title: Investigation to determine staff exposure and describe animal bite surveillance after detection of a rabid zebra in a safari lodge in Kenya, 2011.
abstract: BACKGROUND
  Rabies is a fatal viral infection, resulting in >55,000 deaths globally each year. In August 2011, a young orphaned zebra at a Kenyan safari lodge acquired rabies and potentially exposed >150 tourists and local staff. An investigation was initiated to determine exposures among the local staff, and to describe animal bite surveillance in the affected district.
  
  
  METHODS
  We interviewed lodge staff on circumstances surrounding the zebra's illness and assessed their exposure status. We reviewed animal bite report forms from the outpatient department at the district hospital.
  
  
  RESULTS
  The zebra was reported bitten by a dog on 31(st) July 2011, became ill on 23(rd)August, and died three days later. There were 22 employees working at the lodge during that time. Six (27%) had high exposure due to contact with saliva (bottle feeding, veterinary care) and received four doses of rabies vaccine and one of immune-globulin, and 16 (73%) had low exposure due to casual contact and received only four doses of rabies vaccine. From January 2010 to September 2011, 118 cases of animal bites were reported in the district; 67 (57%) occurred among males, 65 (57%) in children <15 years old, and 61 (52%) were inflicted in a lower extremity. Domestic and stray dogs accounted for 98% of reported bites.
  
  
  CONCLUSIONS
  Dog bites remains the main source of rabies exposure in the district, but exposure can result from wildlife. This highlights the importance of a one health approach with strong communication between wildlife, veterinary, and human health sectors to improve rabies prevention and control.
authors: Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya.
authors: Mark
authors: M
authors: Obonyo
authors: Global Disease Detection, US Centers for Disease Control and Prevention, Kenya.
authors: Wences
authors: W
authors: Arvelo
authors: Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya.
authors: Samuel
authors: S
authors: Kadivane
authors: Loitoktoik District Hospital, Ministry of Public Health and Sanitation, Kenya.
authors: Moses
authors: M
authors: Orundu
authors: Division of Global Migration and Quarantine, US Centers for Disease Control and Prevention, Atlanta, USA ; Epidemic Intelligence Service, US Centers for Disease Control and Prevention, USA.
authors: Emily
authors: E
authors: Lankau
authors: Kenya Wildlife Service, Ministry of Forestry and Wildlife, Kenya.
authors: Francis
authors: F
authors: Gakuya
authors: Global Disease Detection, US Centers for Disease Control and Prevention, Kenya.
authors: Peninah
authors: P
authors: Munyua
authors: Central Veterinary Laboratory, Ministry of Livestock Development, Department of Veterinary Services, Kenya.
authors: Jane
authors: J
authors: Githinji
authors: Epidemic Intelligence Service, US Centers for Disease Control and Prevention, USA.
authors: Nina
authors: N
authors: Marano
authors: Global Disease Detection, US Centers for Disease Control and Prevention, Kenya.
authors: Kariuki
authors: K
authors: Njenga
authors: Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya.
authors: Jared
authors: J
authors: Omolo
authors: Global Disease Detection, US Centers for Disease Control and Prevention, Kenya.
authors: Joel
authors: J
authors: Montgomery
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D018397:Equidae; D005260:Female; D006801:Humans; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011818:Rabies / Q000517:prevention & control* / Q000635:transmission; D011819:Rabies Vaccines / Q000008:administration & dosage*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D011819:Rabies Vaccines
keywords: East Africa; Rabies; epidemiology; outbreak