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Recommendations 1. Studies should be made of the pathogenesis of rabies infection in species that are important in the epidemiology of the disease. Im- munofluorescent staining of frozen sections has provided a clearer picture of the pathogenesis of rabies infection and of the distribu- tion of virus in infected organs than was previously possible. These studies have largely been conducted in experimental animals with standard strains of virus. 2. The occasional occurrence of a long incubation period and the observation in wild animals, especially bats, that virus may be present in saliva for a considerable time before the development of symptoms suggest that certain host factors may be at play. Research directed at elucidating the nature of the host-parasite balance in rabies should be encouraged. 3. There is increasing evidence thatâat least in animalsârecovery from rabies may be more common than is generally accepted. Research that will elucidate the magnitude and parameters of this recovery should be encouraged 4. Examination for rabies-related viruses should be made in the United States, and encouragement should be offered to organizations to continue the search for such viruses outside the United States. For 20
RECOMMENDATIONS 21 example, there is now evidence that some African viruses resemble the rabies virus. Studies of these African viruses indicate that they are morphologically and serologically related to rabies virus but differ sig- nificantly from it, suggesting that the rabies virus is not biologically unique. Further studies of the antigenic components of rabies-related viruses and group relationships should be pursued. Laboratories in the United States should be encouraged within the limits of their facilities to examine the antigenic makeup of isolates from wildlife. Methods for differentiation should include reciprocal cross-complement fixa- tion and neutralization tests. Appropriate reference reagents should be made available to interested laboratories. 5. Special efforts need to be made to identify characteristics in isolates that can serve as markers. The identification of such markers would greatly facilitate epidemiological studies, and the development of a satisfactory oral vaccine for wildlife is at least partially depen- dent on the recognition of such a system. 6. Though a carrier state has not been clearly demonstrated in any species, its potential importance should not be underestimated. Re- search leading to the resolution of this question and study of dynamics of the carrier state in animals should be encouraged. 7. The exact sites of viral multiplication following oral, respiratory, and even parenteral inoculation routes have not been identified. Re- search leading to the identification of early sites of infection, if they exist, should be encouraged. 8. The cost of rabies, including both diagnostic and preventive measures, should be assessed. Responsibility for rabies control is shared by many local and several state and federal agencies; as a result, the total cost is not known and cost-benefit analyses cannot be made. 9. More precise information on local epidemics, including num- bers and types of animals involved, should be obtained. Epidemio- logic studies into the nature of these outbreaks, using ecological and virological techniques so as to understand properly what is happen- ing, should be developed. 10. Persistent trapping or poisoning campaigns as a means to rabies control should be abolished. There is no evidence that these costly and politically attractive programs reduce either wildlife reservoirs or rabies incidence. The money can be better spent on research, vaccina- tion, compensation to stockmen for losses, education, or public warning systems. 11. Control in high-contact areas (picnic grounds, camps, suburban
22 CONTROL OF RABIES areas, etc.) should emphasize removal of particular animals, elimina- tion of shelter and food, and public warnings. 12. An independent Rabies Advisory Committee should be estab- lished by an appropriate agency to advise the Veterinary Biologics Service on the improvement and standardization of rabies vaccines testing. This advisory committee should review the present standard requirements for adequacy. It should be composed of virologists, pathologists, and epidemiologists selected from academic institu- tions, the state and federal governments, the American Animal Hos- pital Association, and the Animal Health Institute. 13. The vaccine compendium provided in the Appendix should become the basis for standardizing animal vaccination programs throughout the United States. The CDC should provide a copy of this compendium to rabies-control officials in every state who should, in turn, distribute a copy of this compendium to every practicing veterinarian in his state. 14. There is a need for one or more vaccines licensed for use in wildlife and exotic species of animals. Due to the rather high costs of developing these vaccines and somewhat restricted economic returns, the USD A and the CDC should cooperate to obtain the necessary information for licensure for use on at least the four most fre- quently kept species of wildlife pets. 15. The "Seed-Lot Principle" presented to the Animal Health Institute is endorsed by this subcommittee. 16. Rabies-control programs should be standardized throughout the United States. The Association of State and Territorial Health Officers should appoint a committee to develop standard regulations.
