Rabies post-exposure prophylaxis (PEP) can prevent fatal encephalitis associated with exposure to the rabies virus. However, overuse and inappropriate administration of rabies PEP are common.1 Mandatory reporting of potential rabies exposures provides opportunities for public health practitioners to monitor the appropriateness of PEP administration and offer recommendations. In Illinois, potential human exposure to rabies, including any person started on PEP and any person with contact to a bat, must be reported to the local health authority. Previous investigations into the completeness of rabies reporting have concluded that active surveillance in addition to mandatory reporting may be useful.2 As rabies PEP is often given in an emergency department setting, syndromic surveillance records may provide a basis for estimating completeness of reporting and identifying candidates for active surveillance follow up.
Objective
To determine whether unreported cases of potential human exposure to rabies can be detected using an emergency department (ED) syndromic surveillance system and to assess both reporting completeness and compliance with clinical guidelines related to rabies exposures in suburban Cook County.