Chapter 2: Principles of Disease Control
Overall Control Strategy
2.1 In the event of an outbreak of Rabies, the overall control strategy of the Scottish Government ( SG) will be as is set out in the strategy box below:
Overall Disease Control Strategy
In the event of an outbreak of rabies, the SG will act swiftly and decisively:
- To protect public health
- To eradicate the disease and regain rabies free status
- To safeguard the health and safety of those involved directly in controlling the outbreak
- To minimise any economic impact of the outbreak
It will endeavour:
- To keep to a minimum the number of animals that have to be destroyed, whether for control purposes or to safeguard animal welfare
- To minimise adverse impacts on animal welfare, the rural and wider economy, the public, rural communities and the environment.
It will achieve its objectives by working with the UK Governments, National and local Operational Partners, those directly affected by the outbreak through their representative groups; and where appropriate, international organisations.
2.2 Powers for controlling a rabies outbreak are primarily set out in the Rabies (Control) Order 1974  , which can be used for declaring Infected Places and Areas plus laying down comprehensive procedures for dealing with possible rabies outbreaks. It allows for a number of measures to be applied within the declared place or area including movement and behaviour restrictions (such as requiring muzzles on dogs in public places) and compulsory vaccination of domestic animals. It also allows for an Infected Area to be divided into zones permitting different measures in different places. There are also powers available for the culling of foxes, should that be necessary, in an Infected Area. These measures are explained later in this chapter.
2.3 Other powers available in support of the 1974 Order include The Animal Health Act 1981  which contains provision for introducing government funded vaccination programmes and for the destruction of animals other than foxes.
2.4 The Rabies (Compensation) Order 1976  applies throughout Great Britain and fixes the amount payable in respect of animals destroyed under the Rabies (Control) Order 1974. Compensation is only paid for compulsorily slaughtered animals. Compensation for suspect animals compulsorily slaughtered is paid at the rate of 100% of market value for animals not diagnosed as rabid and 50% of market value for animals which are so diagnosed.
Types of Rabies Outbreak
2.5 Broadly speaking, there are two principal types of incident to be considered:
- rabies is detected and the incident is deemed to be contained, e.g. in quarantine facilities
- rabies is detected and the index case cannot be established.
2.6 In the latter, it is important not to discount the possibility that the virus has become established in wildlife. In both situations however, it is crucial to urgently establish the suspect animal’s recent contact history within Great Britain.
Phases of a Rabies Outbreak
2.7 The phases of a rabies outbreak may be divided into:
- Suspicion of Rabies – pre-confirmation
- Confirmation that rabies exists (or negation)
- Preventing Disease Spread
- Determining and implementing a rabies outbreak control strategy
- Determining and implementing a rabies outbreak exit strategy
- Returning to normal business.
Suspicion of rabies – pre confirmation
2.8 There is a legal duty on any person who knows or suspects that an animal is suffering from rabies or had died from the disease, to report this to the Local Authority ( LA), the local Animal and Plant Health Agency (APHA) office or the Police under article 4 of the Rabies (Control) Order 1974. The contact details for the APHA Field Services offices in Scotland are listed at Appendix 3.
2.9 On report of suspicion of rabies, APHA Field Services will be notified and will arrange for an investigation by an APHA Veterinary Inspector ( VI) under article 6 of the Rabies (Control) Order 1974. For this purpose, the VI has power to enter premises (including dwelling houses), to order the destruction of suspect animals, to remove those animals or animal carcases for veterinary investigation and to take diagnostic samples.
2.10 While APHA will make every effort to arrive on the premises to investigate reports of rabies as soon as practically possible, if it is dark and there is inadequate light it may be necessary to postpone the investigation until first light for practical as well as health and safety reasons. Under these circumstances the owner of the premises will be instructed, where it is safe and possible, to isolate the suspect animal and be made aware of the public health implications of the situation.
2.11 There is a duty on the occupier of any premises on which there is a suspicion of rabies to be fully co-operative during any investigation under Article 6 (3) and (4) of the Rabies (Control) Order 1974. This includes assisting with the inquiry and supplying any necessary information (including movements of the animal in question).
2.12 In carrying out the investigation, decisions as to how to proceed will be taken by the VI following consultation with the APHA Veterinary Exotic Notifiable Disease Unit ( VENDU). The VI will not commit to a particular course of action until instructed by VENDU. If disease cannot be ruled out the possible options for dealing with the animal are:
- detain and isolate the animal until it dies or requires euthanasia on welfare grounds, when samples should be submitted for testing; or
- detain and isolate the animal until it has survived long enough to indicate that it was not infected with rabies when originally detained as a suspect. VENDU will advise on the period, (usually a minimum of 15 days) and place of detention. This could be either the owner's premises (in which case the CPH(M) would be consulted) or more likely, at the nearest available isolation facility for rabies suspects
- immediate euthanasia and submission of samples to laboratory.
2.13 Human Risk . Where a person has been bitten or scratched by the suspect, it is essential to make the earliest possible diagnosis in the suspect animal to allow rapid effective treatment of the person. The VENDU decision will take account of the opinion of the Consultant in Public Health Medicine ( CPH(M)). Euthanasia of the suspect and submission of its head and neck to Animal and Plant Health Agency’s ( APHA) Weybridge laboratory would secure a provisional diagnosis within 48 hours, whereas detaining and isolating the animal might mean a period of uncertainty for the person of up to 15 days.
Confirmation of disease
Chief Veterinary Officer ( CVO) Scotland Actions pre-confirmation
Case Conference Call. When a suspect case in Scotland is first identified from either clinical inspection or preliminary test results CVO Scotland and CVO UK would discuss the situation. The CVO UK would then call a relatively small case conference to consider the known circumstances and to determine next steps. Such meetings would likely be chaired by the CVO from the affected administration. Attendees would usually comprise the CVOs from all 4 UK administrations and key policy and veterinary officials from each UK agricultural department. In particular, this meeting would determine whether the circumstances warranted triggering an Amber Teleconference.
Amber Teleconference. If suspicion of disease is strong and cannot be ruled out on clinical grounds, an Amber Teleconference will be organised and supported by Defra's Exotic Disease Policy Response Team, although the Scottish Government will be responsible for inviting Scottish operational partners. This involves the CVOs, policy and veterinary officials from each administration together with a range of attendees who would have a role in the outbreak, including other Government Departments, Agencies and operational partners. The purpose of the teleconference is to inform participants of the situation, to assess the risk and to agree on next steps.
At the Amber teleconference, for disease in Scotland, CVO Scotland would either agree to confirm disease, (raising the alert status to Red) or specify what further evidence, such as test results, would be needed. In the latter circumstance, the Amber Teleconference would be reconvened when further information was available.
Once the samples have been submitted to the reference laboratory it may take up to 48 hours to confirm or negate disease. CVO Scotland has responsibility for confirming disease in Scotland (on the basis of the VI report and laboratory results).
The period between suspicion and confirmation of rabies will be used by the Scottish Government to activate the contingency plan and make initial preparations to increase disease management resources if required. CVO ( UK) will be responsible for notifying confirmation to the European Commission and the OIE.
2.14 No samples are taken from a live animal for rabies diagnosis. If the suspicion of rabies cannot be ruled out in a live animal and following discussion with VENDU the decision is made to submit samples, the suspect animal must be euthanased. VENDU will instruct as to sample submission but it would be normal for whole carcase to be submitted. Post mortem examinations, including the removal of the head and neck, are not to be undertaken under field conditions. Bio safety level 3 containment facilities must be used for all post mortem examinations.
2.15 Rabies can only be confirmed by laboratory testing on the brain after death. Results can usually be delivered within a few hours. Slower laboratory tests taking around 2-3 days will also be used to confirm earlier results and identify the serotype (viral strain). When results are negative for a suspect case, all contact animals will continue to remain in isolation until further results of more sensitive tests are available, usually within 2-3 days.
Preventing disease spread
Restrictions on premises
2.16 The first step in the control of a possible outbreak is containment of the suspect animal. Restrictions are placed on suspect premises by serving a legal notice on the owner/occupier of the premises to declare it an “Infected Place” under article 5 of the Rabies (Control) Order 1974. An “Infected Place – Notice of Restriction (EXD 1 (RAB))” can be served by a VI from the APHA, an Inspector from the APHA or by an Inspector from a LA. The notice is set out in the form required under schedule 2 to the Rabies (Control) Order 1974. It will be served where there are reasonable grounds to believe that rabies exists or has, within the preceding 56 days, existed at a premises.
2.17 Such a notice may be served at any time by the designated individuals as long as the requirements under article 5 are met; this includes prior to the investigation by a VI. The notice restricts movement of animals, animal carcases, people, vehicles and most other things on the premises except under the terms of a licence. Before the notice is served, the owner/occupier will be instructed not to move anything off the premises. The purpose of the notice is to contain and isolate the virus. It must be noted that if there are no animals or animal carcases at a premises it is unlikely that an “Infected Place” will be declared.
2.18 The rabies virus cannot live for long outside the body of its host and is destroyed by contact with common household detergents. However, by law you must use an approved disinfectant  where there is an outbreak of a notifiable disease and for rabies you should use disinfectants that are approved under the General Orders list. Premises need only be considered infected until the infected animal has been removed or destroyed and the property has been disinfected and any other animals on the premises have been quarantined and/or destroyed. Animals must not be moved onto the infected premises unless the move is specifically licensed. No animal will be removed from an infected premises unless exception licence is issued or to a designated facility for observation or for humane destruction. See Appendix 4 for further details as to licensing.
2.19 Once the presenting case and all contact animals have been removed from the premises, the infected premises declaration may be lifted by service of a notice by a Veterinary Inspector from APHA, or the controls applied to the premises varied as appropriate to the continuing conditions. Animals remaining on the property would remain under quarantine until further direction from the CVO.
2.20 If, following the investigation, the VI does not suspect disease then the restrictions will also be removed by serving an “Infected Place – Notice Revocation (EXD 5 (RAB))” as above.
2.21 The Veterinary Inspector will also try to establish provisionally the extent to which the animal may have infected or been infected by unknown animals. If the animal has been at large since the onset of clinical signs or in the 15 days before their onset, this may indicate the necessity of preparing wider control measures as it will be impossible to establish all the animal’s contacts in that period.
2.22 Similarly, if the animal has or could have been in contact with wildlife during this period it may be necessary to activate the ‘ Scottish Government’s Rabies Wildlife Control Plan’  in order to begin managing the potential risk of establishing a sylvatic cycle in wildlife.
2.23 A contact animal is one which has been in contact with a suspect or confirmed case but is not exhibiting clinical signs of rabies. A contact animal could remain healthy for a period of weeks or less commonly, months while potentially incubating the disease. This creates significant problems for an owner who could be required to keep the animal isolated for this length of time. For this reason, or because they are uncomfortable with the risk to their own or their family’s health, an owner may decide to have a contact animal humanely destroyed.
2.24 If any contact animals are to be left on the owner’s premises, the Veterinary Inspector must be assured that the owner can guarantee that the animals will not come into contact with any other non-exposed animals. If the initial suspect animal is confirmed positive for rabies then the animal’s quarantine may need to continue for a lengthy period of time. Alternatively, the Veterinary Inspector may decide that the premises are not suitable for this purpose and detain the animals, either placing them in isolation or requiring them to be humanely destroyed. Any high risk of infection, for example where the contact animal has been bitten by a suspect animal, will make humane destruction more likely.
2.25 Where a contact animal has bitten a human, it will be required to be humanely destroyed in order to allow confirmatory testing for rabies to be done.
Determining and implementing a rabies outbreak control strategy
2.26 The use of wider measures to control the spread of rabies, even in cases where it seems unlikely that an animal has been in a position to infect others, is very likely to be instigated given the serious nature of even a small risk of rabies. Measures will be focused on containing and eradicating the disease quickly to protect public and human health and to prevent the disease from becoming established in any animal population. Without rapid and proportionate controls being applied, it is highly likely that a rabies outbreak would lead to the disease becoming endemic in wildlife and potentially the domestic pet population in the UK, based on the experience of other countries.
2.27 Control measures will begin immediately upon suspicion, though the results of laboratory testing and a detailed history may be needed to identify whether wildlife measures are necessary in addition to those for domestic animals. Control measures for wildlife are considered separately in the ‘ Scottish Government’s Rabies Wildlife Control Plan’. 
2.28 There are various standard control measures that could be used in an outbreak, depending on the severity of the incident and the likely spread of the disease. Whilst each outbreak will have its own specific circumstances we can assess the potential application of these measures based on the experiences of other countries and our own scientific, veterinary and practical expertise.
2.29 There is a large range of possible scenarios for a rabies outbreak or incident, from a contained case of an individual pet animal, to the highly unlikely worst case of a nationwide outbreak involving both wildlife and domestic animals. To determine the type of controls that might be appropriate under different circumstances, possible scenarios along this spectrum have been considered, whilst recognising that each case will have to be dealt with individually. Under all scenarios effective communications will remain vital to ensure the public are appropriately informed about the risks and mitigating actions.
2.30 It is anticipated that the most likely scenario for a rabies incident will be an individual infected pet. This is likely to be identified quickly with its source of infection/exposure history capable of being rapidly ascertained (i.e. through recent travel history). In this scenario, the control and containment measures required would be very restricted and localised, likely to be limited to the infected animal and any other pets that had direct contact (for example those in the same house). It is envisaged that containment and control should be quickly achieved and that there would be no subsequent infections.
2.31 If disease were to spread to other domestic animals, either within the same locality or more widely across the country, then a wider range of controls would be required. For example leashing/muzzling or vaccination of pets at risk. In the unlikely circumstance that the disease spreads into wildlife, a broader range of wildlife controls would be instigated alongside tighter restrictions on movements of domestic pets, and requirements for vaccination, muzzling and leashes.
2.32 A range of the potential activities to be undertaken are outlined briefly here, but the specific measures taken will be dictated by the circumstances of an individual incident or outbreak, following advice from rabies experts. Decisions on the use of control measures in an outbreak will need to take into account the public health risks and the relative costs and benefits and effectiveness of the options. The possibility of a rabies outbreak in the UK is very low, and if an outbreak did occur it would in all likelihood be very limited in terms of scale and impact.
2.33 If a rabies case in the UK is confirmed, tracing all animals that have been in contact with the case will be essential. Animal contact tracing investigations are the responsibility of the GB National Emergency Epidemiology Group ( NEEG). Rapid and effective control will depend on establishing whether the first case found is the first in the country and to what extent there has been opportunity for further spread.
2.34 The most likely point of entry of the rabies virus into the UK is a dog or other animal imported illegally into the country. Rabies is unlikely to enter the UK via legal route due to the EU rules on pet movements. This could pose additional challenges for the NEEG, as involvement in illegal activity may make an owner or importer less cooperative. This may require the NEEG to work closely with law enforcement and/or customs officials to establish the source of the outbreak.
2.35 Alternatively, if a stray or wild animal presents with rabies, tracing where it has come from may be very difficult. Both of these scenarios would therefore make wider control measures more likely.
2.36 In a case where rabies first presents in a domestic animal, the NEEG will be working to identify all contact animals. Contact animals can be considered as being either high risk (which might include definite contact with the suspect animal, evidence of biting or wounds, changed behaviour combined with no previous vaccination against rabies) or low risk (an animal that has had possible but unconfirmed contact with the suspect case, or shows no evidence of behavioural changes or biting or wounds which may be combined with a previous vaccination against rabies).
2.37 If the animal has been unsupervised at any point during the possibly infectious period, or in the scenarios mentioned above, surveillance of the wider animal population may be instigated. Notification provisions in Provision VIII of Schedule 3 to the Rabies (Control) Order 1974 could be of assistance here – in order to require the notification of the death of animals. Raising awareness of the possibility of infected animals would also be necessary in order that people could report uncharacteristic behaviour. This would form an important part of the communications strategy and would be led by the Disease Strategy Group ( DSG).
2.38 If the assessment of risk posed by/to the wider animal population is low to medium, then domestic and wild animals routes, pathways and corridors will be put under surveillance for any signs of the disease spreading. If the risk is deemed to be high then the domestic animals (that may have had contact) and foxes found along routes pathways corridors can be humanely destroyed / euthanased under rule 5 of article 7, provision IV of Schedule 3 and article 10 of the Rabies (Control) Order 1974.
Declaring an Infected Area
2.39 The Rabies (Control) Order 1974 allows Scottish Government ( SG) to impose a number of restrictions on movement, premises, gatherings and actions through declaring infected areas. An Infected Area is declared by virtue of a Declaratory Order. The Order itself is a Scottish Statutory Instrument ( SSI) and will need to be expressly revoked when the restrictions are no longer needed. How far these powers are utilised would depend on the nature of the outbreak. Circumstances which might make utilising these stronger powers more likely include:
- Outbreaks where more than one case of rabies is identified with no clear link between them
- Outbreaks that are located in the wildlife population or may have spread into wildlife
- Cases where there is the potential that the infected animal may have infected further unknown animals
- When there is evidence to suggest potentially infected animals may have been imported but are not identified as yet.
2.40 Whether to declare an Infected Area, along with which measures to impose, will be a decision taken by the CVO Scotland.
2.41 The potential length of time that any controls need to be in place in order to be effective will also have to be considered, given the long incubation period for rabies and the difficulties for pet owners in adhering to some of the possible restrictions, with implications for effectiveness and for welfare (for example, not allowing pets off the lead, not moving them in or out of the Infected Area).
2.42 Factors that will have a bearing on the Infected Area will also include geographical location, species affected, strain, possible contacts, human risk and exposure to wildlife. The Infected Area may be divided into separate zones in which different control measures apply. The size of the zones and the measures to be enforced within them will again be determined by the DSG. If no zones are specified in the Declaratory Order then the entire Infected Area is considered a single zone.
2.43 The type of restrictions that could apply within an infected area are the banning of animal gatherings, the muzzling of dogs, the leashing of dogs, the requirement for restrictions on the movement of animals within the Infected Area and the compulsory vaccination of pets.
2.44 The species to which the Infected Area Order can apply are listed at schedule 1 of the Rabies (Control) Order 1974. In some circumstances, there may be no requirement to declare an Infected Area. For example, where the suspect/confirmed rabies case has had no contact with other rabies susceptible animals.
2.45 Rabies is considered a disease for the purposes of section 32 of the Animal Health Act 1981. This empowers the destruction of animals which are suspected or confirmed rabies cases. Owners of any animals destroyed in this way are entitled to seek compensation. Compensation is only paid for compulsorily slaughtered animals. Compensation for suspect animals compulsorily slaughtered is paid at the rate of 100% of market value for animals not diagnosed as rabid and 50% of market value for animals which are so diagnosed.
2.46 Rabies vaccine for domestic animals is one of a range of treatments available via veterinary surgeons and there are no restrictions on pet owners who want to vaccinate their pets against rabies pre-emptively and according to Data Sheet recommendations. Pets that have travelled to the UK under the Pet Travel Scheme must have been vaccinated  against rabies.
2.47 Decisions are required during the early stages of each rabies incident or outbreak which determine whether to advise or require vaccination, the area a vaccination programme should cover and monitoring vaccine uptake if applicable. The use of vaccination as a control measure is likely to increase in outbreaks in which disease may not have been contained or where the disease is suspected to be in the wildlife population. Conversely, vaccination is less likely to be deployed in minor or localised incidents. When a decision is taken to use vaccination, government can act to ensure that the supplies of vaccine and the resource needed to carry out a vaccination campaign will be focused on where they are needed most.
2.48 Practical issues that would also need to be considered are:
- Supply: Control via vaccine would be slow due to the lag time in (a) vaccine production and (b) immunity development following vaccination. Replenishment of the UK supply of rabies vaccine is likely to be quite slow and therefore there is a delay in achieving control through vaccination of dogs and cats. This is however mitigated by the comparatively slow dissemination of rabies due to its long incubation period and the limited ways in which it can transmit
- Enforcement: The DSG may decide that the particular circumstances of an outbreak may necessitate the need to target vaccination in a specific area and to make uptake compulsory. Any compulsory measures would require declaring the area where measures are to be imposed in an Infected Area. It should not be necessary to make vaccination compulsory if local communications are utilised to explain the risks associated with rabies and the benefits of vaccination to pet owners. This will also avoid the enforcement issues likely to be experienced by local authorities and local law enforcement officers should vaccination be compulsory. APHA would liaise with private vets within the designated area to ensure and monitor local take-up. Domestic animals that have been vaccinated should be visibly identified by a tag or similar, possibly in addition to micro chipping
- Costs: The costs associated with a vaccination campaign (including procurement and distribution) would need to be met. DSG would need to make an early decision about whether these costs should be met by Government or pet owners and the incentives and impacts of the alternatives.
2.49 Section 16 of the Animal Health Act 1981 provides that for the purpose of preventing the spread of disease the Scottish Ministers may vaccinate any animal which has been in contact with a diseased animal, exposed in any way to disease or is in an infected area. Article 3 of the Rabies (Control) Order 1974 extends the definition of disease in the Animal Health Act 1981 to include rabies which means Section 16 can be engaged to control the spread of the rabies through vaccination, should this be adopted as a strategy.
2.50 The main objective is to establish the index (first documented) rabies case for an outbreak and to stop any routes of spread. A veterinary enquiry may be carried out on the first confirmed case in an attempt to find out how it became infected. If this is possible then it will provide a valuable source of information in the back-tracing process.
Destruction and detention
2.51 Any domestic animal that is suspected as having been infected by rabies will be humanely destroyed. Under exceptional circumstances animals suspected of being infected may be detained in quarantine rather than destroyed depending on their condition, welfare needs and a veterinary assessment.
2.52 Restrictions on the movement of pet animals could be introduced once an Infected Area has been established. Movement restrictions could mean either confining animals to their owners’ premises or controlling the movement of pets in and out of an Infected Area.
2.53 Restricting pets to the owner’s home and garden should be considered as a possible control measure under any rabies outbreak scenario. For minor or localised incidents such controls may not be viewed as proportionate given the challenges that pet owners will face in meeting the longer term welfare needs of the animal. Enforcement of these controls will require a significant commitment of local authority time and resources. For more significant incidents or a wildlife outbreak, such restrictions are more likely to be imposed.
2.54 Restricting movement in and out of an Infected Area presents particular logistical and practical issues but is an option that will need to be considered at each stage of an outbreak.
2.55 The use of behavioural restrictions will be determined depending on the particular circumstances of an outbreak but should be proportionate and practical. The key behavioural restrictions that could be enforced in an Infected Area are:
- Leashing: Requiring dogs to be on leads at all times when not on their owners’ premises
- Muzzling: Requiring dogs to be muzzled when outside their owners’ premises.
2.56 As with other control measures, the use of these restrictions is likely to increase in line with the severity of the incident, the number of cases and their geographical locations and/or if there is a wildlife element to the outbreak. These restrictions could simply be encouraged through communications activities, or could be required and enforced as part of an Infected Area. The use of leads could be implemented almost immediately under any outbreak scenario as almost all dog owners have leads for their dogs. Not all dog owners own muzzles so Government would need to consider how these could be obtained and distributed if the use of muzzles were considered an appropriate control measure.
2.57 Animal gatherings within a declared Infected Area could be banned under the provisions of the Rabies (Control) Order 1974. However, the only way to ban a dog or cat show taking place elsewhere in the country under the terms of the Order would be to extend the Infected Area to include this location. Given practical and presentation challenges of extending the Infected Area, banning such gatherings is likely only to be considered a proportionate response in major outbreaks or where there is a risk that the disease could be spread by infected wildlife. If a scheduled animal gathering fell within a localised Infected Area then there is a high likelihood that it would be banned under the Infected Area declaration.
2.58 The alternative to banning an animal gathering would be to require dog and cat shows to be licensed which would allow shows to go ahead with certain restrictions such as requiring all participating animals to be vaccinated prior to the gathering and housed separately.
Control of Stray cats and dogs
2.59 The control of stray cats and dogs is the responsibility of the local authority and is necessary to prevent stray or uncontrolled animals becoming a reservoir for the disease. Local authorities also have the power to seize animals (as do the police) if the owner fails to comply with any control provisions. All reasonable costs incurred by the local authority in seizing, detaining, destroying and disposing of these animals, as appropriate, are recoverable from the owner where known. The requirement for compulsory micro chipping of dogs should help identify dog owners in such cases. Local authorities will need to locate detention facilities within their area and both APHA and SG will need to be informed via the LDCC of the location of these detention pounds. Local authorities have implementation plans for dealing with rabies outbreaks that will include identifying potential holding areas for stray animals. They should work closely with animal welfare shelters on monitoring of stray animals and when considering options for control.
2.60 The enforcement of these controls would require a significant commitment of local authority time and resources so the likelihood of using this control method would increase in line with the severity of the incident. If an animal from the stray population presents with rabies, then the control of stray animals will be an essential disease control measure.
2.61 An important control measure in all scenarios is informing the public and raising awareness, particularly among veterinarians and pet owners. The ‘ Scottish Government's Exotic Animal Disease Communication Strategy’  will form the generic basis for a strategic approach.
2.62 Reporting of the Disease: Rabies is a notifiable disease in animals and humans. Communications encouraging reporting of suspicion of the disease will need to be developed in conjunction with the relevant local authority and key stakeholders. An increase in reporting of possible cases is likely as soon as an outbreak is declared, as vets adjust from a scenario where clinical signs are unlikely to arouse suspicion, to a position where clinical signs could indicate the disease.
2.63 A helpline will be set up for members of the public to report either wild or domestic animals behaving strangely or biting incidents. This could be a national or local helpline, depending on the scale of the outbreak.
Guidance on processing personal information
2.66 Reporting of Bites: Until the extent of an outbreak is known, all animal bites received by pets or the human population within the designated area will need to be treated as potentially infected and will need to be reported as quickly as possible to a vet or doctor. Communications campaigns reinforcing this message will need to be undertaken by local authorities and stakeholders in conjunction with SG. HPS would be responsible for human health aspects of bites.
2.67 Further information and guidance on post exposure treatment is available on the NHS ‘Choices’  website and also contained within the Health Protection Network - ‘ Rabies: Guidance on Prophylaxis and Management in Humans in Scotland’. 
Determining the source of the outbreak
2.68 Initially, there will be great uncertainty about the origin of the disease and APHA staff will try to determine the index case. In order to do this they will back-trace the actual and potential movement of animals. To effectively carry out their duties in this regard they will be dependent on the full co-operation of the individual’s involved and good intelligence. A veterinary risk assessment will be carried out by the APHA to assess the likelihood of spread of rabies by these routes to other animals. Visits will be made to those premises that are identified. Animals on those premises will be examined and attempts will be made to identify which, if any, of those animals is the index case. If there is reasonable suspicion that rabies exists on the premises then it will be declared an “Infected Place” and routes of spread from and to it will be investigated.
2.69 Under article 7, rule 8 of the Rabies (Control) Order 1974 provides that every part of an Infected Place will be disinfected by the occupier in a manner approved by a Veterinary Inspector from the APHA, an Inspector on behalf of the APHA or by an Inspector from a LA. By law you must use an approved disinfectant  where there is an outbreak of a notifiable disease and for rabies you should use disinfectants that are approved under the General Orders list.
Determining and implementing a rabies outbreak exit strategy
2.70 Determining a workable exit strategy to restore Scotland and the rest of the UK to rabies free status is crucial when considering how to approach an outbreak and must be at the forefront of any plans that are put into action. In accordance with the OIE Code  the period of time allowed to lapse between the end of the surveillance period and declaring the UK to be rabies free is currently two years. During this time there must be no further cases of the virus for rabies free status to be restored. Deploying a vaccination programme as a control method may prolong the time between the suspicion and exit stages. This is because the surveillance period to prove the UK is rabies free will be extended every time another confirmed case is found until no further cases are confirmed.
2.71 Once an outbreak has been confirmed to the EU the Commission will decide about any trade restrictions that may be applied to the UK.
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