_8_14_1","unstructured":"Ontario Chief Medical Officer of Health(2014).Memorandum: Canadian Food Inspection Agency (CFIA) Rabies Program Changes effective April 1 2014."},{"key":"e_1_2_8_15_1","unstructured":"Ontario e\u2010Laws.Communicable Disease \u2013 General R.R.O 1990 Reg 557. Retrieved fromhttp:\/\/www.e-laws.gov.on.ca.html\/regs\/english\/elaws_regs_900557_e.htm(Accessed on November 23 2016)."},{"key":"e_1_2_8_16_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care(2013).Rabies prevention and control protocol. Retrieved fromhttp:\/\/www.healthunit.org\/aboutus\/boh\/orientation\/rabies_prevention.pdf."},{"key":"e_1_2_8_17_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care(2010).Guidelines for management of suspected rabies exposures. January 2010 Queen's Printer of Ontario Toronto ON."},{"key":"e_1_2_8_18_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care(2011).Publicly funded vaccine price list.Toronto ON:Queen's Printer of Ontario."},{"key":"e_1_2_8_19_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care(2013).Guidance document for the management of suspected rabies exposures September 2013. Retrieved fromhttp:\/\/www.health.gov.on.ca\/en\/pro\/programs\/publichealth\/oph_standards\/docs\/guidance\/gd_mng_suspected_rabies_exposures.pdf(Accessed on November 22 2016)."},{"key":"e_1_2_8_20_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care(2013\u20132015).Ontario population. IntelliHEALTH Ontario (Accessed on July 2 2014)."},{"key":"e_1_2_8_21_1","unstructured":"Public Health Agency of Canada(2012).Canadian immunization guide. Retrieved fromhttp:\/\/www.phac-aspc.gc.ca\/publicat\/cig-gci\/p04-rabi-rage-eng.php."},{"key":"e_1_2_8_22_1","unstructured":"Queen's Printer for Ontario(2016).About Ontario. Retrieved fromhttps:\/\/www.ontario.ca\/page\/about-ontario(Accessed on October 12 2016)."},{"key":"e_1_2_8_23_1","first-page":"362","article-title":"Rabies in Canada \u2013 history, epidemiology and control","volume":"29","author":"Rosatte R. C.","year":"1988","journal-title":"Canadian Veterinary Journal"},{"issue":"4","key":"e_1_2_8_24_1","first-page":"8","article-title":"The rabies reporter","volume":"24","author":"Stevenson B.","year":"2014","journal-title":"Ontario Ministry of Natural Resources and Forestry"},{"issue":"1","key":"e_1_2_8_25_1","first-page":"7","article-title":"The rabies reporter","volume":"27","author":"Stevenson B.","year":"2016","journal-title":"Ontario Ministry of Natural Resources and Forestry"},{"key":"e_1_2_8_26_1","unstructured":"World Health Organization(2016).WHO vaccine reaction rates information sheets. 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