Institutional members access full text with Ovid®

Share this article on:

Completeness of Reporting of Rabies Postexposure Prophylaxis in King County, Washington

Thiede, Hanne DVM, MPH; Close, Natasha S. MPH; Koepsell, Jennifer MS; Baer, Atar PhD, MPH; Duchin, Jeffrey S. MD

Journal of Public Health Management & Practice: September/October 2008 - Volume 14 - Issue 5 - p 448–453
doi: 10.1097/01.PHH.0000333879.55572.a4
Article

The completeness of rabies postexposure prophylaxis (PEP) reporting was evaluated in King County, Washington State. Information on rabies immune globulin prescriptions was obtained from hospital pharmacies associated with emergency departments in King County from 2003 to June 2006. Rabies immune globulin is given at the initiation of rabies PEP which is usually started at emergency departments. Because pharmacies are not regular sources of rabies PEP reporting, we compared pharmacy cases with cases reported via routine passive surveillance methods. A capture-recapture method was used to calculate the estimated number of unreported cases from all sources. Reporting completeness was calculated by dividing the number of cases reported via routine surveillance with the sum of reported and estimated unreported cases. Seventy-one unreported rabies PEP cases were identified by comparing previously reported cases with pharmacy cases. A total of 128 cases were estimated to have been missed by the surveillance system. Overall reporting completeness was 62 percent increasing to almost 80 percent in 2005 and 2006. Our findings illustrate the importance of evaluating surveillance systems and suggest that it may be useful to institute active rabies PEP surveillance with emergency departments in addition to continuing educating healthcare providers and facilities about reporting.

This study focuses on completeness of rabies postexposure prophylaxis reporting and illustrates the importance of evaluating surveillance systems.

Hanne Thiede, DVM, MPH, received her DVM degree at the Royal Veterinary and Agricultural University, Copenhagen, Denmark and her MPH in epidemiology from the University of Washington School of Pubic Health and Community Medicine. She is an epidemiologist with the Communicable Disease Epidemiology & Immunization Section and the HIV/AIDS Epidemiology Program of Public Health – Seattle & King County. She is a Clinical Assistant Professor in the Department of Epidemiology at the University of Washington.

Natasha S. Close, MPH, was a research assistant with the Communicable Disease Epidemiology & Immunization Section of Public Health – Seattle & King County and a student in the Department of Epidemiology at University of Washington School of Public Health and Community Medicine at the time this article was written. She is currently an epidemiologist with the Environmental Health Division of Public Health – Seattle & King County.

Jennifer Koepsell, MS, received her MS degree in epidemiology at the University of Washington School of Public Health and Community Medicine while also working at the Harborview Injury Prevention and Research Center. She is currently an epidemiologist in the Communicable Disease Epidemiology & Immunization Section of Public Health – Seattle & King County.

Atar Baer, PhD, MPH, received her MPH in epidemiology from the University of Michigan and her PhD in epidemiology from the University of Washington School of Public Health and Community Medicine. Dr Baer is an epidemiologist in Communicable Disease Epidemiology & Immunization Section of Public Health – Seattle & King County. Her previous research at the University of Washington and at the Centers for Disease Control and Prevention focused on sexually transmitted diseases and cervical cancer prevention.

Jeffrey S. Duchin, MD, is Chief of the Communicable Disease Epidemiology & Immunization Section for Public Health – Seattle & King County, Washington. He is Associate Professor of Medicine, Division of Infectious Diseases and Adjunct Associate Professor, School of Public Health and Community Medicine at the University of Washington. Dr Duchin is board certified in internal medicine and infectious diseases and is a graduate of the Centers for Disease Control and Prevention's Epidemic Intelligence Service.

Corresponding Author: Hanne Thiede, DVM, MPH, Public Health Veterinarian, 401 5th Avenue, Suite 900, Seattle, WA 98104 (hanne.thiede@kingcounty.gov).

The authors thank Dean Webb from Public Health – Seattle & King County and Amy Blanchard and Hollianne Bruce from Snohomish Health District for their help in this evaluation. We appreciate the thoughtful reviews of the manuscript by Shelly McKeirnan and Patrick Hanley. This work was supported by an NIAID award establishing the Northwest Regional Center of Excellence for Biodefense and Emerging Infectious Diseases U54 AI057141.

© 2008 Lippincott Williams & Wilkins, Inc.