8000016 Occupational rabies exposure on a dairy farm - minnesota, 2024

<h3>Objective</h3> Rabies clusters in domestic livestock are rare but can result in occupational rabies exposures and significant economic losses for farmers. The Minnesota Department of Health (MDH) and Minnesota Board of Animal Health (BAH) were notified of a rabid steer on a dairy farm and began a joint investigation. <h3>Materials and Methods</h3> MDH and BAH investigated human and animal exposures through interviews and site visits to provide recommendations and impose quarantines. Whole genome sequencings of rabies viruses were performed. Direct costs to the farmers and the medical sector were estimated from veterinary charges and rabies post-exposure prophylaxis (PEP) estimates. <h3>Results</h3> Between May 11 and June 9, 2024, five of 35 steers on a Minnesota dairy farm developed neurologic signs consistent with rabies. Three of the five affected steers had brain specimens sent in for rabies testing, which confirmed the North Central Skunk rabies virus variant in all three tested steers. On May 13, a second steer exhibited similar neurologic signs, was tested and came back positive for rabies on May 16. BAH placed the herd under a 45-day quarantine. On May 18, the herd received a rabies vaccine, and two additional steers developed neurologic signs (May 24, May 27) and tested positive for rabies. BAH extended the quarantine to 120 days. The second rabies vaccine was administered on June 1 and on June 9th a fifth steer became symptomatic and died. MDH epidemiologists conducted interviews with potentially exposed persons and five people were recommended to receive PEP. <h3>Conclusion</h3> This outbreak, likely attributable to a single rabid skunk, put farmers at risk of a fatal disease. Total costs to the farmers and medical sector from loss of livestock and PEP exceeded $47,000, compared to $310 for preventive vaccination of the herd. Vaccination of cattle can be considered in areas with high terrestrial rabies activity, high-value animals, and potential for human exposure. <h3>Funding</h3> Funding for this work was made possible in part by the cooperative agreement award CK24-0002 for the Centers for Disease Control and Prevention Epidemiology and Laboratory Capacity Program and from the National Institute for Occupational Safety and Safety grant (MCOHS)T42OH008434.