U.S. Air Force's (USAF) Public Health Response to the Deployment-Related Rabies Prevention Outreach Program

On 31 August 2011, the rabies-related death of a U.S. Army soldier prompted the Department of Defense to identify personnel who deployed since March 2010 and had indicated an animal exposure on their post-deployment health assessment. The USAF followed up on 701 airmen to ensure their animal exposure was properly assessed. An algorithm, based on recommendations by the Advisory Committee on Immunization Practices, was used to assist public health officials and medical providers in assessing individual exposures and treatment regimens. As only 43 medical records were complete, direct patient interviews (554) were conducted and documented using an internet-based electronic questionnaire. Potential rabies exposure was identified in 10 airmen and an additional 5 individuals were referred to a provider for further assessment. Among the patients who were subsequently referred to a provider for postexposure prophylaxis, 8 received treatment. Certified letters were sent to airmen who couldn't be reached by phone (23), advising them to contact their provider. Despite the success of the outreach, the investigation accentuated the need for emphasis on rabies prevention and treatment education prior to deployment. Additionally, the paucity of complete medical records necessitated contacting the majority of individuals, which consumed considerable time and resources; therefore, improved medical record documentation should be made a priority.