Anatomy of the Cape Cod Oral Rabies Vaccination Program

Rabies remains a globally significant zoonotic disease, but rabies control is achievable under certain circumstances. Canine rabies has been eliminated from the U.S.; however, approximately 55,000 humans die annually worldwide from the disease. In the U.S., economic losses continue to be substantial and the risk to humans and domestic animals has not been eliminated. As an example of the complexity of rabies management, we describe a local rabies control program and efforts to restore Cape Cod, MA to terrestrial rabies-free status, after a 2004 oral rabies vaccination (ORV) barrier breach following 10 years of rabies-free status. The emergence of raccoon rabies in southeastern New England in 1992 prompted the U.S. Centers for Disease Control and Prevention, the Tufts Cummings School of Veterinary Medicine, and the Massachusetts Department of Public Health to begin an ORV program to reduce the occurrence of carnivore rabies in an area directly adjacent to the Cape Cod Canal. In 2001, USDA APHIS Wildlife Services began full-time collaboration on the Cape Cod Oral Rabies Vaccination Program (CCORVP) as part of national wildlife rabies control efforts. The primary objective of the CCORVP was to use ORV in tandem with the physical barrier created by the Canal to prevent the spread of rabies to peninsular Cape Cod, a heavily-populated tourist destination southeast of Boston. After an increase in rabies cases within the traditional Cape Cod ORV zone, ORV bait distribution efforts were modified to reduce the risk of rabies spread onto the Cape. In spite of these modifications, raccoon rabies was detected for the first time on peninsular Cape Cod in March 2004. A trap-vaccinate-release campaign, removal of suspect raccoons and skunks, and expanded ORV efforts were unsuccessful in preventing the spread of the virus. Rabies surveillance became the priority of the Cape Cod Rabies Task Force. In 2006, rabies was finally detected at the eastern extremity of the peninsula. In this paper, we summarize ORV efforts, explore possible causes for the spread of raccoon rabies onto the Cape, summarize several small-scale Cape Cod rabies research projects, and suggest a 5-year plan for future Cape Cod rabies controls efforts