Amended Complaint Britton v. Heller et al

1
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW MEXICO
MARCY BRITTON,
Plaintiff,
v. No. 1:19-CV-01113-KWR-JHR
MAYOR TIM KELLER,
DANNY NEVAREZ,
Director of Animal Welfare Department,
CITY OF ALBUQUERQUE,
Defendants.
COMPLAINT FOR DAMAGES FOR INVERSE CONDEMNATION AND TRESPASS;
AND FOR INJUNCTIVE RELIEF
Plaintiff Marcy Britton, by her undersigned counsel, for her cause of action, states:
JURISDICTION AND VENUE
1. Jurisdiction and Venue are proper in the United States District Court for the District of
New Mexico pursuant to U.S. Const. amend. V, 42 U.S.C. §§ 1983, 1988, and 28 U.S.C. § 1367,
N.M. Const., Article II, Section 20 and NMSA 1978, Section 42A-1-29 as an action to recover
damages for inverse condemnation or, alternatively, for trespass to land. This action is also brought
under common law to abate a public nuisance created and maintained by the Defendant.
2. This suit is brought against the City of Albuquerque as a political subdivision of the State
of New Mexico, and Mayor Tim Keller and Director Danny Nevarez individually acting under
color of state law.
PARTIES
3. Plaintiff Marcy Britton (hereinafter “Plaintiff”) is a resident of Albuquerque, New Mexico
Case 1:19-cv-01113-KWR-JHR Document 14 Filed 01/28/20 Page 1 of 7

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and owning the residential property at issue in this case.
4. Defendant the City of Albuquerque (hereinafter “Defendant or City”) is a municipal
corporation organized and existing under the laws of New Mexico.
5. Defendant Mayor Tim Keller is the elected Mayor of Albuquerque, with oversight and
control over the City’s executive departments including the Animal Welfare Department.
6. Defendant Danny Nevarez is the Director of the City’s Animal Welfare Department
appointed and under the supervision of the Mayor.
GENERAL ALLEGATIONS
7. At all times material to the allegations of this Complaint, Plaintiff owned or maintained a
real property interest in certain real estate located in the City of Albuquerque, Bernalillo County,
New Mexico, having a street address of 1601 Pennsylvania Street NE, Albuquerque, New Mexico
87110 (herein "the Subject Land").
8. It is the responsibility of the City of Albuquerque under NMSA 1978 §77-1-12 that they
“[s]hall make provision by ordinance for the seizure and disposition of dogs and cats running at
large and not kept or claimed by any person on the person's premises.”
9. Beginning several years ago under Mayor Richard Berry and continuing under the direction
of current Mayor Tim Keller, Defendants through the City’s Animal Welfare Department has
maintained a program that operates to fulfill the policy of “trap, neuter and release” (hereinafter
“TNR”) in the handling of stray feral cats and kittens. The Defendants’ TNR program operates so
that stray or feral cats and kittens are trapped, sterilized and vaccinated, and then abandoned at the
location at which they were trapped, such abandonment is done without regard for the cruelty to
animals and without regard for compliance with City Ordinances, State law, federal endangered

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species law and impacts to human health and welfare. In practice, the City of Albuquerque pays
for and partners with organizations to take and abandon stray feral cats or even young kittens at
the location of their original capture or new location unfamiliar to the cat regardless of whether
the appropriate care or sustenance exists at that location and without regard to impacts to property
values, or damage to private property.
10. The actions of Defendants (individually – the Mayor has directed the TNR program to
continue and the Director orders that the cats continue to be dumped) to dump feral cats at locations
around Albuquerque as part of the City’s program, including locations at Plaintiff’s property, have
resulted in the establishment or growth of feral cat colonies that amount to an extreme nuisance
that exposes Plaintiff, her neighbors and especially children unnecessarily to disease vectors for
toxoplasmosis, rabies, plague and other diseases, leads to property damage from cat defecation,
urination and physical damage from the feral cats themselves, all of which result in the diminution
of Plaintiff’s property values.
11. There are now or have been dozens, if not tens of dozens of feral cats acting to blight
Plaintiff’s property as a direct result of the actions of Defendants.
12. In June of 2019, Plaintiff attempted to sell her property. While speaking to an interested
party that was preparing to make an offer, the interested party saw a cat at the location, and asked
if cats lived in the area. Plaintiff was required to make a good faith disclosure regarding the feral
cats the have overrun her property due to the TNR program and the potential buyer backed out,
stating emphatically that the did not want to live in an area where there were feral cats loose, and
being released. See Exhibit 1, Declaration of Marcy Britton. Plaintiff had not attempted to sell her
property prior to this occurrence and was not aware that a decrease in saleability of her property.
Based upon this conversation and upon information and belief, Plaintiffs property will now

4
appraise for less that she purchased the property for as a result of the blight from the City’s
programs.
13. One week before the last mayoral election, in October 2018, Tim Keller contacted Plaintiff
and discussed with her the problems with the Albuquerque Animal Welfare Services and the Trap-
Neuter-Release program. Mr. Keller promised Plaintiff that he was aware of the problem and
promised to stop TNR. See Exhibit 1, Declaration of Marcy Britton.
14. Plaintiff spoke with Mr. Neverez on December of 2018 regarding the issues listed in this
complaint. Mr. Neverez simply told Plaintiff that he could not talk to her about it.
15. Both Mayor Keller and Mr. Neverez were made aware of the issues surrounding TNR by
Plaintiff.
16. Plaintiff insured via her telephone conversations with Defendants that they were aware of
the problem facing her community as a direct result of the TNR program, and Mayor Keller
promised to end the program.
17. In addition, Plaintiff has been sending letters to the City of Albuquerque regarding the
issues with TNR, and requesting relief, for several years.
CAUSE OF ACTION NO. I – UNLAWFUL TAKING UNDER THE UNITED STATES
CONSTITUTION AND THE NEW MEXICO CONSTITUTION
18. Plaintiff incorporates the preceding paragraphs as though fully set forth herein.
19. Plaintiff is entitled to recover just compensation and damages pursuant to U.S. Const.
amend. V, 42 U.S.C. § 1983, N.M.Const., Art. II, §20 and §42A-1-29, supra as a result of
Defendant's partial takings of, and damages caused to, the Subject Land. Such damages, the
amount of which shall be proven at trial, include without limitation: direct physical damage to the
Subject Land and the loss of property value as result of the Defendants’ actions. See Exhibit 1,

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Declaration of Marcy Britton.
20. Plaintiff is entitled to recover her costs and is also entitled to recover her reasonable
attorney fees for inverse condemnation pursuant to 42 U.S.C. § 1988, N.M.Const. NMSA 1978,
§42A-l-25(A)(3) as held by the New Mexico Supreme Court in Landavazo v. Sanchez, 111 N.M.
137, 802 P.2d 1283(S.Ct. 1990).
21. Plaintiff seeks a declaration from this Court that Defendants have unlawfully and
unconstitutionally taken property for public use without just compensation. Plaintiff also requests
an order awarding attorneys’ fees and costs.
COUNT II – TRESPASS AND NUISANCE
22. Plaintiff incorporates the preceding paragraphs as though fully set forth herein.
23. Alternatively, Defendants’ TNR program, operated outside of lawful authority, constitutes
a direct infringement on Plaintiff’s rights of ownership and possession of the Subject Land such
as to constitute a trespass.
24. The Defendants’ actions to create and maintain such an extreme and unpleasant nuisance
resulting in a partial takings of the Subject Land resulted in damages to Plaintiff such as to justify
an action in trespass and was in wanton and reckless disregard of Plaintiff’s rights such as to justify
an award of punitive damages.
25. The actions of the Defendants to operate their TNR program to dump/abandon feral cats
throughout the City represent substantial and unreasonable interference with the common right of
the citizens of Albuquerque to the quiet enjoyment of their property without concern for damage
to that property or the unnecessary risk of disease. The actions of the Defendants constitute
creating and maintaining a public nuisance.

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26. Abandoned feral cats and kittens are commonly known to defecate and urinate on people’s
property and in public places such as playgrounds in parks or at schools. Such realities lead to
unpleasant odors and can lead to exposure of humans to toxoplasmosis, plague and other diseases.
Feral cats are a known concern to carry and spread rabies. Feral cats are commonly understood to
have severe negative impacts on bird populations, including birds protected by either the
Endangered Species Act or the Migratory Bird Treaty Act. They also pose a health and fatality
risk to citizens’ domesticated pets. The death of feral cats through starvation, accident or disease
is by definition cruel and unnecessary, a reality that must be witnessed and impacts the enjoyment
of everyday life of the City’s citizens.
27. Under common law doctrine a government agency may be held liable for creating and
maintaining a public nuisance such that equitable relief enjoining the Defendants from continuing
to create and maintain this public nuisance is appropriate and warranted.
WHEREFORE, Plaintiff seeks a declaration that the Defendants City of Albuquerque,
Mayor Keller and Director Nevarez: 1) inversely condemned the private property of Plaintiff
through the actions to dump feral cats at the property of Plaintiff as part of the City’s TNR program
without providing just compensation, 2) unlawfully trespassed against Plaintiff’s property, and 3)
have perpetrated an extreme nuisance against Plaintiff and the other residents of the City. Plaintiff
prays for a judgment for just compensation for the property taken from her, actual damages against
Defendants in the amount to be proven at trial, for punitive damages, for prejudgment interest, for
an injunction prohibiting the trap, neuter and release of feral cats and kittens by the City, and for
its reasonable attorney fees and costs.
JURY DEMAND
Plaintiff requests a trial by a jury of twelve (12) persons.

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Dated: January 28, 2020
Respectfully submitted,
/s/ A. Blair Dunn
A. Blair Dunn, Esq.
abdunn@ablairdunn-esq.com
Western Agriculture, Resource
and Business Law Advocates, LLP
400 Gold St. SW, Suite 1000
Albuquerque, NM 87102
(505)750-3060; Fax (505)226-8500
CERTIFICATE OF SERVICE
I hereby certify that on January 28, 2020, I filed the foregoing pleading electronically through
the CM/ECF system which caused all parties and/or counsel of record to be served by electronic
means.
/s/ A. Blair Dunn
A. Blair Dunn, Esq.

IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW MEXICO
MARCY BRITTON,
Plaintiff,
v. No.
CITY OF ALBUQUERQUE,
MAYOR TIM KELLER,
DANNY NEVAREZ,
Director of Animal Welfare Department
Defendants.
DECLARATION OF MARCYBRITTON
I, MARCY BRITTON, declare as follows:
1. I am a resident of New Mexico and I own property located at 1601 Pennsylvania
St. NE, Albuquerque, 87110.
2. I am over 18 years of age and am authorized to act and make statements on behalf
of myself.
3. I have personal knowledge of the facts set forth in this Declaration, the facts set
forth are true to the best of my knowledge and recollection. If called, I could and would
testify to these facts in a court of law.
4. The City never asked me if they could put cats outside my door and window and I
hate living like this. I and other citizens suffer so that the City can falsify its statistics and
make the shelter appear “no kill”. The shelter euthanasia numbers may look lower because
cats and kittens are dumped outside to be killed by cars, disease or people who harm them
1:19-cv-01113-KWR-JHR
EXHIBIT 1
Case 1:19-cv-01113-KWR-JHR Document 14-1 Filed 01/28/20 Page 1 of 51

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5. A week before the last mayoral election, Tim Keller called me about his plans for
improving Albuquerque Animal Welfare Services (“AAW”), He said “I promise to fire Paul
Caster.” Caster was the director of AAW. Mayor Keller further stated, “And I promise to stop
TNR (“Trap-Neuter-Release”) immediately.” After hearing that, I made up my mind to vote for
Mr. Keller and I did.
6. I was very happy to hear his promises because, like many property owners and tenants
living where the City dumps cats in its TNR program, my property and psychological and
physical health had and has been compromised by the feral cat colony introduced to my property
by the City. Since most of the City-dumped cats where I live had been killed by cars and Tim
Keller promised TNR would stop, I felt that, at least, I could sell my condo and the cats would
not be an issue. Although Mayor Keller did fire Paul Caster, he broke is promises to stop TNR.
7. The program became even worse. New TNR cats (as identified by freshly notched
ears) were dumped on my property which lowered its value. I lost a potential buyer because they
were not willing to live with stray cats and kittens. I completely understood. I have seen too
many injured, suffering cats and kittens right outside my bedroom window.
8. I did buy a humane cat trap and brought many cats to the shelter only to see them
brought back again to my property, sometimes within hours. They eventually got hit by cars. One
night in December 2018, my neighbor pounded on my door and told me he ran over a small cat
and she was bleeding profusely. She was too injured to move. All I could do was stay with her
until she died. It took an hour in 11-degree weather. She was about 4 months old and I knew she
was a TNR cat because of her freshly notched ear. I have taken other injured TNR cats to a
veterinarian at my own expense because the City refuses to pick up cats.

When Cats Bite: 1 in 3 Patients Bitten in Hand Hospitalized,
Infections Common
By Sharon Theimer | February 5, 2015
Middle-aged women were most common cat bite victims
Rochester, Minn. — Feb. 5, 2014 — Dogs aren’t the only pets who sometimes bite the hands that feed
them. Cats do too, and when they strike a hand, can inject bacteria deep into joints and tissue, perfect
breeding grounds for infection. Cat bites to the hand are so dangerous, 1 in 3 patients with such wounds
had to be hospitalized, a Mayo Clinic study covering three years showed. Two-third of those hospitalized
needed surgery. Middle-aged women were the most common bite victims, according to the research,
published in the Journal of Hand Surgery.
Journalists: sound bites with Dr. Carlsen are available in the downloads.
Why are cat bites to the hand so dangerous? It’s not that their mouths have more germs than dogs’
mouths — or people’s, for that matter. Actually, it’s all in the fangs.
“The dogs’ teeth are blunter, so they don’t tend to penetrate as deeply and they tend to leave a larger
wound after they bite. The cats’ teeth are sharp and they can penetrate very deeply, they can seed
bacteria in the joint and tendon sheaths,” says senior author Brian Carlsen, M.D., a Mayo Clinic plastic
surgeon and orthopedic hand surgeon.
“It can be just a pinpoint bite mark that can cause a real problem, because the bacteria get into the
tendon sheath or into the joint where they can grow with relative protection from the blood and immune
system,” Dr. Carlsen adds.
The bacteria injected by a cat bite can include a strain common in animals and particularly hard to fight
with antibiotics, he says.
In the study, researchers identified 193 Mayo Clinic patients with cat bites to the hand from January 1,
2009, through 2011. Of those, 57 were hospitalized; on average, they were in the hospital three days. Of
those hospitalized, 38 needed to have their wounds surgically irrigated, or flushed out, and infected tissue
removed, a procedure known as debridement. Eight patients needed more than one operation, and some
needed reconstructive surgery.
Of the 193 patients, 69 percent were female, and the mean age was 49. About half of the patients first
went to the emergency room, and the others went to primary care. The mean time between the bite and
medical care was 27 hours. Patients with bites directly over the wrist or any joint in the hand had a higher
risk of hospitalization than people with bites over soft tissue, the study found.
Thirty-six of the 193 patients were hospitalized immediately when they sought medical care, while 154
were treated with oral antibiotics as outpatients and three weren’t treated. The outpatient antibiotic
treatment failed in 21 patients, a 14 percent failure rate, and those patients needed to be hospitalized.
The bottom line: Physicians and victims of cat bites to the hand need to take the wounds seriously and
carefully evaluate them, Dr. Carlsen says. When patients have inflamed skin and swelling, aggressive
treatment should be pursued, he and the other researchers say.
People tend to be more dismissive of cat bites than dog bites, in part because cat bites often look like
a pinprick, and dog bites look much worse, Dr. Carlsen says.
That’s a mistake, he says: “Cat bites look very benign, but as we know and as the study shows, they are
not. They can be very serious.”
### Attachment 1 page Page 1 of 2

About Mayo Clinic
Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in
medical care, research and education for people from all walks of life. For more information,
visit 150years.mayoclinic.org, MayoClinic.org or https://newsnetwork.mayoclinic.org/.
https://newsnetwork.mayoclinic.org/discussion/when-cats-bite-1-in-3-patients-bitten-in-hand-hospitalized-
infections-common/
Attachment 1 page Page 2 of 2

REVIEW ARTICLE
Zoonotic Diseases Associated with Free-Roaming Cats
R. W. Gerhold1
and D. A. Jessup2
1
Center for Wildlife Health, Department of Forestry, Wildlife, and Fisheries, The University of Tennessee, Knoxville, TN, USA
2
California Department of Fish and Game (retired), Santa Cruz, CA, USA
Impacts
• Free-roaming cats are an important source of zoonotic diseases including
rabies, Toxoplasma gondii, cutaneous larval migrans, tularemia and plague.
• Free-roaming cats account for the most cases of human rabies exposure
among domestic animals and account for approximately 1/3 of rabies post-
exposure prophylaxis treatments in humans in the United States.
• Trap–neuter–release (TNR) programmes may lead to increased naı¨ve
populations of cats that can serve as a source of zoonotic diseases.
Domestic cats are a potential source of numerous infec-
tious disease agents; however, many of these diseases are
controlled in cats belonging to responsible owners
through routine veterinary care, proper vaccination regi-
mens and parasite chemotherapy. Free-roaming cats often
lack the necessary preventative care to control these dis-
eases and consequently pose a potential health threat to
other domestic animals, wildlife and humans. Historically,
animal control programmes have been paramount in
minimizing zoonotic risk in the United States. In the
1950s, a rabies control programme began, which included
mandatory rabies vaccination in dogs and animal control
programmes aimed at removing free-roaming animals
(Rupprecht et al., 2001). These programmes have signifi-
cantly reduced the incidence of human rabies in the Uni-
ted States. However, in the last decade, there has been a
marked reduction in social support for collection and
euthanasia of free-roaming animals, particularly cats. In
some areas, animal control has been turned over to pri-
vate organizations that follow a ‘no-kill’ philosophy and
routinely release free-roaming animals. Diminished
resources and willingness to collect free-roaming animals
Keywords:
Cutaneous larval migrans; free-roaming cats;
rabies; toxoplasmosis; zoonoses
Correspondence:
R. Gerhold. Center for Wildlife Health,
Department of Forestry, Wildlife, and
Fisheries, The University of Tennessee,
Knoxville, TN 37996-4563, USA. Tel.: 865
974 0465; Fax: 865-974-0465; E-mail:
rgerhold@utk.edu
Received for publication March 16, 2012
doi: 10.1111/j.1863-2378.2012.01522.x
Summary
Free-roaming cat populations have been identified as a significant public health
threat and are a source for several zoonotic diseases including rabies,
toxoplasmosis, cutaneous larval migrans because of various nematode parasites,
plague, tularemia and murine typhus. Several of these diseases are reported to
cause mortality in humans and can cause other important health issues includ-
ing abortion, blindness, pruritic skin rashes and other various symptoms. A
recent case of rabies in a young girl from California that likely was transmitted
by a free-roaming cat underscores that free-roaming cats can be a source of
zoonotic diseases. Increased attention has been placed on trap–neuter–release
(TNR) programmes as a viable tool to manage cat populations. However, some
studies have shown that TNR leads to increased immigration of unneutered
cats into neutered populations as well as increased kitten survival in neutered
groups. These compensatory mechanisms in neutered groups leading to
increased kitten survival and immigration would confound rabies vaccination
campaigns and produce naı¨ve populations of cats that can serve as source of
zoonotic disease agents owing to lack of immunity. This manuscript is a review
of the various diseases of free-roaming cats and the public health implications
associated with the cat populations.
Zoonoses and Public Health
ª 2012 Blackwell Verlag GmbH • Zoonoses and Public Health 1

have led to increasing numbers of free-roaming animals;
and rabies exposure in humans remains an important
public health threat.
Rabies
Since 1988, rabies has been detected more frequently in
cats than dogs in the United States (Rupprecht, 2002),
and in 2008 the number of rabies cases in cats (n = 294)
was approximately four times the number of cases in
dogs (Blanton et al., 2009). In 2010, rabies cases declined
in all domestic animals, except for cats, which comprised
62% (n = 303) of all rabies cases in domestic animals
(Blanton et al., 2011). In contrast, dogs accounted for 69
rabies cases, which is a 14% decrease from 2009.
Although rabies is detected most frequently in various
wild animals in the United States and the majority of
human rabies cases in the United States are attributable
to bites of rabid bats, multiple studies have disclosed that
human exposure to rabies is largely associated with free-
roaming cats because of people being more likely to come
in contact with cats, large free-roaming cat populations
and lack of stringent rabies vaccination programmes
(Childs, 1990; Cole and Atkins, 2007; Roseveare et al.,
2009; Eidson and Bigman, 2010). A recent case of rabies
in an 8-year old girl from California in 2010 disclosed
that the patient had multiple cat bites from free-roaming
cat colonies near her house (Blanton et al., 2011).
Although rabies RNA was unable to be collected for
molecular typing, the epidemiological data highly suggest
that the girl was exposed by a rabid free-roaming cat
(CDC MMWR, 2012).
From 2002 to 2006 in Georgia, 70 cats tested positive
for rabies and the virus was detected more frequently in
cats than in any other domestic animal (Cole and Atkins,
2007). Moreover, 17% of all confirmed human rabies
exposures in Georgia were attributable to cat bites from
2004 to 2006, whereas domestic dogs comprised 5% of all
confirmed human rabies in Georgia during the same time
period. A separate investigation of rabies exposure in
domestic animals in upstate South Carolina disclosed that
free-roaming cats were disproportionately associated with
potential human rabies exposure and were most fre-
quently reported rabid among domestic exposure animals
(Roseveare et al., 2009). Similarly, in New York from
1993 to 2010, cats accounted for the majority of human
rabies exposure incidents (32%) and post-exposure pro-
phylaxis (PEP) treatments (31%) (Eidson and Bigman,
2010). In Pennsylvania, rabid cat cases exceeded all cases
of rabid wild animals, with the exception of raccoons,
and in 2009 and 2010, rabid cat cases (n = 56) were tied
with skunks for the second most frequently diagnosed
animal (Herman, 2010). In contrast to the 56 free-roam-
ing cat cases in 2010 in Pennsylvania, dogs, cattle and
horses constituted 4, 7 and 5 cases, respectively. In 2011,
numerous press releases from various county health
departments have documented the presence of rabid cats
including a rabid cat in Worchester County, MD: two
human exposure cases in Cecil County, MD, owing to
bites by a rabid cat; four human exposures in Wantage
Township, NJ, owing to two rabid free-roaming cats; and
two cases of human exposure owing to free-roaming cat
bites in Hall County, GA. Similarly in 2012, a rabid free-
roaming cat in Cherokee County, GA, led to rabies PEP
treatment for at least seven people. Unfortunately, report-
ing to county health departments is not performed in
uniform manner; thus, the actual cases of rabies exposure
in humans owing to cats are likely underestimated.
Rabies virus is transmitted via saliva from one host to
another primarily via a bite from a rabid animal. Follow-
ing a bite of a rabid animal and virus inoculation, the
virus replicates in neurons and disseminates via the ner-
vous system. Later in the infection, the virus can be
found in highly innervated organs including cornea, skin
and salivary glands (Iwasaki, 1991). Rabies leads to vari-
ous neurological impairment symptoms, and the disease
is invariably fatal. Individuals exposed to potentially rabid
animals are administered PEP, and cat exposures account
for approximately 1/3 of all PEP recipients. Post-exposure
prophylaxis regimen generally costs $5000–8000 for each
individual, which is mostly borne by public health agen-
cies (Recuanco et al. 2007). Although rabies vaccination
may be provided to free-roaming cats by some trap–neu-
ter–release (TNR) programmes, it does not decrease the
need for PEP because (i) cats can shed virus for a few
days prior to clinical onset, (ii) the uncertainty about
free-roaming cat vaccination status, (iii) the inability to
determine time and route of virus exposure in the cats,
and (iv) the inability to confine free-roaming cats for
observation similar to dogs (Jessup and Stone, 2010;
Brown et al., 2011). Additionally, Murray et al. (2009)
reported rabies cases in 22 (2%) of vaccinated cats,
including two cats classified as currently vaccinated, indi-
cating that vaccine failures can occur. Moreover, TNR
advocates are unlikely to administer rabies immunization
of all free-roaming cats. This is significant because one
rabid cat in an aggressive (i.e. furious rabies) condition
can lead to multiple exposure events because furious
rabid animals often seek potential hosts to bite. Rabid
cats were found to exhibit aggressive behaviour (55% of
cases) more frequently than dumb behaviour, which is in
contrast to rabid dogs which only displayed aggressive
behaviour in 33% of cases (Eng and Fishbein, 1990).
Moreover, rabid cats were significantly more likely than
rabid dogs to bite a person (62% vs. 36%) (Eng and
Fishbein, 1990).
Zoonoses and Free-Roaming Cats R. W. Gerhold and D. A. Jessup
2 ª 2012 Blackwell Verlag GmbH • Zoonoses and Public Health

In vaccination studies, it was demonstrated that feline
leukaemia virus (FeLV)-infected cats may not be able to
mount adequate immune response to some rabies vaccines
(Franchini, 1990). The author indicated that FeLV-infected
cats should be confined strictly indoors to prevent spread
of FeLV to other cats in the neighbourhood and if left out-
side in areas at risk of rabies, FeLV-positive cats should
receive more frequent rabies vaccination (every 6 months).
In a prospective study of FeLV and feline immunodefi-
ciency virus (FIV) in Canada, the authors noted that 6%
(n = 14) of free-roaming cats were FeLV seropositive,
whereas only 2% (n = 4) of owned cats were FeLV sero-
positive (Little, 2011). The risk of being seropositive for
either virus was most frequently associated with being free-
roaming, followed by having access to outdoors. Owing to
the threat of rabies exposure as documented above, the
2011 Compendium of Animal Rabies Prevention and Con-
trol states that stray animals including cats should be
removed from the community through local health depart-
ments and animal control officials (Brown et al., 2011).
Free-roaming cat behaviour
An investigation of the demographic differences of urban
groups of neutered and sexually intact free-roaming cats
following a TNR procedure disclosed that the neutered
groups increased significantly compared to intact groups
because of higher immigration and lower emigration
(Gunther et al., 2011). Additionally, the authors noted
that sexually intact adult cats immigrated into the neu-
tered groups at a significantly higher rate than the sexu-
ally intact groups. These immigrating cats were not
tame and succeeded to integrate into the group, which
highly suggests that these were free-roaming cats and not
abandoned house cats. In addition, kitten survival in the
neutered groups was significantly higher than in the
unneutered groups. The authors suggested that immigrat-
ing sexually intact females had increased fertility along
with increased survivorship of kittens as a population
compensation response to neutered individuals. These
data suggest that neutered cat groups act as attractant of
sexually intact free-roaming cats, thus negating the belief
that TNR programme leads to decrease in free-roaming
cat populations. In a separate study, free-roaming cats
changed movement patterns and habitat on a seasonal
basis compared to owned cats (Horn et al., 2011). Inter-
estingly, the free-roaming cats used more grasslands and
urban areas than predicted because of available habitat.
Although the owned cats were neutered, it was not con-
sidered a reason for the movement pattern differences
because in a separate investigation, Guttilla and Stapp
(2010) did not find a significant difference between the
movement of neutered cats and intact cats. These data
suggest that immigrating and habitat switching of unvac-
cinated cats may severely limit the protection offered by
vaccination of TNR processed cats and would not abate
the zoonotic threat of rabies in these groups.
Secondary mesocarnivore impacts
Free-roaming cat colony feeding stations attract wild
mesocarnivores (Gehrt, 2003), potentially exacerbating
human rabies exposure incidents. Raccoons, bats, skunks
and various fox species are the wildlife species most fre-
quently infected with rabies, depending on the region of
the United States. By attracting mesocarnivores, feeding
stations likely increase the potential interaction between
humans and mesocarnivores, leading to a greater public
health risk of exposure to rabies. Furthermore, raccoons
harbour an intestinal nematode parasite, Baylisascaris
procyonis (i.e. raccoon roundworm), that has caused mor-
bidity and mortality in humans, especially children (Kaza-
cos, 2001). Infections occur after accidental ingestion of
the microscopic B. procyonis eggs containing embryonated
larvae followed by larvae migration (i.e. larval migrans)
through visceral organs, eyes and brain. The geographical
distribution of B. procyonis is expanding from its historical
range from Midwestern, Western and Northeastern United
States (Kazacos, 2001). Baylisascaris-positive raccoons have
been found in multiple states in the Southeastern United
States, Canada, Europe and Japan (Kazacos, 2001; Souza et
al., 2009; Blizzard et al., 2010; Yabsley et al., 2010). The
finding of B. procyonis in raccoons only near urban areas
in Georgia (Blizzard et al., 2010) is of particular interest
given that managed free-roaming cat colonies are likely to
be found in urban and suburban settings.
Domestic cats can be a source of infection for native wild-
life. Contact or consuming domestic cats can be a threat to
native predators. Consumption of free-roaming cats by cou-
gar or panther (Felis concolor) poses a risk of FeLV transmis-
sion, and suspected cases of domestic cat-transmitted FeLV
in wild felids have been reported in California and Florida
(Jessup et al., 1993; Cunningham et al., 2008). Genetic anal-
ysis of the FeLV virus associated with mortality in 5 Florida
panthers indicated that the virus envelope sequence was
nearly identical indicating the source or the infection was
likely from a single domestic cat (Brown et al., 2008).
Endoparasities
Domestic and wild felids are the definitive host for several
zoonotic parasites, including the protozoan Toxoplasma
gondii and the ascarid Toxocara cati. Similar to B. procyo-
nis of raccoons, the host defecated eggs (Toxocara) or
oocysts (Toxoplasma) of these parasites are extremely
environmentally resistant (Long, 1990; Kazacos, 2001),
R. W. Gerhold and D. A. Jessup Zoonoses and Free-Roaming Cats

and human infections can occur months or possibly even
years after the cat has excreted the parasite egg. For this
reason, cat faeces-contaminated playgrounds, garden soil,
sandboxes and other outdoor recreational areas may serve
as a source of infection for humans (Holland and Smith,
2006; Lee et al., 2010). The prevalence of T. cati was
higher in urban areas than rural areas, and soil samples
from urban parks contained a higher proportion of
T. cati compared to the canine Toxocara, Toxocara canis.
These data suggest that the higher levels of T. cati are
associated with free-roaming cats in urban areas. Toxocara
cati infections have been associated with visceral and ocu-
lar larval migrans and can result in permanent ocular
damage in infected humans (Lee et al., 2010).
In toxoplasmosis, humans are infected primarily by
ingestion of sporulated oocyst in cat faeces-contaminated
soil or water or tissue cysts in undercooked or raw meat
(Elmore et al., 2010). Nutter et al. (2004) reported a
higher seroprevalence of T. gondii in free-roaming cats
than pet cats, with the lowest prevalence in cats kept
indoors. Similar results were found among free-roaming
cats in Sri Lanka and Seoul, Korea (Kulasena et al., 2011;
Lee et al., 2011). Contact with infective T. gondii oocysts
in cat faeces has been shown to be a primary risk factor
for human toxoplasmosis (Elmore et al., 2010).
For many years, the risk of infection from oocysts has
been dismissed as considerably less common than infec-
tion from ingestion of undercooked or raw meat.
Recently, a T. gondii embryogenesis-related protein anti-
body (TgERP), which is sporozoite specific, has been
developed, which allows for serological distinction
between oocyst and tissue cyst infection given that spor-
ozoites are only present in oocysts (Hill et al., 2011). The
TgERP can be detected within 6–8 months post-infection
allowing for detection of oocyst infection in acute
stage infections. Of 163 individuals in acute stage infec-
tion, 103 (63%) were positive for TgERP indicating that
the majority of human infection was attributable to
oocyst infection (Hill et al., 2011). Toxoplasma infections
can manifest as ocular diseases, neurological impairment
and lead to blindness, abortions and birth defects, partic-
ularly hydrocephalus, in humans (Dubey and Odening,
2001). Toxoplasmosis is also a significant risk for individ-
uals receiving immuosuppressive therapy, transplant
recipients and is a major cause of systemic infection and
death for immunosuppressed (e.g. HIV/AIDS) patients
(Elmore et al., 2010). An increased risk of schizophrenia,
autism, Alzheimer’s and other neuro-inflammatory dis-
eases has been proposed with T. gondii infection (Fekadu
et al., 2010; Prandota, 2010), but further research is
needed to fully understand the neurological effects of
T. gondii. Toxoplasmosis is also a major disease issue for
wildlife and has been documented in multiple wild avian
and mammalian species, especially marine mammals and
Australian marsupials (Dubey and Odening, 2001; Dubey,
2002; De Thoisy et al., 2003; Lindsay and Dubey, 2007).
In addition, toxoplasmosis is an important cause of
abortion in domestic animals including sheep and goats.
In addition to the above parasite species, human infec-
tions with domestic cat hookworms, including Uncinaria
stenocephala, Ancyclostoma tubaeforme, A. brazilense and
A. ceylanicum, have been reported (Bowman et al., 2010).
After defecation, hookworm eggs hatch and the infectious
filariform larvae can penetrate the skin of animals or
human hosts. Infective larvae can cause skin lesions known
as cutaneous larva migrans (CLM) and less frequently
pneumonitis, muscle infection and ocular manifestations.
Occasionally, A. ceylanicum can develop into an adult
hookworm in humans and cause abdominal discomfort
(Prociv, 1998). Several reports of human infections of feline
hookworm infections have been reported from soil under
houses or on beaches that cats defecate upon. Approxi-
mately 75% of free-roaming cats in Florida were positive
for A. tubaeforme, and 33% were positive for A. braziliense
(Anderson et al., 2003). In 2006, 22 people were diagnosed
with CLM at a Miami-Dade County children’s camp.
Although free-roaming cats were found in the vicinity of
the camp, the source of the infection was not determined
(CDC MMWR, 2007). In 2010, contaminated cat faeces
was responsible for at least seven confirmed and eight
unconfirmed human hookworm infections in Miami-Dade
County from contaminated beaches (Personal communica-
tion Miami Dade health Department). In both of these
incidents, the County public health department bore the
expense and responsibility of trapping the free-roaming
cats and removing faeces from the contaminated areas to
minimize further human infections.
Ectoparasites and vector-borne diseases
Ectoparasites of domestic cats, especially the cat flea (Cte-
nocephalides felis), are important in transmission of zoo-
notic diseases. Three major flea-associated diseases of cats
in the United States include cat-scratch disease (CSD),
flea-borne typhus and plague (McElroy et al., 2010). Cat-
scratch disease or bartonellosis is caused by the gram-neg-
ative bacterium Bartonella henselae. Cats are the primary
source of the bacteria; however, they are inapparent carri-
ers and thus appear healthy. Animal to animal and ani-
mal to human infection occurs by exposure of an open
wound, from a scratch or bite, or B. henselae-contami-
nated flea faeces. Fleas acquire B. henselae from a previ-
ous bloodmeal from an infected cat. Symptoms in human
with CSD include fever, headaches and regional lymph
node enlargement, and the disease is one of the most fre-
quent diagnoses of benign lymphadenopathy in children

and young adults (McElroy et al., 2010). Atypical compli-
cations including encephalitis, retinitis and endocarditis
occur in 5–15% of CSD-infected humans (Chomel et al.,
2004), and recently Bartonella spp. infection has been
associated with chronic rheumatic symptoms, clinically
similar to chronic Lyme disease, in humans (Maggi et al.,
2012). Seroprevalence of B. henselae in cats ranges from
14 to 93% (Nutter et al., 2004; Case et al., 2006; Lappin
et al., 2006), and free-roaming cats had a significantly
higher seroprevalence than pet cats (Nutter et al., 2004).
In addition to CSD, cat fleas are potentially able to
vector rickettsial diseases including murine typhus (Ric-
kettesia typhi) and a closely related zoonotic disease agent,
Rickettesia felis which are potential human health threats
wherever cat, rat or flea populations are dense (Case
et al., 2006). Similar to CSD, cats are inapparent carriers
of R. typhi, and outbreaks have been associated with
free-roaming cat colonies in Hawaii (Jessup, 2004). Other
reported cases of murine typhus in the United States are
focused in central and south-central Texas and Los Ange-
les area (Adams et al., 1970; Sorvillo et al., 1993). In the
Los Angeles R. typhi focus, 90% (n = 9) of collected cats
were seropositive for R. typhi antibodies, whereas no sero-
positive cats (n = 21) were found in the control areas
where no human infections were reported (Sorvillo et al.,
1993). Flea suppression is the first public health action
often initiated; however, failure to control free-roaming
cat populations can lead to future disease outbreaks.
Additionally, human bacterial diseases including tulare-
mia, caused by Francisella tularensis, and plague, caused
by Yersinia pestis, have been associated with direct contact
with cats or cat fleas (Liles and Burger, 1993; Gage et al.,
2000; McElroy et al., 2010). Approximately, 8% of plague
cases in the United States are associated with transmission
from cats, and cases of cat exposure associated plague are
reported year round where flea-associated cases are gener-
ally restricted to warmer months (Gage et al., 2000). Cats
frequently develop the pneumonic form of plague, which
is considerably more infectious to humans in close con-
tact, and results in rapidly progressive and frequently fatal
disease. Both tularemia and plague can cause various
symptoms and potentially lead to fatal respiratory disease
or multiorgan failure in both humans and other animals
(Spagnoli et al., 2011). It is suggested that in addition to
harbouring infected fleas, cats preying on infected rodents
can contain the bacterial agents of tularemia and plague
in their mouths and potentially transmit the bacteria to
humans via bites or scratches.
Viruses
Cats have been implicated as potential vectors of other
diseases not historically associated with felines, including
SARS and H1N1 and H5N1 avian influenza as evidenced
by natural and experimental infection of domestic cats
(Kuiken et al., 2004; Songserm et al., 2006; Thiry et al.,
2007; Anonymous, 2011). In the experimentally infected
cats, excreted virus was transmitted to sentinel cats dem-
onstrating horizontal transmission and suggesting cats
can be involved in epidemiology and transmission of the
virus (Kuiken et al., 2004). Cats have been infected with
H5N1 through ingestion or close contact of infected birds
as well as intratracheal and intra-oral infection of a
human isolated virus strain (Thiry et al., 2007). Addition-
ally, cats have been found to be subclinically infected with
H5N1 (Leschnik et al., 2007), and more research is
needed to determine the role cats may play in the epide-
miology and spread of avian influenza.
Conclusion
The information in this review highlights the serious pub-
lic health diseases associated with free-roaming cats and
underscores the need for increased public health attention
directed towards free-roaming cats. Diseases including
rabies, toxoplasmosis, cutaneous larval migrans and vari-
ous vector-borne diseases have been shown to be associ-
ated with free-roaming cats. Rabies exposure in human is
disproportionally associated with free-roaming cats com-
pared to other domestic animals. This fact should be of
paramount concern to public health officials because of
the high mortality rate of clinical rabies and the signifi-
cant cost of PEP in exposed people. Furthermore, TNR
programmes can increase immigration and kitten recruit-
ment, which would lead to naı¨ve populations of cats that
would be a source for zoonotic diseases including
rabies and toxoplasmosis. While citizens who are con-
cerned about the perceived improved welfare of cats in
TNR programmes may be very vocal in their support of
free-roaming cat populations, local, county and state
legislative and medical officials need to understand the
economic and public health threats associated with
various policies and laws associated with free-roaming cat
populations. Further resources are needed to educate the
public, the medical community and public health officials
about the zoonotic disease potential associated with free-
roaming cats.
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JAVMA •Vol 248 • No. 5 • March 1, 2016 505
Rabies is a fatal viral zoonosis and serious public
health problem.1 All mammals are believed to be
susceptible to the disease, and for the purposes of
this document, use of the term animal refers to mam-
mals. The disease is an acute, progressive encephali-
tis caused by viruses in the genus Lyssavirus.2 Rabies
virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are main-
tained in wild mammalian reservoir populations such
as raccoons,skunks,foxes,and bats.Although the Unit-
ed States has been declared free from transmission of
canine rabies virus variants, there is always a risk of
reintroduction of these variants.3–7
The rabies virus is usually transmitted from ani-
mal to animal through bites.The incubation period is
highly variable.In domestic animals,it is generally 3 to
12 weeks, but can range from several days to months,
rarely exceeding 6 months.8 Rabies is communicable
during the period of salivary shedding of rabies virus.
Experimental and historic evidence documents that
dogs, cats, and ferrets shed the virus for a few days
prior to the onset of clinical signs and during illness.
Clinical signs of rabies are variable and include inap-
Compendium of Animal Rabies Prevention
and Control, 2016
National Association
of State Public HealthVeterinarians
Compendium of Animal Rabies Prevention
and Control Committee
Catherine M.Brown dvm,msc, mph (Co-Chair)
Sally Slavinski dvm,mph (Co-Chair)
Paul Ettestad dvm,ms
Tom J. Sidwa dvm,mph
Faye E. Sorhage vmd,mph
From the Massachusetts Department of Public Health, 305 South St, Jamaica Plain,
MA 02130 (Brown); the New York City Department of Health and Mental Hygiene,
2 Gotham Center, CN# 22A, 42-09 28th St, Queens, NY 11101 (Slavinski); the New
Mexico Department of Health, 1190 St Francis Dr, Room N-1350, Santa Fe, NM 87502
(Ettestad); and the Texas Department of State Health Services, PO Box 149347, MC
1956,Austin,TX 78714 (Sidwa).
Consultants to the Committee: Jesse Blanton, PhD (CDC, 1600 Clifton Rd, Mailstop
G-33, Atlanta, GA 30333); Richard B. Chipman, MS, MBA (USDA APHIS Wildlife
Services, 59 Chenell Dr, Ste 2, Concord, NH 03301); Rolan D. Davis, MS (Kansas State
University, Room 1016 Research Park, Manhattan, KS 66506); Cathleen A. Hanlon,VMD,
PhD (Retired); Jamie McAloon Lampman (McKamey Animal Center, 4500 N Access
Rd, Chattanooga, TN 37415 [representing the National Animal Care and Control
Association]); Joanne L. Maki, DVM, PhD (Merial a Sanofi Co, 115TransTech Dr,Athens,
GA 30601 [representing the Animal Health Institute]); Michael C. Moore, DVM, MPH
(Kansas State University, Room 1016 Research Park, Manhattan, KS 66506); Jim Powell,
MS (Wisconsin State Laboratory of Hygiene, 465 Henry Mall, Madison, WI 53706
[representing the Association of Public Health Laboratories]); Charles E. Rupprecht,
VMD, PhD (Wistar Institute of Anatomy and Biology, 3601 Spruce St, Philadelphia, PA
19104); Geetha B. Srinivas, DVM, PhD (USDA Center for Veterinary Biologics, 1920
Dayton Ave, Ames, IA 50010); Nick Striegel, DVM, MPH (Colorado Department of
Agriculture, 305 Interlocken Pkwy, Broomfield, CO 80021); and Burton W. Wilcke Jr,
PhD (University of Vermont, 302 Rowell Building, Burlington,VT 05405 [representing
the American Public Health Association]).
Endorsed by the AVMA, American Public Health Association, Association of Public
Health Laboratories, Council of State and Territorial Epidemiologists, and National
Animal Care and Control Association.
This article has not undergone peer review.
Address correspondence to Dr. Brown (catherine.brown@state.ma.us).
petance, dysphagia, cranial nerve deficits, abnormal
behavior, ataxia, paralysis, altered vocalization, and
seizures. Progression to death is rapid.There are cur-
rently no known effective rabies antiviral drugs.
The recommendations in this compendium serve
as a basis for animal rabies prevention and control pro-
grams throughout the United States and facilitate stan-
dardization of procedures among jurisdictions, there-
by contributing to an effective national rabies control
program. The compendium is reviewed and revised
as necessary, with the most current version replacing
all previous versions.These recommendations do not
supersede state and local laws or requirements. Prin-
ciples of rabies prevention and control are detailed in
Part I, and recommendations for parenteral vaccina-
tion procedures are presented in Part II.All animal ra-
bies vaccines licensed by the USDA and marketed in
the United States are listed and described inAppendix
1, and contact information for manufacturers of these
vaccines is provided in Appendix 2.
Modifications of note in this updated version of
the compendium, compared with the previous ver-
sion,9 include clarification of language, explicit en-
Public Veterinary Medicine: Public Health

506 JAVMA •Vol 248 • No. 5 • March 1, 2016
couragement of an interdisciplinary approach to ra-
bies control, a recommendation to collect and report
at the national level additional data elements on rabid
domestic animals, changes to the recommended man-
agement of dogs and cats exposed to rabies that are ei-
ther unvaccinated or overdue for booster vaccination,
reduction of the recommended 6-month quarantine
period for certain species, and updates to the list of
marketed animal rabies vaccines.
Part I. Rabies Prevention
and Control
A. Principles of rabies prevention
and control
1. Case definition. An animal is determined to
be rabid after diagnosis by a qualified laboratory
as specified (see Part I.A.10.Rabies diagnosis).The
national case definition for animal rabies requires
laboratory confirmation on the basis of either a
positive result for the direct fluorescent antibody
test (preferably performed on CNS tissue) or isola-
tion of rabies virus in cell culture or a laboratory
animal.10
2. Rabies virus exposure. Rabies is transmitted
when the virus is introduced into bite wounds,
into open cuts in skin,or onto mucous membranes
from saliva or other potentially infectious material
such as neural tissue.11 Questions regarding pos-
sible exposures should be directed promptly to
state or local public health authorities.
3. Interdisciplinary approach. Clear and con-
sistent communication and coordination among
relevant animal and human health partners across
and within all jurisdictions (including interna-
tional, national, state, and local) is necessary to
most effectively prevent and control rabies.As is
the case for the prevention of many zoonotic and
emerging infections, rabies prevention requires
the cooperation of animal control, law enforce-
ment, and natural resource personnel; veterinar-
ians; diagnosticians; public health professionals;
physicians; animal and pet owners; and others.
An integrated program must include provisions
to promptly respond to situations; humanely re-
strain, capture, and euthanize animals; administer
quarantine,confinement,and observation periods;
and prepare samples for submission to a testing
laboratory.
4. Awareness and education. Essential compo-
nents of rabies prevention and control include
ongoing public education,responsible pet owner-
ship, routine veterinary care and vaccination, and
professional continuing education. Most animal
and human exposures to rabies can be prevented
by raising awareness concerning rabies transmis-
sion routes, the importance of avoiding contact
with wildlife, and the need for appropriate vet-
erinary care. Prompt recognition and reporting
of possible exposures to medical and veterinary
professionals and local public health authorities
are critical.
5. Human rabies prevention. Rabies in humans
can be prevented by eliminating exposures to
rabid animals or by providing exposed persons
prompt postexposure prophylaxis consisting of
local treatment of wounds in combination with
appropriate administration of human rabies im-
mune globulin and vaccine. An exposure assess-
ment should occur before rabies postexposure
prophylaxis is initiated and should include dis-
cussion between medical providers and public
health officials. The rationale for recommending
preexposure prophylaxis and details of both pre-
exposure and postexposure prophylaxis adminis-
tration can be found in the current recommenda-
tions of theAdvisory Committee on Immunization
Practices.11,12 These recommendations,along with
information concerning the current local and re-
gional epidemiology of animal rabies and the
availability of human rabies biologics, are avail-
able from state health departments.
6. Domestic animal vaccination. Multiple vac-
cines are licensed for use in domestic animal spe-
cies. Vaccines available include inactivated and
modified-live virus vectored products, products
for IM and SC administration, products with dura-
tions of immunity for periods of 1 to 3 years, and
products with various minimum ages of vaccina-
tion. Recommended vaccination procedures are
specified in Part II of this compendium;animal ra-
bies vaccines licensed by the USDA and marketed
in the United States are specified in Appendix 1.
Local governments should initiate and maintain
effective programs to ensure vaccination of all
dogs,cats,and ferrets and to remove stray and un-
wanted animals.Such procedures have reduced lab-
oratory-confirmed cases of rabies among dogs in
the United States from 6,949 cases in 1947 to 89
cases in 2013.3 Because more rabies cases are re-
ported annually involving cats (247 in 2013) than
dogs,vaccination of cats should be required.3 Ani-
mal shelters and animal control authorities should
establish policies to ensure that adopted animals
are vaccinated against rabies.
An important tool to optimize public and ani-
mal health and enhance domestic animal rabies
control is routine or emergency implementation
of low-cost or free clinics for rabies vaccination.
To facilitate implementation, jurisdictions should
work with veterinary medical licensing boards,
veterinary associations, the local veterinary com-
munity, animal control officials, and animal wel-
fare organizations.
7. Rabies in vaccinated animals. Rabies is rare in
vaccinated animals.13–15 If rabies is suspected in a
vaccinated animal, it should be reported to pub-
lic health officials, the vaccine manufacturer, and
the USDA APHIS Center for Veterinary Biologics

(www.aphis.usda.gov; search for “adverse event
reporting”). The laboratory diagnosis should be
confirmed and the virus variant characterized by
the CDC’s rabies reference laboratory.A thorough
epidemiologic investigation including documen-
tation of the animal’s vaccination history and po-
tential rabies exposures should be conducted.
8. Rabies in wildlife. It is difficult to control
rabies among wildlife reservoir species.16 Vacci-
nation of free-ranging wildlife or point infection
control is useful in some situations,17 but the suc-
cess of such procedures depends on the circum-
stances surrounding each rabies outbreak (See
Part I. C. Prevention and control methods related
to wildlife). Because of the risk of rabies in wild
animals (especially raccoons,skunks,coyotes,fox-
es, and bats), the AVMA, American Public Health
Association,Council of State andTerritorial Epide-
miologists, National Animal Care and Control As-
sociation,and National Association of State Public
Health Veterinarians strongly recommend the en-
actment and enforcement of state laws prohibit-
ing the importation, distribution, translocation,
and private ownership of wild animals.
9. Rabies surveillance. Laboratory-based ra-
bies surveillance and variant typing are essential
components of rabies prevention and control
programs. A comprehensive surveillance pro-
gram should not be limited to testing only those
animals that have potentially exposed people or
domestic animals to rabies.Accurate and timely
information and reporting are necessary to guide
decisions regarding postexposure prophylaxis in
potentially exposed humans, determine appro-
priate management of potentially exposed ani-
mals, aid in the discovery of emerging variants,
describe the epidemiology of the disease, and
assess the effectiveness of vaccination programs
for domestic animals and wildlife. Every animal
submitted for rabies testing should be reported
to the CDC to evaluate surveillance trends.Public
health authorities should implement electronic
laboratory reporting and notification systems.18
Information reported on every animal submitted
for rabies testing should include species, point
location, vaccination status, rabies virus variant
(if rabid), and human or domestic animal expo-
sures.To enhance the ability to make evidence-
based recommendations from national surveil-
lance data, additional data should be collected
and reported on all rabid domestic animals. In
this regard, essential data elements include age,
sex, neuter status, ownership status, quarantine
dates (if any), date of onset of any clinical signs,
and complete vaccination history. Rabid animals
with a history of importation into the United
States within the past 60 days are immediately
notifiable by state health departments to the
CDC; for all indigenous cases, standard notifica-
tion protocols should be followed.19
10. Rabies diagnosis.
a) The direct fluorescent antibody test
is the gold standard for rabies diagnosis.The
test should be performed in accordance with
the established national standardized proto-
col (www.cdc.gov/rabies/pdf/rabiesdfaspv2.
pdf) by a qualified laboratory that has been
designated by the local or state health depart-
ment.20,21 Animals submitted for rabies test-
ing should be euthanized22,23 in such a way as
to maintain the integrity of the brain so that
the laboratory can recognize anatomic struc-
tures.Except in the case of very small animals,
such as bats, only the head or entire brain
(including brainstem) should be submitted
to the laboratory.To facilitate prompt labora-
tory testing, submitted specimens should be
stored and shipped under refrigeration with-
out delay.The need to thaw frozen specimens
will delay testing.Chemical fixation of tissues
should be avoided to prevent significant test-
ing delays and because such fixation might
preclude reliable testing. Questions about
testing of fixed tissues should be directed to
the local rabies laboratory or public health
department.
b) Rabies testing should be available out-
side of normal business hours at the discre-
tion of public health officials to expedite ex-
posure management decisions.20 When con-
firmatory testing is needed by state health
departments (eg,in the event of inconclusive
results, unusual species, or mass exposures),
the CDC rabies laboratory can provide addi-
tional testing and results within 24 hours of
sample receipt.24
c) Professional associations such as the
Association of Public Health Laboratories
should advocate for, distribute, and promote
the development of guidelines for routinely
assessing testing practices within rabies labo-
ratories to ensure maintenance of quality and
safety.
d) Adirectrapidimmunohistochemicaltest
(referred to as dRIT) is being used by trained
field personnel in surveillance programs for
specimens not involved in human or domestic
animal exposures.25–28 All positive direct rapid
immunohistochemical test results need to be
confirmed by means of direct fluorescent anti-
body testing at a qualified laboratory.
e) Currently, there are no commercially
available, USDA-licensed rapid test kits for ra-
bies diagnosis. Unlicensed tests should not be
used owing to the following concerns:sensitiv-
ity and specificity of these tests are not known,
the tests have not been validated against cur-
rent standard methods, the excretion of virus
in the saliva is intermittent and the amount var-
ies over time, any unlicensed test result would

need to be confirmed by validated methods
such as direct fluorescent antibody testing on
brain tissue, and the interpretation of results
from unlicensed tests may place exposed ani-
mals and persons at risk.
11. Rabies serology. Some jurisdictions require
evidence of vaccination and rabies virus antibod-
ies for animal importation purposes. Rabies virus
antibody titers are indicative of a response to vac-
cine or infection.Titers do not directly correlate
with protection because other immunologic fac-
tors also play a role in preventing rabies and our
abilities to measure and interpret those other fac-
tors are not well-developed. Therefore, evidence
of circulating rabies virus antibodies in animals
should not be used as a substitute for current vac-
cination in managing rabies exposures or deter-
mining the need for booster vaccination.29–32
12. Rabies research. Information derived from
well-designed studies is essential for the devel-
opment of evidence-based recommendations.
Data are needed in several areas, including viral
shedding periods for domestic livestock and lago-
morphs, potential shedding of virus in milk, the
earliest age at which rabies vaccination is effec-
tive, protective effect of maternal antibody, dura-
tion of immunity, postexposure prophylaxis pro-
tocols for domestic animals, models for treatment
of clinical rabies,extralabel vaccine use in domes-
tic animals and wildlife rabies reservoir species,
host-pathogen adaptations and dynamics, and the
ecology of wildlife rabies reservoir species, espe-
cially in relation to the use of oral rabies vaccines.
B. Prevention and control methods
in domestic and confined animals
1. Preexposure vaccination and management. Ad-
herence to a regular rabies vaccination schedule is
critical to protect animals against recognized and
unrecognized rabies exposures. Parenteral animal
rabies vaccines should be administered only by
or under the direct supervision of a licensed vet-
erinarian on premises. Rabies vaccines may be
administered under the supervision of a licensed
veterinarian to animals held in animal shelters be-
fore release.33,34 The veterinarian signing a rabies
vaccination certificate must ensure that the person
who administered the vaccine is identified on the
certificate and has been appropriately trained in
vaccine storage, handling, and administration and
in the management of adverse events.This ensures
that a qualified and responsible person can be held
accountable for properly vaccinating the animal.
Within 28 days after initial vaccination, a
peak rabies virus antibody titer is expected, and
the animal can be considered immunized.31,35–37
Regardless of the age of the animal at initial vac-
cination, a booster vaccination should be admin-
istered 1 year later (see Part II and Appendix 1).
An animal is currently vaccinated and is consid-
ered immunized immediately after any booster
vaccination.38,39
a) Booster vaccination. Following the ini-
tial vaccination, booster vaccinations should
be given in a manner consistent with the
manufacturer’s label.If a previously vaccinated
animal is overdue for any booster vaccination,
including the first booster vaccination due 1
year after initial vaccination,it should be given
a booster vaccination. Immediately after this
booster vaccination, the animal is considered
currently vaccinated and should be placed
on a booster vaccination schedule consistent
with the label of the vaccine used.There are
no laboratory or epidemiological data to sup-
port the annual or biennial administration of
3-year vaccines after completion of the initial
vaccine series (ie, the initial vaccination and
1-year booster vaccination).
b) Dogs, cats, and ferrets.All dogs, cats,
and ferrets should be vaccinated against
rabies and revaccinated in accordance
with recommendations in this compendi-
um (Appendix 1).
c) Livestock. All horses should be vac-
cinated against rabies.40 Livestock, including
species for which licensed vaccines are not
available, that have frequent contact with
humans (eg, in petting zoos, fairs, and other
public exhibitions) should be vaccinated
against rabies.41,42 Consideration should also
be given to vaccinating livestock that are par-
ticularly valuable.
d) Captive wild animals and wild animal
hybrids (the offspring of wild animals cross-
bred to domestic animals).
(1) Wild animals and wild animal hy-
brids should not be kept as pets.43,44 No
parenteral rabies vaccines are licensed
for use in wild animals or wild animal
hybrids.45
(2) Animals that are farmed (eg, for
food, fur, or fiber) or maintained in ex-
hibits or zoological parks and that are
not completely excluded from all con-
tact with rabies vectors can become in-
fected.46 Moreover,wild animals might be
incubating rabies when initially captured.
Therefore, wild-caught animals suscep-
tible to rabies should be quarantined for
a minimum of 6 months.
(3) Employees who work with ani-
mals in exhibits or zoological parks should
receive preexposure rabies vaccination.
The use of preexposure or postexposure
rabies vaccination for handlers who work
with animals at such facilities might re-
duce the need for euthanasia of captive
animals that expose handlers. Carnivores
and bats should be housed in a manner

that precludes direct contact with the
public.41,42 Consideration may be given to
vaccinating animals that are particularly
valuable (see Part II.D.Vaccination of wild-
life and wild animal hybrids).
2. Stray animals. Stray dogs, cats, and ferrets
should be removed from the community,and mech-
anisms should be put in place to facilitate voluntary
surrender of animals to prevent abandonment. Lo-
cal health departments and animal control officials
can enforce the removal of strays more effectively if
owned animals are required to have identification
and be confined or kept on leash. Strays should be
impounded for at least 3 business days to determine
whether human exposure has occurred and to give
owners sufficient time to reclaim animals.
Stray and feral cats serve as a significant source
of rabies exposure risk.47 If communities allow
maintenance of feral cat colonies despite this risk,
they should safeguard the health of the cats and
the communities in which they reside by requiring
that cats receive initial rabies vaccinations and ap-
propriately scheduled booster vaccinations.
3. Importation and interstate movement of animals.
a) Areas with dog-to-dog rabies transmis-
sion. Canine rabies virus variants have been
eliminated from the United States3,7; howev-
er, rabid dogs and a rabid cat have been in-
troduced into the continental United States
from areas with dog-to-dog rabies transmis-
sion.4–6,48,49 The movement of dogs for the
purposes of adoption or sale from areas with
dog-to-dog rabies transmission increases the
risk of introducing canine-transmitted rabies
to areas where it does not currently exist,and
this practice should be prohibited.
b) International importation.Current fed-
eral regulations are insufficient to prevent the
introduction of rabid animals into the United
States and must be strengthened and appro-
priately enforced.4–6,48,49 The CDC and USDA
APHIS have regulatory authority over the
importation of dogs and cats into the United
States.6 Importers of dogs must comply with
rabies vaccination requirements.50,51 These
regulations require that dogs from rabies-
endemic countries be currently vaccinated
against rabies prior to importation.The appro-
priate health official of the state of destination
should be notified by the appropriate federal
authorities within 72 hours of the arrival of
any unvaccinated imported dog required to
be placed in confinement (as defined by the
CDC52) under these regulations.Failure of the
owner to comply with these confinement re-
quirements should be promptly reported to
the CDC’s Division of Global Migration and
Quarantine (CDCAnimalImports@cdc.gov).
All imported dogs and cats are also subject
to state and local laws governing rabies and
should be currently vaccinated against rabies
with USDA-licensed products in accordance
with this compendium. Failure of the owner
to comply with state or local requirements
should be referred to the appropriate state or
local official.
c) Interstate movement (including com-
monwealths and territories). Before inter-
state movement occurs, dogs, cats, ferrets,
and horses should be currently vaccinated
against rabies in accordance with this com-
pendium.Animals in transit should be accom-
panied by a current, valid rabies vaccination
certificate such as Form 51 from the National
Association of State Public Health Veterinar-
ians.53 When an interstate health certificate
or certificate of veterinary inspection is re-
quired,it should contain the same rabies vac-
cination information as Form 51.
4. Adjunct procedures. Methods or procedures
that enhance rabies control include the following54:
a) Identification. Dogs, cats, and ferrets
should be identified (eg, metal or plastic tags
or microchips) to allow for verification of ra-
bies vaccination status.
b) Licensure. Registration or licensure of
all dogs,cats,and ferrets is an integral compo-
nent of an effective rabies control program.A
fee is frequently charged for such licensure,
and revenues collected are used to maintain
rabies or animal control activities. Evidence
of current vaccination should be an essential
prerequisite to licensure.
c) Canvassing. House-to-house canvass-
ing by animal control officials facilitates
enforcement of vaccination and licensure
requirements.
d) Citations.Citations are legal summons-
es issued to owners for violations, including
the failure to vaccinate or license their ani-
mals.The authority for officers to issue cita-
tions should be an integral part of animal con-
trol programs.
e) Animal control. All local jurisdictions
should incorporate training and continuing
education of personnel regarding stray-ani-
mal control, leash laws, animal bite preven-
tion, and rabies prevention and control into
their programs.
f) Public education. All local jurisdic-
tions should incorporate education covering
responsible pet ownership, bite prevention,
and appropriate veterinary care into their
programs.
5. Postexposure management. This section re-
fers to any animal exposed (see Part I.A. 2. Rabies
virus exposure) to a confirmed or suspected ra-
bid animal. Wild mammalian carnivores, skunks,
and bats that are not available or suitable for test-
ing should be regarded as rabid.The rationale for

observation, confinement, or strict quarantine
periods of exposed animals despite previous vac-
cination is based in part on the potential for over-
whelming viral challenge, incomplete vaccine ef-
ficacy, improper vaccine administration, variable
host immunocompetence, and immune-mediated
death (ie,early death phenomenon).13,55–57
a) Dogs, cats, and ferrets.Any illness in an
exposed animal should be reported immedi-
ately to the local health department. If signs
suggestive of rabies develop (eg, paralysis or
seizures), the animal should be euthanized,
and the head or entire brain (including brain-
stem) should be submitted for testing (see Part
I.A.10.Rabies diagnosis).
(1) Dogs, cats, and ferrets that are
current on rabies vaccination should im-
mediately receive veterinary medical care
for assessment, wound cleansing, and
booster vaccination. The animal should
be kept under the owner’s control and
observed for 45 days.
(2) Dogs, cats, and ferrets that have
never been vaccinated should be eutha-
nized immediately. There are currently
no USDA-licensed biologics for postex-
posure prophylaxis of previously unvac-
cinated domestic animals, and there is
evidence that the use of vaccine alone
will not reliably prevent the disease in
these animals.58 If the owner is unwilling
to have the animal euthanized,the animal
should be placed in strict quarantine for
4 (dogs and cats) or 6 (ferrets) months.
Strict quarantine in this context refers
to confinement in an enclosure that pre-
cludes direct contact with people and
other animals. A rabies vaccine should
be administered at the time of entry into
quarantine to bring the animal up to cur-
rent rabies vaccination status.Administra-
tion of vaccine should be done as soon
as possible. It is recommended that the
period from exposure to vaccination not
exceed 96 hours.59,60 If vaccination is de-
layed,public health officials may consider
increasing the quarantine period for dogs
and cats from 4 to 6 months, taking into
consideration factors such as the severity
of exposure, the length of delay in vac-
cination, current health status, and local
rabies epidemiology.
(3) Dogs and cats that are overdue for
a booster vaccination and that have appro-
priate documentation of having received a
USDA-licensed rabies vaccine at least once
previously should immediately receive
veterinary medical care for assessment,
wound cleansing,and booster vaccination.
The animal should be kept under the own-
er’s control and observed for 45 days.39
If booster vaccination is delayed, public
health officials may consider increasing
the observation period for the animal,tak-
ing into consideration factors such as the
severity of exposure,the length of delay in
booster vaccination, current health status,
and local rabies epidemiology.
(4) Dogs and cats that are overdue
for a booster vaccination and without
appropriate documentation of having
received a USDA-licensed rabies vaccine
at least once previously should imme-
diately receive veterinary medical care
for assessment, wound cleansing, and
consultation with local public health
authorities.
(a) The animal can be treated as
unvaccinated, immediately given a
booster vaccination, and placed in
strict quarantine (see Part I.B.5.a) (2)).
(b)Alternatively,prior to booster
vaccination, the attending veterinar-
ian may request guidance from the
local public health authorities in
the possible use of prospective se-
rologic monitoring. Such monitoring
would entail collecting paired blood
samples to document prior vacci-
nation by providing evidence of an
anamnestic response to booster vac-
cination. If an adequate anamnestic
response is documented, the animal
can be considered to be overdue for
booster vaccination (see Part I. B. 5.
a) (3)) and observed for 45 days.39 If
there is inadequate evidence of an
anamnestic response, the animal is
considered to have never been vacci-
nated and should be placed in strict
quarantine (see Part I.B.5.a) (2)).
(5) Ferrets that are overdue for a
booster vaccination should be evalu-
ated on a case-by-case basis, taking into
consideration factors such as the sever-
ity of exposure, time elapsed since last
vaccination, number of previous vacci-
nations, current health status, and local
rabies epidemiology, to determine need
for euthanasia or immediate booster vac-
cination followed by observation or strict
quarantine.
b) Livestock. All species of livestock are
susceptible to rabies;cattle and horses are the
most frequently reported infected species.3
Any illness in an exposed animal should be re-
ported immediately to the local health depart-
ment and animal health officials. If signs sug-
gestive of rabies develop, the animal should
be euthanized, and the head or entire brain

(including brainstem) should be submitted for
testing (see Part I.A.10.Rabies diagnosis).
(1) Livestock that have never been
vaccinated should be euthanized imme-
diately. Animals that are not euthanized
should be confined and observed on a
case-by-case basis for 6 months.
(2) Livestock that are current on ra-
bies vaccination with a USDA-licensed
vaccine approved for that species should
be given a booster vaccination immedi-
ately and observed for 45 days.
(3) Livestock overdue for a booster
vaccination should be evaluated on a
case-by-case basis, taking into consider-
ation factors such as severity of expo-
sure, time elapsed since last vaccination,
number of previous vaccinations,current
health status, and local rabies epidemiol-
ogy, to determine need for euthanasia or
immediate booster vaccination followed
by observation or strict quarantine.
(4) Multiple rabid animals in a herd
and herbivore-to-herbivore transmission of
rabies are uncommon.61 Therefore,restrict-
ing the rest of the herd if a single animal has
been exposed to or infected with rabies is
usually not necessary.
(5) Rabies virus is widely distributed in
the tissues of rabid animals.62–64Tissues and
products from a rabid animal should not be
used for human or animal consumption65,66
or transplantation.67 However, pasteuriza-
tion and cooking will inactivate rabies vi-
rus.68Therefore,inadvertently drinking pas-
teurized milk or eating thoroughly cooked
animal products does not constitute a ra-
bies exposure.
(6) Handling and consumption of
uncooked tissues from exposed animals
might carry a risk for rabies transmis-
sion.69 Persons handling exposed animals,
carcasses, and tissues should use appro-
priate barrier precautions.69,70 State and
local public health authorities,state meat
inspectors,and the USDA Food Safety and
Inspection Service should be notified if
exposures occur in animals intended for
commercial use. Animals should not be
presented for slaughter in a USDA-regu-
lated establishment if such animals origi-
nate from a quarantine area and have not
been approved for release by the proper
authority. If an exposed animal is to be
custom slaughtered or home slaughtered
for consumption, it should be slaugh-
tered immediately after exposure, and all
tissues should be cooked thoroughly.
c) Other animals. Other mammals ex-
posed to a rabid animal should be euthanized
immediately. Animals maintained in USDA-
licensed research facilities or accredited zoo-
logical parks should be evaluated on a case-by-
case basis in consultation with public health
authorities. Management options may include
quarantine, observation, or administration of
rabies biologics.
6. Management of animals that bite humans.
a) Dogs, cats, and ferrets. Rabies virus is
excreted in the saliva of infected dogs, cats,
and ferrets during illness and for only a few
days before the onset of clinical signs or
death.71–73 Regardless of rabies vaccination
status, a healthy dog, cat, or ferret that expos-
es a person should be confined and observed
daily for 10 days from the time of the expo-
sure74;administration of rabies vaccine to the
animal is not recommended during the ob-
servation period to avoid confusing signs of
rabies with rare adverse vaccine reactions.15
Any illness in the animal should be reported
immediately to the local health department.
Such animals should be evaluated by a veteri-
narian at the first sign of illness during con-
finement. If signs suggestive of rabies devel-
op, the animal should be euthanized, and the
head or entire brain (including brainstem)
should be submitted for testing (see Part I.A.
10. Rabies diagnosis).Any stray or unwanted
dog, cat, or ferret that exposes a person may
be euthanized immediately, and the head or
entire brain (including brainstem) should be
submitted for testing (see Part I.A. 10. Rabies
diagnosis).
b) Other animals. Other animals that
might have exposed a person to rabies
should be reported immediately to the local
health department. Management of animals
other than dogs,cats,and ferrets depends on
the species, the circumstances of the expo-
sure, the epidemiology of rabies in the area,
the exposing animal’s history and current
health status, and the animal’s potential for
exposure to rabies.The shedding period for
rabies virus is undetermined for most spe-
cies. Previous vaccination of these animals
might not preclude the necessity for eutha-
nasia and testing.
7. Outbreak prevention and control. The emer-
gence of new rabies virus variants or the introduc-
tion of nonindigenous viruses poses a significant
risk to humans,domestic animals,and wildlife.75–82
A rapid and comprehensive response involves
coordination of multiple agencies (see Part I.A. 3.
Interdisciplinary approach) to accomplish the fol-
lowing outcomes83:
• Characterize the virus at the national refer-
ence laboratory.
• Identify and control the source of the
introduction.

• Enhance laboratory-based surveillance in
wild and domestic animals.
• Increase animal rabies vaccination rates.
• Restrict the movement of animals.
• Evaluate the need for wildlife intervention
activities (eg, point infection control, trap-
vaccinate-release programs, and oral rabies
vaccination programs).
• Provide public and professional outreach and
education.
8. Disaster response. Animals might be dis-
placed during and after man-made or natural disas-
ters and require emergency sheltering.84–86 Animal
rabies vaccination and exposure histories are often
not available for displaced animals, and disaster re-
sponse can create situations where animal caretak-
ers might lack appropriate training or preexposure
vaccination.In such situations,it is critical to imple-
ment and coordinate rabies prevention and control
measures to reduce the risk of rabies transmission
and the need for human postexposure prophylaxis.
Such measures include the following actions:
• Coordinate relief efforts of individuals and or-
ganizations with the local emergency opera-
tions center before deployment.
• Examine each animal at a triage site for pos-
sible bite injuries or signs of rabies.
• Isolate animals exhibiting signs of rabies
pending evaluation by a veterinarian.
• Ensure that all animals have a unique identifier.
• Administer a rabies vaccine to all dogs, cats,
and ferrets unless reliable proof of current
vaccination exists.
• Adopt minimum standards for animal caretak-
ers as feasible,including use of personal protec-
tive equipment,completion of the preexposure
rabies vaccination series prior to deployment,
and provision of appropriate training.87
• Maintain documentation of animal disposi-
tion and location (eg,returned to owner,died
or euthanized,adopted,or relocated to anoth-
er shelter with address of new location).
• Provide facilities to confine and observe ani-
mals involved in exposures (see Part I. B. 6.
Management of animals that bite humans).
• Report human exposures to appropriate pub-
lic health authorities (see Part I. A. 2. Rabies
virus exposure).
C. Prevention and control methods
related to wildlife
The public should be warned not to handle or
feed wild mammals. Wild mammals and wild animal
hybrids that expose persons, pets, or livestock should
be considered for euthanasia and rabies testing.A per-
son exposed by any wild mammal should immediately
wash the wound thoroughly and report the incident
to a health-care provider who, in consultation with
public health authorities, can evaluate the need for
postexposure prophylaxis.11,12
Translocating infected wildlife has contributed
to the spread of rabies,75–80,88 and animals that appear
healthy can still be rabid.Therefore, translocation (ie,
moving live animals from their point of capture and
releasing them) of known rabies reservoir species
should be prohibited.89 Whereas state-regulated wild-
life rehabilitators and nuisance-wildlife control opera-
tors should play a role in a comprehensive rabies con-
trol program, minimum standards for these persons
who handle wild mammals should include rabies pre-
exposure vaccination, specific rabies prevention and
control training,and ongoing continuing education.
1. Carnivores. The use of oral rabies vaccines for
mass vaccination of free-ranging wildlife should be
considered in selected situations, with the approval
of appropriate state and local agencies.16,90 There
have been documented successes using oral rabies
vaccines to control rabies in wildlife in North Amer-
ica.90–93 The currently licensed vaccinia-vectored oral
rabies vaccine is labeled for use in raccoons and coy-
otes.Research to improve existing oral rabies vaccine
and baits and to develop and test novel products to
determine safety and efficacy must be encouraged.
The distribution of oral rabies vaccines should be
based on scientific assessments of the target species
and followed by timely and appropriate analysis of
surveillance data, with results provided to all stake-
holders. In addition, parenteral vaccination (trap-vac-
cinate-release) of wildlife rabies reservoir species may
be integrated into coordinated oral rabies vaccine
programs to enhance their effectiveness.Continuous
and persistent programs for trapping or poisoning
wildlife are not effective in reducing populations of
wildlife rabies reservoir species on a statewide basis.
However, limited population control in high-contact
areas (eg,picnic grounds,camps,and suburban areas)
might be indicated for the removal of selected high-
risk species of wildlife.State agriculture,public health,
and wildlife agencies should be consulted for plan-
ning, coordination, and evaluation of vaccination or
point infection control programs.16
2. Bats. From the 1950s to today,indigenous rabid
bats have been reported from every state except Ha-
waii and have caused rabies in at least 54 humans in
the United States.94–103 Bats should be excluded,using
appropriate methods, from houses, public buildings,
and adjacent structures to prevent direct association
with humans.104,105 Such structures should then be
made bat-proof by sealing entrances used by bats.Con-
trolling rabies in bats through programs designed to
reduce bat populations is neither feasible nor desirable.
Part II. Recommendations
for Parenteral Rabies
Vaccination Procedures
A. Vaccine administration
All animal rabies vaccines should be restricted to
use by or under the direct supervision of a veterinar-

ian,106 except as recommended otherwise (see Part I.
B.1.Preexposure vaccination and management).
B. Vaccine selection
All vaccines licensed by the USDA and marketed
in the United States at the time of publication of this
compendium are listed (Appendix 1).Newly approved
vaccines and changes in label specifications made sub-
sequent to publication should be considered as part
of this list.Any of the listed vaccines can be used for
revaccination, even if the product is not the same as
the one previously administered. Vaccines used in
state and local rabies control programs should have
at least a 3-year duration of immunity.This constitutes
the most effective method of increasing the propor-
tion of immunized dogs and cats in any population.107
C.Adverse events
Currently, no epidemiological association exists
between any particular licensed vaccine product
and adverse events.15,34,108–110 Although rare, adverse
events such as vomiting, injection site swelling, leth-
argy, hypersensitivity, and the occurrence of rabies
despite previous vaccination of an animal have been
reported. Adverse events should be reported to the
vaccine manufacturer and to USDA APHIS’s Center
forVeterinary Biologics (www.aphis.usda.gov;search
for “adverse event reporting”). Although ill animals
may not have a full immunologic response to vac-
cination,there is no evidence to suggest that adverse
events are more likely to occur with rabies vaccina-
tion of ill than healthy animals.A veterinarian choos-
ing to temporarily delay vaccinating an animal with
an acute illness or condition should ensure that the
animal is vaccinated as soon as possible.Animals with
a previous history of anaphylaxis can be medically
managed and observed after vaccination.56 Severe
adverse events related to rabies vaccination are ex-
tremely rare in animals. Decisions concerning rabies
vaccination of animals with well-documented severe
adverse events to rabies vaccine must be made with-
in the context of a valid veterinarian-client-patient
relationship. Due consideration should be given to
the attendant risks and benefits of not vaccinating,in-
cluding regulatory noncompliance.Animals not cur-
rently vaccinated that experience a rabies exposure
are at greater risk for infection and death and also put
their owners and the community at risk.
D. Vaccination of wildlife
and wild animal hybrids
The safety and efficacy of parenteral rabies vac-
cines in wildlife and wild animal hybrids have not been
established, and no rabies vaccines are currently li-
censed for use in these animals.Thus,any use of rabies
vaccines in these animals is considered extralabel use.
Zoos or research institutions may establish vaccination
programs in an attempt to protect valuable animals,
but these should not replace appropriate public health
activities that protect humans (see Part I.B.1.d) (3)).
E. Accidental human exposure
to rabies vaccines
Human exposure to parenteral animal rabies vac-
cines listed in Appendix 1 does not constitute a risk
for rabies virus infection.Human exposure to vaccinia-
vectored oral rabies vaccines should be reported to
state health officials.111,112
F. Rabies certificates
All agencies and veterinarians should use Form 51,
the rabies vaccination certificate recommended by the
National Association of State Public Health Veterinar-
ians,53 or should use an equivalent.The form must be
completed in full and signed by the administering or
supervising veterinarian. Computer-generated forms
containing the same information are also acceptable.
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Wkly Rep 2009;58:1204–1207.

Ageatprimary Routeof
Productname Producedby Marketedby Forusein Dose vaccination* Boostervaccination inoculation
Monovalent(inactivated)
RABVAC1 BoehringerIngelheimVetmedicaIncLicenseNo.124 BoehringerIngelheimVetmedicaInc Dogsandcats 1mL 3mo Annually IMorSC
RABVAC3 BoehringerIngelheimVetmedicaIncLicenseNo.124 BoehringerIngelheimVetmedicaInc Dogsandcats 1mL 3mo 1yearlaterandtriennially IMorSC
Horses 2mL 3mo Annually IM
EQUI-RABwithHavlogen MerckAnimalHealthLicenseNo.165A MerckAnimalHealth Horses 1mL 4mo Annually IM
DEFENSOR1 ZoetisLicenseNo.190 Zoetis Dogs 1mL 3mo Annually IMorSC
Cats 1mL 3mo Annually SC
DEFENSOR3 ZoetisLicenseNo.190 Zoetis Dogs 1mL 3mo 1yearlaterandtriennially IMorSC
Cats 1mL 3mo 1yearlaterandtriennially SC
Sheepandcattle 2mL 3mo Annually IM
NOBIVAC:1-Rabies ZoetisLicenseNo.190 MerckAnimalHealth Dogs 1mL 3mo Annually IMorSC
Cats 1mL 3mo Annually SC
NOBIVAC:3-Rabiesand ZoetisLicenseNo.190 MerckAnimalHealth Dogs 1mL 3mo 1yearlaterandtriennially IMorSC
3-RabiesCA Cats 1mL 3mo 1yearlaterandtriennially SC
Sheepandcattle 2mL 3mo Annually IM
IMRAB1 MerialIncLicenseNo.298 MerialInc Dogsandcats 1mL 3mo Annually SC
IMRAB1TF MerialIncLicenseNo.298 MerialInc Dogsandcats 1mL 3mo Annually SC
IMRAB3 MerialIncLicenseNo.298 MerialInc Dogsandcats 1mL 3mo 1yearlaterandtriennially IMorSC
Sheep 2mL 3mo 1yearlaterandtriennially IMorSC
Cattleandhorses 2mL 3mo Annually IMorSC
Ferrets 1mL 3mo Annually SC
IMRAB3TF MerialIncLicenseNo.298 MerialInc Dogsandcats 1mL 3mo 1yearlaterandtriennially IMorSC
Ferrets 1mL 3mo Annually SC
IMRABLargeAnimal MerialIncLicenseNo.298 MerialInc Dogsandcats 1mL 3mo 1yearlaterandtriennially IMorSC
Cattleandhorses 2mL 3mo Annually IMorSC
Sheep 2mL 3mo 1yearlaterandtriennially IMorSC

Monovalent(rabiesglycoprotein;
livecanarypoxvector)
PUREVAXFelineRabies MerialIncLicenseNo.298 MerialInc Cats 1mL 3mo Annually SC
PUREVAXFeline MerialIncLicenseNo.298 MerialInc Cats 1mL 3mo 1yearlaterandtriennially SC
Rabies3YR

Combination(inactivated)
EquinePOTOMAVAC+ MerialIncLicenseNo.298 MerialInc Horses 1mL 3mo Annually IM
IMRAB
Combination(rabiesglycoprotein;
livecanarypoxvector)
PUREVAXFeline3/Rabies MerialIncLicenseNo.298 MerialInc Cats 1mL 8wk Every3to4wkuntil3mo SC
andannually
3mo 3to4wklaterandannually SC
PUREVAXFeline4/Rabies MerialIncLicenseNo.298 MerialInc Cats 1mL 8wk Every3to4wkuntil3mo SC
andannually
3mo 3to4wklaterandannually SC

Oral(rabiesglycoprotein;live
vacciniavector)†
RABORALV-RG MerialIncLicenseNo.298 MerialInc Raccoonsandcoyotes NA NA Asdeterminedbylocal Oral
authorities
*Onemonth=28days.†Oralrabiesvaccinesarerestrictedforuseinfederalandstaterabiescontrolprograms.
NA=Notapplicable.
InformationisprovidedbythevaccinemanufacturersandUSDAAPHIS’sCenterforVeterinaryBiologicsandissubjecttochange.
Appendix1
RabiesvaccineslicensedandmarketedintheUnitedStates,2016.

Appendix 2
Rabies vaccine manufacturer contact information
Manufacturer Phone No. URL
Boehringer IngelheimVetmedica Inc 800–638–2226 www.bi-vetmedica.com
Merck Animal Health Inc 800–521–5767 www.merck-animal-health-usa.com
Merial Inc 888–637–4251 us.merial.com
Zoetis 800–366–5288 www.zoetis.com

ORIGINAL ARTICLE
Rabies Prevention and Management of Cats in the Context of
Trap–Neuter–Vaccinate–Release Programmes
A. D. Roebling1
, D. Johnson1
, J. D. Blanton1
, M. Levin1
, D. Slate2
, G. Fenwick3
and C. E. Rupprecht1
1
Centers for Disease Control and Prevention, Atlanta, GA, USA
2
United States Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, Manchester, NH, USA
3
American Bird Conservancy, The Plains, VA, USA
Impacts
• Trap–neuter–vaccinate–return (TNVR) programmes are growing in
popularity as alternatives to euthanizing feral cats
• Their ability to adequately address disease threats and population growth
within managed cat colonies is not clear
• Appropriate animal control laws including removal of stray or unwanted
cats should be enforced rather than relying on indirect population manage-
ment strategies (e.g. trap-neuter-vaccinate-release programmes) in order to
control feral cat populations and reduce the risk of zoonotic diseases such
as rabies.
Keywords:
Cat; vaccination; TNR; release; trap
Correspondence:
Jesse D. Blanton. Centers for Disease Control
and Prevention, 1600 Clifton Rd, MS G33,
Atlanta, GA 30333, USA. Tel.: 404 639 2289;
Fax: 404 639 1564; E-mail: Asi5@cdc.gov
Received for publication January 3, 2013
doi: 10.1111/zph.12070
Summary
Domestic cats are an important part of many Americans’ lives, but effective con-
trol of the 60–100 million feral cats living throughout the country remains prob-
lematic. Although trap–neuter–vaccinate–return (TNVR) programmes are
growing in popularity as alternatives to euthanizing feral cats, their ability to ade-
quately address disease threats and population growth within managed cat colo-
nies is dubious. Rabies transmission via feral cats is a particular concern as
demonstrated by the signiﬁcant proportion of rabies post-exposure prophylaxis
associated with exposures involving cats. Moreover, TNVR has not been shown
to reliably reduce feral cat colony populations because of low implementation
rates, inconsistent maintenance and immigration of unsterilized cats into colo-
nies. For these reasons, TNVR programmes are not effective methods for reduc-
ing public health concerns or for controlling feral cat populations. Instead,
responsible pet ownership, universal rabies vaccination of pets and removal of
strays remain integral components to control rabies and other diseases.
Introduction
The relationship between humans and domestic cats origi-
nated 10 000 years ago when modern cats diverged from
wildcat ancestors to live among Homo sapiens in the Middle
East (South-West Asia) (Driscoll et al., 2009). These cat
ancestors spread throughout the Old World and eventually
were brought to the Americas, where they are not native,
by European settlers less than 500 years ago (Lipinski et al.,
2008). Today, domestic cats persist in the United States as
popular and beloved pets; however, effective control of the
60–100 million feral cats living throughout the country
remains problematic (Jessup, 2004). While removal of
unowned (‘stray’) domestic animals has been the historical
approach, these animal control programmes are criticized
for euthanizing cats that are not, or cannot, be adopted
(Alley Cat Allies, 2012a). Recent focus has turned to
trap–neuter–release (TNR), trap–neuter–vaccinate–return
(TNVR) and other similarly named programmes as alterna-
tives to euthanasia. These programmes involve humane
trapping of feral cats, sterilization surgery and return to the
environment, often but not always with vaccination against
rabies and other diseases (Alley Cat Allies, 2012c). Such
programmes generate support and enthusiasm from many
animal welfare advocates, yet these managed feral cat ‘colo-
nies’ are not innocuous. Feral cats can cause considerable
© 2013 Blackwell Verlag GmbH 1
Zoonoses and Public Health

mortality to local wildlife (Hawkins et al., 1999; Jessup,
2004; Baker et al., 2008), act as reservoirs for feline-specific
diseases (Nutter et al., 2004a; Al-Kappany et al., 2011;
Cohn, 2011) and transmit zoonotic diseases to humans
(CDC, 1995, 2008b; Nutter et al., 2004a; McElroy et al.,
2010). Additionally, claims by TNR advocates that man-
aged colonies can reduce feral cat populations and control
rodents are contradicted by research (Hawkins et al., 1999;
Castillo and Clarke, 2003; Longcore et al., 2009; Gunther
et al., 2011). As such, communities deciding how to man-
age feral cat overpopulation are torn between the compet-
ing interests of cats, wildlife and public health.
Rabies is a zoonotic disease of particular importance.
The World Health Organization attributes more than
55 000 human deaths each year to rabies worldwide pri-
marily in countries where canine rabies has not been con-
trolled (WHO, 2005). Effective rabies control programmes
in the United States limit human deaths attributed to rabies
to just a few each year. However, up to 38 000 persons are
estimated to receive rabies post-exposure prophylaxis
(PEP) annually due to a potential exposure (Christian
et al., 2009). In addition to PEP, vaccination of owned pets
and removal of stray cats and dogs are also important in
preventing human rabies mortality by reducing the oppor-
tunities for exposure. The interaction between cats and rac-
coons or other wildlife rabies reservoirs is the source of
rabies infection by which cats may subsequently infect peo-
ple. As a rabies vector, cats pose a disproportionate risk for
potential human exposures compared with wildlife reser-
voir species in part because people, and especially children,
are more likely to approach them. As such, potential expo-
sures from cats of unknown vaccination history account for
a substantial proportion of PEP administered annually in
the United States (Hensley, 1998; Moore et al., 2000). They
also pose a considerable rabies risk to persons who are
exposed but fail to recognize the need for PEP, as is some-
times the case with children (CDC, 2012). Thus, compre-
hensive rabies control requires continued implementation
of current policies for animal vaccination and removal of
strays, as well as administration of PEP following potential
exposures. The policies outlined in the National Associa-
tion of State Public Health Veterinarians (NASPHV) Com-
pendium of Animal Rabies Control and Prevention
specifically state that all cats be up to date on rabies vaccine,
a daunting challenge for any caretaker with a sizable feral
cat colony (National Association of State Public Health
Veterinarians, 2011).
In this review, we focus on the impact of managed feral
cats from a public health perspective. Special emphasis is
given to rabies virus because it is often discounted as a risk
by TNVR advocates (Alley Cat Allies, 2012b). In addition,
we review scientific literature regarding the efficacy of
TNVR programmes to achieve rabies vaccination coverage
and impact feral cat populations. Lastly, we consider other
community concerns that arise when addressing managed
feral cat colonies and their impact on wildlife.
Cats and the Threat of Rabies
Throughout the world, dogs are the rabies reservoir of
greatest human health concern, causing 99% of human
infections (WHO, 2005). In the United States, however, the
canine rabies virus variants have been recently eliminated,
and, as such, dogs are now a vector species for wildlife
rabies instead of a reservoir. In 2010, 303 rabid cats were
reported through national surveillance, compared with
only 69 dogs (Blanton et al., 2011). This 4-fold difference is
in sharp contrast to the pattern reported in 1946 (prior to
mass vaccination of dogs), when 8384 rabid dogs were
reported rabid compared with only 455 cats (Held et al.,
1967). The dramatic decline in dog rabies from over 8000
cases a year to fewer than a hundred was accomplished
through policies that promote mass vaccination coverage
and control of strays, but adherence to these policies
appears limited for cats (CDC, 2008a; National Association
of State Public Health Veterinarians, 2011). Legislation
reflects this disparity; canine rabies vaccination is required
by 38 states, but only 30 states require cats to be vaccinated
(Blanton et al., 2010). Because control tactics for cats are
less emphasized, the number of reported rabies cases in cats
has not declined in the same way as it has in dogs.
Post-exposure prophylaxis has been crucial to the pre-
vention of human deaths due to rabies following contact
with rabid cats, where contact is defined as an exposure
that could potentially transmit rabies virus. No national
reporting system exists to quantify the proportion of PEP
attributable to cat exposures, but estimates indicate that
16% of PEP administration in the United States is likely
due to cats and may account for the majority of PEP
administration in some areas (Christian et al., 2009). Some
regions experience much higher rates of PEP from cat
exposures. A study of 67 counties in Pennsylvania found
that 44% of PEP administration was due to cats, most of
which (82%) were feral, stray or unowned (Moore et al.,
2000). Similarly, New York state attributes more PEP
administration to cat exposures (32%) than any other spe-
cies (Eidson and Bingman, 2010). Most striking, a study in
Montgomery County, Virginia, attributed 63% of PEP rec-
ommendations to stray cat exposures compared with only
8% for wild animal contact (Hensley, 1998). In this com-
munity, the high rate of PEP due to cats resulted in part
from the lack of a county animal shelter facility for cats,
illustrating the need for removal of feral and stray cats as a
means of rabies control and PEP reduction.
The propensity to underestimate rabies risk from
cats has led to multiple large-scale rabies exposures and
© 2013 Blackwell Verlag GmbH2
Rabies Prevention in the Context of TNVR A. D. Roebling et al.

potentially caused a recent case of clinical rabies. In 1994,
665 persons in New Hampshire received PEP following
exposures to a rabid stray kitten of unknown history, one
of the largest documented mass exposure events recorded
in the United States (CDC, 1995); for each person, expo-
sure status either was sufficient for transmission or could
not be determined because of the young age of those poten-
tially exposed. Similarly, contact with a rabid stray kitten
found at a South Carolina softball tournament led to 27
individuals requiring and receiving PEP in 2008 based on
exposure of open wounds or mucous membranes to the
kitten’s saliva (CDC, 2008b). Individuals who are exposed
to saliva from rabid cats in an open wound or mucous
membrane and are not administered PEP are at risk of
developing rabies and death. During 2011, an 8-year-old
girl contracted rabies because no one was aware of an expo-
sure; investigation showed that she had petted and been
scratched by stray cats around her school weeks before
developing clinical signs, but because she recalled no ani-
mal bites and none of the cats captured after her illness
were rabid, and the definitive source of her infection was
never identified (CDC, 2012). While this was an atypical
case of human rabies with the child surviving, the vast
majority of rabies victims die. Historically, exposures to
rabid cats resulted in human fatalities in 1960 and 1975
(Anderson et al., 1984). In addition to these reported
human cases associated with exposures to cats, more than
25 000 cats are submitted for rabies diagnosis each year in
the United States to rule out potential human exposures
(Blanton et al., 2011). All of these examples illustrate both
the real potential for feline rabies infection and potential
for transmission to humans.
Human rabies fatalities are rare in the United States
thanks to the effectiveness of properly administered mod-
ern PEP, but treatment is expensive. Biologics alone cost in
excess of $2000 (Shwiff et al., 2007). When mass exposure
events occur, the monetary burden can be substantial; PEP
for the New Hampshire mass exposure event referenced
above totalled $1.1 million (CDC, 1995). Also, while com-
paratively safe, it should be noted that severe adverse events
have been rarely reported in association with rabies PEP
(CDC, 2008a).
Public Health and TNVR Programmes
The ability of TNVR programmes to achieve appropriate
levels of rabies vaccination coverage in feral cat populations
is doubtful. The current recommendations of the American
Association of Feline Practitioners (AAFP) and the Euro-
pean Advisory Board on Cat Diseases (ABCD) state that kit-
tens should be vaccinated against rabies between 12 and
16 weeks of age, boostered at a year and then again at the
interval recommended by the manufacturer (Richards et al.,
2006). Unfortunately, most cats in TNVR programmes will
only be trapped once in their lifetimes (Richards et al.,
2006). While feral cats in managed colonies live far shorter
lives on average than indoor cats, many can live at least six
years (Levy et al., 2003), and therefore, one vaccine dose
does not necessarily offer lifetime coverage. Additionally,
annual trapping rates of less than 10% (Foley et al., 2005)
cannot reach a sufficient proportion of the population to
establish and maintain herd immunity, even without
accounting for declines in vaccine-induced immunity over
time. Furthermore, the lack of consistent, verifiable docu-
mentation of vaccination for cats in TNVR programmes
makes it unlikely that vaccination would change practices
regarding human exposure assessment and PEP. When a
stray cat involved in an exposure to a human is captured, it
is recommended that the animal be confined and observed
for ten days or immediately euthanized and tested for rabies
(CDC, 2008a). Generally, if the animal cannot be captured,
persons should begin PEP. Given the challenges mentioned
above, ongoing vaccination of colony cats in a TNVR cam-
paign would not be likely to impact these recommendations
or the risk assessment process.
Many other potential zoonotic and cat-specific diseases
are harboured in feral cat populations in addition to rabies.
Among these are bartonellosis, toxoplasmosis, plague, endo-
and ectoparasites, feline immunodeficiency virus (FIV),
feline leukaemia virus (FeLV) and rickettsial diseases (Nut-
ter et al., 2004b; McElroy et al., 2010; Al-Kappany et al.,
2011; Little, 2011). The feline immunosuppressive diseases
(i.e. FIV and FeLV) are especially important because they
may predispose infected cats to developing additional viral,
bacterial or parasitic diseases that can be passed to humans
or owned cats (Al-Kappany et al., 2011). Many of these dis-
eases are prevalent at higher levels in feral cats compared
with the owned pet population because outdoor access
poses the greatest risk of infection (Little, 2011). Group
feeding of cats by colony caretakers puts cats at greater risk
for contracting diseases whose transmission is augmented
by increased animal density and contact rates among cats.
Feline respiratory disease complex (FRDC), a group of
pathogens that lead to high morbidity in shelters, catteries
and colony feeding sites, is one such example (Cohn, 2011);
however, other diseases are likely to be facilitated as well.
Group feeding also increases risk of contracting rabies
and other wildlife diseases by enabling greater contact along
the interface between cat colonies and wildlife reservoirs. A
TNVR study in Florida reported that a feral cat feeding site
attracted raccoons and opossums (Levy et al., 2003), and
studies with rabies oral vaccine baits have shown cats shar-
ing sites with these species as well as gray foxes (Olson
et al., 2000) (Fig. 1). Feeding sites that attract raccoons,
skunks and foxes are particularly dangerous because these
species are rabies reservoirs in the United States (CDC,
A. D. Roebling et al. Rabies Prevention in the Context of TNVR

2008a). Cross-species contact also allows feral cat popula-
tions to spread diseases to wildlife. In one study, about a
third of raccoons and opossums sharing habitats with feral
cats showed evidence of past infection with Toxoplasma
gondii, a deadly zoonosis that requires felids to complete its
life cycle (Fredebaugh et al., 2011).
Effectiveness of TNVR Programmes
Other disease risks notwithstanding, maintaining adequate
rabies vaccination coverage in feral cat populations is
impractical, if not impossible. Therefore, these populations
must be reduced and eliminated to manage the public
health risk of rabies transmission. Traditional animal con-
trol policies have stressed stray animal control and removal
since the 1940s (Held et al., 1967; Anderson et al., 1984),
and such policies were a major factor in the decline of
canine rabies in the United States. In contrast, less empha-
sis on control and removal of stray cats is likely the cause of
increased numbers of rabid cats compared with dogs
(CDC, 2008a). Trap–neuter–vaccinate–return programmes
claim to reduce stray cat populations over time, but evi-
dence indicates that current implementations are unlikely
to achieve declines in populations (Longcore et al., 2009).
A study of 103 local colonies in Rome, Italy, found that
while half of the colonies reported population decreases,
virtually the same number were stable or showed increases
(Natoli et al., 2006) in spite of an active sterilization cam-
paign and the adoption of most of the kittens being born in
colonies. A Tel Aviv, Israel study similarly showed that two
colony populations continued to grow even at 73–75%
sterilization, mostly due to immigration from surrounding
cat populations (Gunther et al., 2011). Likewise, managed
cat colonies in two Florida parks increased in size despite
TNR programmes (Castillo and Clarke, 2003). These fail-
ures can be attributed in part to inadequate levels of sterili-
zation. One model estimates that the per cent sterilization
needed to reduce feral cat populations is between 71% and
94%, levels that are rarely reached in real-world scenarios
(Foley et al., 2005). Similarly, another study concluded
that 90% sterilization is necessary to reduce feral cat
populations (Jones and Downs, 2011).
Evidence from other model-based analyses of TNR pro-
grammes showed that while TNVR may be useful if broadly
implemented in closed populations when no animals can
immigrate into colonies (e.g. island settings), it is ineffec-
tive in open populations that more closely resemble most
cat colonies in the United States (Schmidt et al., 2009).
Facing these challenges, many TNVR programmes only
show positive results at temporarily reducing cat numbers
when heavily subsidized by adoptions and assisted by col-
ony cat emigration to other areas (Levy et al., 2003). More-
over, while emigrants do technically reduce the number of
cats living in a particular colony, they should not be inter-
preted as reducing the overall feral cat population. Thus,
unless sterilization is nearly universal and unneutered cats
are prevented from immigrating, colony populations do
not decrease and eventually disappear with time and may
increase in response to supplemental feeding.
Feral Cats and Wildlife
Exotic feral cats can have profound ecological effects on
native species. As an obligate predator, this invasive species
often preys on native wildlife. A study comparing an area
with supplemental feral cat feeding to one without it found
that the area with feeding had reduced abundance of native
rodent and bird populations, illustrating that supplemental
feeding attracts cats without substantially decreasing their
hunting behaviour (Hawkins et al., 1999). When the quan-
titative effects of cat predation have been estimated, results
are striking. One study in the United Kingdom observed
sites where the estimated number of birds killed was greater
than the number ﬂedged for multiple passerine species
(Baker et al., 2008). Despite their ability to affect native
bird and mammal populations, cats do not appear to sig-
niﬁcantly decrease populations of synanthropic pest spe-
cies. Feeding sites do not show decreased populations of
house mice, as access to a constant food source may
increase their populations (Hawkins et al., 1999). The dif-
ference in the effects of cats on native fauna compared with
exotic rodents may be due to their coevolution with foreign
pest species, which made pests better adapted to evasion of
cats (Jessup, 2004). In addition to the risks posed by feral
Fig. 1. Potential interaction between a cat and raccoon. (Credit: Alan
Hopkins).

cats to biodiversity and ecosystems, several wildlife veteri-
narians and scientists question the logic of prioritizing feral
cat welfare over the welfare of native prey animals (Jessup,
2004).
Discussion
Rabies remains an important cause of human mortality
throughout the world, but the effectiveness of control pro-
grammes in the United States may subdue the collective
memory of the significance of rabies. Despite the presence
of enzootic rabies in nearly every state, only a few human
deaths are reported each year in the United States. This
accomplishment is entirely the result of practical, effective
public health policy and education in tandem with appro-
priate animal vaccines and vaccination schedules, use of
PEP and stray animal management.
Unfortunately, most current applications of TNVR pro-
grammes do not provide effective rabies vaccination cover-
age or cat population control. Current NASPHV rabies
recommendations stipulate that all cats, dogs and ferrets be
current on rabies vaccinations. Within feral cat colonies,
even those with TNVR programmes, compliance with
national vaccination recommendations or laws that uphold
them are likely to be impractical. Although most caretakers
provide food for colonies, adequate domestic animal care
also requires prevention of disease and unmitigated breed-
ing. Feeding of feral cat colonies sustains their populations,
and it likely subjects them to increased disease transmission
by increasing cat densities and contact rates at feeding sites
(Hawkins et al., 1999; Jessup, 2004; Cohn, 2011). Trap–
neuter–vaccinate–return does not adequately meet feral cat
population control needs that public health and animal
welfare necessitate.
Feral cat population control should be conducted with
the input of all invested stakeholders such that an effective
and ethically acceptable method for controlling feral cats
and their associated potential public health concerns can be
achieved. One recent study, which modelled costs and ben-
efits for TNVR as compared to trap and euthanize pro-
grammes, found that in all scenarios, trap and euthanize
programmes were less expensive to conduct and had a
higher economic benefit (Lohr et al., 2012). However, that
study found that the relative difference in benefits between
both programmes was reduced as the abandonment rate of
cats in the community increased.
Domestic cats are an important part of American culture
and provide companionship for millions of people. As
such, it is important for public health institutions to take a
science-based stance for effective and humane management
of feral cat populations. While TNVR programmes may be
a component in controlling small populations of cats (par-
ticularly in closed population settings), it should not be
endorsed as an effective approach by itself or as a method
for mitigating health concerns related to feral cat colonies.
Any stance should include objectives that are shown to
reduce the disease burden on both the feral and owned
populations of cats and to lessen the risk of zoonotic dis-
eases, including rabies, to humans. Most importantly, any
programme focused on reducing feral cat populations
should include components to reduce abandonment rates
of cats. It is critical to educate cat owners on responsible
pet ownership including the importance of maintaining a
regular vaccination schedule, keeping records of these vac-
cinations for their cats, restricting their cats from roaming
freely and spaying and neutering to prevent unwanted kit-
tens that will be abandoned rather than adopted to respon-
sible homes. Furthermore, state and local governments will
need to enact or enforce existing animal control laws to
uphold these public health recommendations. In particular,
requirements for rabies vaccination, requirements or incen-
tives to spay or neuter and prohibitions against free-roam-
ing should be applied to cats as they are generally applied
to dogs; they reflect standards of ownership that are appro-
priate for all domestic companion animals. By following
these steps, feral cat populations and associated zoonotic
diseases such as rabies can be better controlled. However,
continued research to establish best practices for develop-
ing and effectively implementing comprehensive cat
population control programmes is warranted.
Acknowledgements
The authors would like to thank Ben Beard, Marta Guerra,
Barbara Knust, Robert Massung, Andrea McCollum, Jenni-
fer McQuiston and Susan Montgomery at the Centers for
Disease Control and Prevention and Steve Holmer at the
American Bird Conservancy for their review and input dur-
ing the writing of the manuscript. The findings and conclu-
sions in this report are those of the authors and do not
necessarily represent the views of the Centers for Disease
Control and Prevention. Allison Roebling is a recent gradu-
ate of the University of Georgia’s dual DVM/MPH pro-
gramme. Her studies focus on zoonotic infectious diseases
including rabies and leishmaniasis.
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Plague-Infected Cat in North ABQ Acres Prompts Warning
By Olivier Uyttebrouck, Staff Writer | April 17, 2017
ALBUQUERQUE, N.M. — The discovery of a plague-infected cat this month in far Northeast Albuquerque
prompted a city health official to warn people not to feed feral animals, and to take precautions against
disease when handling strays.
The cat’s death, after the death of a pet dog from plague in March, has raised concerns about the re-
emergence of plague in North Albuquerque Acres, where the bacterial illness had not been observed
since the late 1990s.
North Albuquerque Acres is in far Northeast Albuquerque, west of Tramway NE, including neighborhoods
both north and south of Paseo del Norte NE.
Mark DiMenna, deputy director of the city’s Environmental Health Department, said city officials have
trapped about 30 stray cats in the area and are testing the animals for plague. Test results were not
complete on Monday.
DiMenna said he doesn’t expect the city to alter its trap-neuter-return program for feral cats in response to
the infected animals.
Under trap-neuter-return, cats living in feral colonies are trapped, sterilized, vaccinated and returned to
the area where they were found.
“We are not trying to leverage this to make any changes” to trap-neuter-return, DiMenna said in an
interview on Monday. “I think the city is pretty committed to this program.”
DiMenna urged groups and individuals who work with feral cats to take precautions, such as wearing
gloves when they handle cats, and seeking prompt treatment for bites and scratches.
He also urged people not to put out food for feral cats, which can attract wild animals, such as skunks and
raccoons, that can carry plague, in addition to predators such as coyotes that prey on cats.
People also need to be aware of symptoms of plague in both cats and people, he said.
Symptoms of plague in cats can include swollen lymph nodes, vomiting, diarrhea, loss of appetite, and
the presence of abscesses, discharge or bloody sputum.
Symptoms of plague in humans include sudden onset of fever, chills, headache, weakness and painful
swelling of the lymph nodes in the groin, armpit or neck areas.
https://www.abqjournal.com/989331/plagueinfected-cat-prompts-warning.html

Tularemia, Plague Cases in NM Pets Are Above Average
By Rick Nathanson, Journal Staff Writer | June 13, 2016
SANTA FE, N.M. — The New Mexico Department of Health has confirmed 10 cases of plague and 19
cases of tularemia in dogs and cats – “higher than average” this year – in multiple counties.
Plague-positive pets have been reported in Los Alamos, Rio Arriba, Sandoval, Santa Fe, Taos and
Torrance counties; while pet positive tests for tularemia have been reported in Bernalillo, Los Alamos,
Sandoval and Santa Fe counties.
Plague and tularemia are bacterial diseases of rodents and rabbits. Human contraction of plague is
generally from flea bites, while human contraction of tularemia is from deer fly bites, Department of Health
veterinarian Dr. Paul Ettestad said Monday. These illnesses also can be transmitted by direct contact with
infected animals, including pets.
Ettestad said the contraction rate of both plague and tularemia this year “is higher than average, but not
on a record pace.” In New Mexico, plague and tularemia are more prevalent in the spring and early
summer.
“We are seeing recent die-offs of rabbits in several areas of New Mexico from both plague and tularemia,”
Ettestad said.
“People can be exposed to plague when pets bring infected fleas back into the home, by caring for a sick
pet without proper precautions, or by contact with rodents or fleas outdoors. Exposure to tularemia can
occur from bites from deer flies or handling infected animals or pets who have been exposed,” he said.
Symptoms of plague and tularemia in humans are similar and include sudden onset of fever, chills,
headache, weakness, swollen lymph nodes and possible infection at the bite site, Ettestad said.
Likewise, he noted, symptoms of plague and tularemia in cats and dogs are similar, and include fever,
lethargy, loss of appetite and possible swelling in the lymph node under the jaw.
The only sure way to distinguish the difference between the two is through laboratory testing, he said.
With prompt diagnosis and appropriate antibiotic treatment, the fatality rate in people and pets can be
greatly reduced.
According to statistics compiled by the Department of Health for 2015, four people in New Mexico
contracted plague, with one fatality in Santa Fe County, and eight cases of tularemia were confirmed, with
no fatalities. There were also 63 confirmed cases of tularemia in dogs and cats in 2015, and 18 confirmed
pet plague cases.
Plague prevention tips
• Keep pets from roaming and hunting.
• Use a veterinarian-approved, animal- and people-safe flea control product on your pets.
• Clear areas near the home where rodents could live, such as wood and brush piles, junk and
abandoned vehicles.
• Place necessary piles of hay, wood or compost as far away from the home as possible.
• Promptly take sick animals to a veterinarian for evaluation.
• Promptly see your physician for unexplained illnesses involving sudden and severe fever.
http://www.abqjournal.com/791345/tularemia-plague-in-pets-higher-than-average.html

1st Human Case of Plague This Year in New Mexico is
Reported
By The Associated Press | June 6, 2017
SANTA FE, N.M. (AP) - The state Department of Health has reported the first human case of plague in
New Mexico this year.
Health officials say a 63-year-old Santa Fe County man is currently hospitalized with the bacterial
disease.
They're conducting an environmental investigation at the man's home to look for ongoing risk and ensure
the health of his immediate family and neighbors.
Health Department staff also is going door-to-door near the man's home to inform them about plague
found in the area and educate them on reducing their risk.
Plague generally is transmitted to humans through the bites of infected fleas, but can be transmitted by
direct contact with infected animals including rodents, wildlife and pets.
So far there have been 10 dogs and five cats with confirmed plague in New Mexico this year.
http://ht.ly/MK6M50bXVAu

April 16, 2012 • State News
ALBUQUERQUE, N.M. (AP) — A rabies outbreak in
Carlsbad has prompted a local shelter to suspend efforts to
trap feral cats.
Volunteers for the program run by the Noah’s Ark Animal
Shelter recently trapped a rabid skunk and learned that it
had tangled with a group of feral cats. The group traps feral
cats in Carlsbad so they can be vaccinated, spayed or
neutered and released back into the wild.
The shelter’s board suspended the program because of the
danger last week.
At least a dozen Eddy County residents have been forced to
get rabies shots this year, and more than 30 pet dogs have
been euthanized because of exposure.
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attempt to protect the people and pets in the community,”
Cary said.
Carlsbad Police Department Lt. Jennifer Moyers said most
of the cats that tangled with the rabid skunk have been
trapped and animal control officers are still attempting to
trap the remaining three cats in the group.
A rabid skunk was also observed with a group of more than
10 feral cats on Canal Street. Moyers said last week that
seven of the cats have been trapped and animal control
officers continue to trap in that area.
Cary said residents are conditioned to “run the other way” if
they encounter a skunk, but their first instinct with a friendly
cat, especially when it approaches a child, is to pet it.
“The only thing that will keep us from having to euthanize
more pets is if every owner in Carlsbad does the right thing
and keeps their animals up-to-date on rabies vaccinations,”
she said.
“If rabies gets a foothold in the huge feral cat population, it
would be extremely dangerous for pets and people,
especially children.”
Each year, about 50 to 70 New Mexicans receive post-
exposure treatment for rabies. But health officials were
alarmed by the concentration of 12 treatments in a single
county in just a couple of months.
The cause of the outbreak appears to be a combination of a
large skunk population and the region’s extended drought,
June 23, 2017 June 21, 2017 June 21, 20
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forcing skunks to look for food in areas where there are
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