BACKGROUND: Rabies postexposure prophylaxis (rPEP) is administered to prevent mortality after exposure to an animal with known or suspected rabies. In 2011, 1 of 2 manufacturers of human rabies vaccine reported supply limitations. Because rabies is fatal, rPEP supply disruptions have grave consequences. Understanding how much rPEP has been used can help to predict how much is needed in the future. Indiana law requires reporting of rPEP in the Indiana National Electronic Disease Surveillance System (I-NEDSS), which is managed solely by local health departments. We evaluated the ability of I-NEDSS to report rPEP administration.
METHODS: I-NEDSS was compared with the Indiana Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), a syndromic surveillance system using emergency department (ED) visits. By using data during January 1–December 31, 2015, animal bites with rPEP reported in I-NEDSS were matched with ESSENCE records. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
RESULTS: In 2015, rPEP was documented for 198 persons in I-NEDSS, and rabies exposure was the chief complaint for 265 persons in ESSENCE. Eighty-three persons had ESSENCE reports, but no rPEP report in I-NEDSS. We identified 106 persons with reports in both I-NEDSS and ESSENCE. By using matched records, I-NEDSS had 76.3% sensitivity, 100% specificity, 100% PPV, and 62.5% NPV.
CONCLUSIONS: Because rPEP supply fluctuates, monitoring rPEP administration allows public health departments to anticipate future needs by knowing how much rPEP is currently being administered. On the basis of this analysis, all ED-administered rPEP events are not being reported into I-NEDSS. Case-based reporting might be improved by allowing the ED to report rabies PEP administration directly into I-NEDSS.