HUMAN RABIES RISK MITIGATION

UNCLASSIFIED//

ATTENTION INVITED TO  

ROUTINE

R 282020Z OCT 11 PSN 301232H11

FM CNO WASHINGTON DC

TO NAVADMIN
ZEN//OU=DOD/OU=NAVY/OU=ADDRESS LISTS(UC)/CN=AL NAVADMIN(UC)

INFO ZEN/CNO WASHINGTON DC

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***THIS IS A 2 SECTION MESSAGE COLLATED BY OIX GATEWAY HONOLULU HI*** QQQQ

SUBJ: HUMAN RABIES RISK MITIGATION
UNCLASSIFIED/
PASS TO ALL OFFICE CODES:
FM CNO WASHINGTON DC//DNS//
TO NAVADMIN
INFO CNO WASHINGTON DC
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NAVADMIN 324/11

MSGID/GENADMIN/CNO WASHINGTON DC/N093/OCT//

SUBJ/HUMAN RABIES RISK MITIGATION//



REF/A/MSGID:DOC/CENTCOM GENERAL ORDER NO 1B/YMD:2006MAR13//

REF/B/MSGID:DOC/MOD TEN TO USCENTCOM INDIVIDUAL PROTECTION AND INDIVIDUAL UNIT 
DEPLOYMENT POLICY/YMD:2010MAR05//

REF/C/MSGID:DOC/BUMEDINST 6230.15A/YMD:2006SEP29//

REF/D/MSGID:DOC/BUMEDINST 6220.13/YMD:2004MAY28//

REF/E/MSGID:DOC/SECNAVINST 6401.1B/YMD:2006SEP29//

REF/F/MSGID:DOC/CENTERS FOR DISEASE CONTROL AND PREVENTION 
(CDC)/YMD:2010MAR19//

NARR/REF (A) IS CENTCOM GENERAL ORDER NUMBER 1B (GO-1B) PROHIBITING ADOPTION, 
CARING FOR, OR FEEDING ANY TYPE OF DOMESTIC OR WILD ANIMAL. REF (B) IS MOD 10 
TO CENTCOM PROTECTION AND DEPLOYMENT POLICY HIGHLIGHTING LOCAL ANIMAL DISEASE 
RISK AND ORDERING DEPLOYED PERSONNEL TO AVOID CONTACT WITH LOCAL ANIMALS. REF 
(C) IS BUMEDINST 6230.15A, IMMUNIZATION AND CHEMOPROPHYLAXIS, PROVIDING POLICY 
ON PRE-EXPOSURE PROPHYLAXIS AS WELL AS POST EXPOSURE RABIES VACCINATION.
REF (D) IS BUMEDINST 6220.13, RABIES PREVENTION AND CONTROL, PROVIDING POLICY 
ON ENSURING STANDARD PROCEDURES EXIST FOR THE INVESTIGATION, EVALUATION, 
TRACKING, FOLLOWUP, AND MANAGEMENT OF ANIMAL BITES. REF (E) IS SECNAVINST 
6401.1B, VETERINARY HEALTH SERVICES, PROVIDING POLICY ON RABIES CONTROL. REF 
(F) IS CDC PUBLICATION MORBIDITY AND MORTALITY WEEKLY REPORT (MMWR), USE OF A 
REDUCED (4-DOSE) VACCINE SCHEDULE FOR POST-EXPOSURE PROPHYLAXIS TO PREVENT 
HUMAN RABIES, RECOMMENDATIONS OF THE ADVISORY COMMITTEE ON IMMUNIZATION 
PRACTICES, VOL 59:
NO RR-2, 19 MAR 2010.//
POC/CDR ROBERT LIPSITZ/BUMED/M3C1/LOC: WASHINGTON DC/TEL:
COMM 202-762-3495/TEL:DSN 762-3495//
POC/CDR WILLIAM PADGETT/HQMC(HS)/LOC: WASHINGTON DC/TEL:COMM 703-614-4477/TEL 
DSN 224-4477//

RMKS/1. PURPOSE. THIS NAVADMIN REITERATES EXISTING FORCE HEALTH PROTECTION 
RABIES CONTROL POLICIES AND PROCEDURES.

2. BACKGROUND.
A. IN AUGUST 2010, AN ARMY SOLDIER SUDDENLY DIED OF RABIES AFTER BEING BITTEN 
BY AN AFGHANI DOG 6-12 MONTHS EARLIER. THIS TRAGIC LOSS IS A GRIM REMINDER 
THAT SAILORS AND MARINES GOING INTO HARMS WAY FACE DANGERS BEYOND KINETIC 
COMBAT. THE SUBSEQUENT INVESTIGATION IDENTIFIED THAT SERVICE MEMBERS HAD 
ADOPTED LOCAL ANIMALS AS PETS, UNITS AND INSTALLATIONS HARBORED LOCAL ANIMALS, 
SERVICE MEMBERS FAILED TO COMPLETE POST-EXPOSURE RABIES VACCINE REQUIREMENTS, 
AND OTHER PERSONNEL SUFFERED INJURIES CAUSED BY ANIMALS THAT WERE NOT REPORTED 
OR DOCUMENTED.
B. RABIES IS A REAL AND DEADLY THREAT TO PERSONNEL. ALL LOCAL ANIMALS, 
PARTICULARLY DOGS AND BATS, SHOULD BE VIEWED AS POTENTIALLY RABID. ANIMALS 
OFTEN APPEAR HEALTHY WHILE CARRYING THE RABIES VIRUS, ENABLING A SEEMINGLY 
LOYAL ANIMAL TO SPREAD THE DISEASE TO HUMANS. ONCE SYMPTOMS OCCUR, RABIES IS 
FATAL, BUT TIMELY MEDICAL EVALUATION AND COMPLETE TREATMENT AFTER AN ANIMAL 
INJURY IS HIGHLY EFFECTIVE AT SAVING LIVES.

3. FORCE HEALTH PROTECTION POLICY MUST BE EXECUTED CORRECTLY AND INJURIES 
CAUSED BY ANIMALS REPORTED IMMEDIATELY TO ENSURE THE SAFETY AND WELL-BEING OF 
PERSONNEL. COMMANDERS MUST ENFORCE FORCE HEALTH PROTECTION POLICIES FOR THEIR 
AREAS OF RESPONSIBILITY (AOR), INCLUDING REFS (A) AND (B) WHEN OPERATING IN 
THE CENTRAL COMMAND (CENTCOM) AOR, MANDATING AVOIDANCE OF CONTACT WITH LOCAL 
ANIMALS AND IMMEDIATELY REPORTING INJURIES DUE TO ANIMALS. UNREPORTED INJURIES 
CAUSED BY ANIMALS THAT OCCURRED WITHIN THE PAST 18 MONTHS MUST BE IDENTIFIED 
AND EVALUATED BY PROPER MEDICAL OFFICIALS TO ENSURE PROPER TREATMENT IS 
PROVIDED, IF REQUIRED.

4. EXECUTION
A. PRE-EXPOSURE RABIES PROPHYLAXIS. PER REF (C), PRE-EXPOSURE IMMUNIZATION IS 
REQUIRED FOR PERSONNEL OCCUPATIONALLY AT RISK OF EXPOSURE TO RABID ANIMALS AND 
PEOPLE ASSIGNED LONG-TERM TO REGIONS WITH ENDEMIC RABIES. PERSONNEL THAT WILL 
REQUIRE PROPHYLAXIS INCLUDE:
(1) ALL ANIMAL HANDLERS SUCH AS MILITARY WORKING DOG, IMPROVISED EXPLOSIVE 
DEVICE DETECTOR DOG, AND TACTICAL EXPLOSIVE DETECTOR DOG HANDLERS.
(2) VETERINARY WORKERS AND CERTAIN LABORATORY PERSONNEL.
(3) WILDLIFE MANAGEMENT PROFESSIONALS AS WELL AS PERSONNEL RESPONSIBLE FOR 
ANIMAL CONTROL PROGRAMS WHILE DEPLOYED SUCH AS PREVENTIVE MEDICINE 
TECHNICIANS.
(4) SPECIAL OPERATIONS PERSONNEL.
(5) PERSONNEL ASSIGNED TO AREAS WITH ENDEMIC RABIES WHO WILL NOT BE ABLE TO 
RECEIVE POST-EXPOSURE RABIES TREATMENT WITHIN A FEW DAYS OF AN INJURY CAUSED 
BY A HIGH-RISK ANIMAL.
B. RABIES RISK MITIGATION. REFS (A) AND (B) PROHIBIT SAILORS AND MARINES FROM 
ADOPTING AS PETS OR MASCOTS, CARING FOR, OR FEEDING ANY TYPE OF DOMESTIC OR 
WILD ANIMAL WHILE DEPLOYED TO THE CENTCOM AOR. THE SAME PROHIBITION SHOULD 
APPLY IN FORCE HEALTH PROTECTION ORDERS CONCERNING OTHER DEPLOYMENT AREAS.
REF (D) DIRECTS COMMANDERS TO EDUCATE PERSONNEL ON THE RISKS AND CONSEQUENCES 
OF ANIMAL BITES, APPROPRIATE MEASURES TO PREVENT BITES FROM STRAY OR WILD 
ANIMALS, AND GENERAL MEASURES TO OBTAIN EVALUATION AND TREATMENT UPON POSSIBLE 
EXPOSURE IN HOMEPORT AND WHILE DEPLOYED. REF (E) PROVIDES POLICY TO HUMANELY 
AND SAFELY REMOVE ANIMALS FROM MILITARY BASES AND CAMPS IN THE HOMEPORT AND 
DEPLOYED SETTING TO MINIMIZE RABIES EXPOSURE RISK.
C. POST-EXPOSURE EVALUATION AND TREATMENT. PER REF (F), ANY INJURY CAUSED BY 
AN ANIMAL SUCH AS BITES AND SCRATCHES AS WELL AS ANY ANIMAL LICKING AN 
INDIVIDUALS MUCUS MEMBRANES OR OPEN SKIN WOUND REQUIRES URGENT MEDICAL 
EVALUATION TO ASSESS RABIES RISK AND PROVIDE TIMELY TREATMENT, IF REQUIRED. 
BATS FOUND IN SLEEPING QUARTERS ARE CONSIDERED A RABIES RISK THAT REQUIRES 
EVALUATION EVEN WHEN THERE IS NO KNOWN BAT BITE (BECAUSE OF THE PAINLESS BITES 
THAT MAY HAVE BEEN INFLICTED). BECAUSE LONG DELAYS AFTER EXPOSURE CAN OCCUR 
BEFORE RABIES SYMPTOMS DEVELOP, PREVIOUSLY UNREPORTED/UNDOCUMENTED INJURIES AS 
WELL AS INCOMPLETELY TREATED CASES MUST BE EVALUATED BY MEDICAL PERSONNEL QQQQ 
FOR POSSIBLE TREATMENT.

5. PERSONNEL NO LONGER ELIGIBLE FOR MILITARY MEDICAL CARE OR WHO ARE NOT NEAR 
A MILITARY TREATMENT FACILITY WHO NEED TO BE EVALUATED FOR A PREVIOUSLY 
UNREPORTED/UNDOCUMENTED/INCOMPLETELY
TREATED EXPOSURE, SHOULD CALL THE ARMY WOUNDED SOLDIER AND FAMILY HOTLINE AT 
(800) 984-8523 TO COORDINATE THEIR EVALUATION AND CARE. ALL SERVICES ARE USING 
THE CENTRAL ARMY HOTLINE FOR RABIES EXPOSURE EVALUATION WHEN LOCAL MEDICAL 
ASSETS ARE NOT AVAILABLE.

6. THIS NAVADMIN IS EFFECTIVE IMMEDIATELY UPON RELEASE AND APPLIES TO ALL 
NAVAL FORCES.

7. RELEASED BY VICE ADMIRAL J. M. BIRD, DIRECTOR NAVY STAFF.//

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