Melioidosis in a Resident of Texas with No Recent Travel History, United States.

To our knowledge, environmental isolation of Burkholderia pseudomallei, the causative agent of melioidosis, from the continental United States has not been reported. We report a case of melioidosis in a Texas resident. Genomic analysis indicated that the isolate groups with B. pseudomallei isolates from patients in the same region, suggesting possible endemicity to this region.

Management of a pet dog after exposure to a human patient with Ebola virus disease.

In October 2014, a health-care worker who had been part of the treatment team for the first laboratory-confirmed case of Ebola virus disease imported to the United States developed symptoms of Ebola virus disease. A presumptive positive reverse transcription PCR assay result for Ebola virus RNA in a blood sample from the worker was confirmed by the CDC, making this the first documented occurrence of domestic transmission of Ebola virus in the United States. The Texas Department of State Health Services commissioner issued a control order requiring disinfection and decontamination of the health-care worker's residence. This process was delayed until the patient's pet dog (which, having been exposed to a human with Ebola virus disease, potentially posed a public health risk) was removed from the residence. This report describes the movement, quarantine, care, testing, and release of the pet dog, highlighting the interdisciplinary, one-health approach and extensive collaboration and communication across local, county, state, and federal agencies involved in the response.

Evaluation of a postexposure rabies prophylaxis protocol for domestic animals in Texas: 2000-2009.

OBJECTIVE: To determine whether postexposure rabies prophylaxis (PEP) in domestic animals, as mandated in Texas, has continued to be effective and to evaluate preexposure or postexposure vaccination failures from 2000 through 2009. DESIGN: Retrospective case series. ANIMALS: 1,014 unvaccinated domestic animals (769 dogs, 126 cats, 72 horses, 39 cattle, 3 sheep, 4 goats, and 1 llama) that received PEP and 12 vaccinated domestic animals (7 dogs and 5 cats) with possible failure of protection. PROCEDURES: Zoonotic incident reports from 2000 through 2009 were reviewed for information regarding unvaccinated domestic animals that received PEP in accordance with the state protocol after exposure to a laboratory-confirmed rabid animal; reports also were reviewed for any preexposure or postexposure vaccination failures. The state-required PEP protocol was as follows: immediately vaccinate the animal against rabies, isolate the animal for 90 days, and administer booster vaccinations during the third and eighth weeks of the isolation period. RESULTS: From 2000 through 2009, 1,014 animals received PEP; no failures were recorded. One preexposure vaccination failure was recorded. CONCLUSIONS AND CLINICAL RELEVANCE: The Texas PEP protocol was used during the 10-year period. Results indicated that an effective PEP protocol for unvaccinated domestic animals exposed to rabies was immediate vaccination against rabies, a strict isolation period of 90 days, and administration of booster vaccinations during the third and eighth weeks of the isolation period.

Epidemiology of rabies in skunks in Texas.

OBJECTIVE: To obtain epidemiologic information on rabies in skunks in Texas. DESIGN: Epidemiologic study. SAMPLE POPULATION: Reports of skunks that had been submitted for rabies testing in Texas from 1953 through 2007. PROCEDURES: Reports were reviewed to obtain information on seasonality of rabies in skunks, seasonality of human and domestic animal exposure to rabid skunks, commonly reported clinical signs of rabies in skunks, domestic animals frequently exposed to rabid skunks, common scenarios for exposure of domestic animals to rabid skunks, disposition of domestic animals exposed to rabid skunks, age and gender of humans exposed to rabid skunks, and usual routes of exposure of humans to rabid skunks. RESULTS: On a yearly basis, the number of rabid skunks peaked in 1961, 1979, and 2001. On a monthly basis, the number of rabid skunks peaked in March and April. Over the study period, the percentage of rabid skunks from urban areas increased and the percentage from rural areas decreased. Striped skunks were the most common species. Dogs and cats were the domestic animals most frequently exposed to rabid skunks. On average, the highest numbers of humans exposed to rabid skunks were between 36 and 50 years old. Most humans were exposed through means other than a bite. Typical behaviors of rabid skunks were entering a dog pen, appearing outside during daytime, and attacking pets. CONCLUSIONS AND CLINICAL RELEVANCE: Information on the epidemiology of rabies in skunks may be useful in planning and implementing local, state, and national rabies control and prevention campaigns.

Evaluation of oral rabies vaccination programs for control of rabies epizootics in coyotes and gray foxes: 1995-2003.

OBJECTIVE: To evaluate the effectiveness of intervention efforts to halt 2 wildlife rabies epizootics from 1995 through 2003, including 9 oral rabies vaccination campaigns for coyotes and 8 oral rabies vaccination campaigns for gray foxes. DESIGN: Retrospective study. ANIMALS: 98 coyotes during prevaccination surveillance and 963 coyotes and 104 nontarget animals during postvaccination surveillance in south Texas, and 699 gray foxes and 561 nontarget animals during postvaccination surveillance in west-central Texas. PROCEDURES: A recombinant-virus oral rabies vaccine in edible baits was distributed by aircraft for consumption by coyotes and gray foxes. Bait acceptance was monitored by use of microscopic analysis of tetracycline biomarker in upper canine teeth and associated bone structures in animals collected for surveillance. Serologic responses were monitered by testing sera for rabies virus-neutralizing antibodies by use of the rapid fluorescent focus inhibition test. The incidence of rabies in the distribution area was recorded via active and passive surveillance activities; tracking of rabies virus variants in confirmed rabid animals was used to determine the number and type of rabies cases before and after distributions of the vaccine. RESULTS: The expansion of both epizootics was halted as a result of the vaccine bait program. The number of laboratory-confirmed rabid animals attributable to the domestic dog-coyote rabies virus variant in south Texas declined to 0, whereas the number of laboratory-confirmed rabid animals attributable to the Texas fox rabies virus variant in west-central Texas decreased. CONCLUSIONS AND CLINICAL RELEVANCE: Data indicated that oral rabies vaccination resulted in protective immunity in a sufficient percentage of the target wildlife population to preclude propagation of the disease and provided an effective means of controlling rabies in these species.