Describing the Rabies Management System in an Ontario Municipality: A Mixed Methods Study of Human and Companion Animal Health Outcomes

Abstract

Rabies management can be described as successful only if examined through a human health perspective. Negating companion animal health outcomes in rabies management creates systemic failures as cats and dogs are significant within our society and bridge humans and wildlife in rabies transmission. A shifting pet ownership culture has created opportunities for increased rabies risk. This thesis applied the One Health concept to the rabies management system in an Ontario municipality. The One Health concept considers that the health of humans is inherently connected to the health of companion animals and their shared environment. A mixed methods design informed a visual conceptualization of the rabies management system. Factors influencing human and companion animal health outcomes were identified through multivariable logistic regression models. The human outcome of interest was the recommendation of rabies post-exposure prophylaxis after a potential rabies exposure by a companion animal; the companion animal outcomes were receiving a post-incident rabies vaccine, being euthanized for rabies testing and being placed under observation. Semi-structured interviews were conducted with private veterinarians to understand their perceived role in rabies management. Rabies management is more complex than linear interactions and processes that occur to protect human health. An explicit link between the human and companion animal health outcomes was found. Companion animal species appeared as an influential factor and indicates that ownership practices differ between cats and dogs. This implies that veterinarians are not effectively leveraged as the link between public health and pet owners. Indeed, veterinarian’s approach their rabies management roles based on their prioritization of the seriousness of rabies compared to the risk. Through the application of One Health thinking to the municipal rabies management system, it is clear that there is a public-private divide where mitigating human rabies exposures conflicts with the prevention of rabies in companion animals.