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HomeMy WebLinkAboutRabies - 1997L4- The Commonwealth of Massachusetts WX If Executive Office of Health and Human Services Department of Public Health State Laboratory Institute 305 South Street, Jamaica Plain, MA 02130 ARGEO PAUL CELLUCCI 617 983-6200 GOVERNOR ( ) Bureau of WILLIAM D. O'LEARY Communicable SECRETARY Disease Control HOWARD K. KOH, MD, MPH COMMISSIONER Memorandum To: Animal Control Officers; Boards of Health From: Michael W. McCuill, D.V.M. Ov . State Public Health Veterinarian Janine Cory, M.P.H. Epidemiologist/Health ' ducator Re: Rabies Update Date: November 3, 1997 As you know, Massachusetts has had a raccoon -strain rabies epidemic since 1992, Rabies occurs in a cycle in nature, and the population of rabid animals will normally rise and then fall. The numbers for late 1997 show that Massachusetts is in the upswing of the rabies cycle once more. In 1997, we are seeing more than double the number of animals testing positive for rabies at the State Laboratory than in 1996. Bat strain rabies has remained a consistent public health threat since the 1960's. Exposure to bats has been the only risk factor in 21 of the 24 human rabies cases in the United States since 1980. In all but one of the 21 bat -related cases, the victim did not remember having been bitten or scratched by a bat. Because bites and scratches by bats may be so small as to not -be noticed, the Massachusetss Department of Public Health (MDPH) recommends that you call them if any person has contact with a bat. The MDPH will help you decide if the bat- should be tested for rabies. Unfortunately, we have come across several cases of human exposures when a bat was mistakenly released instead of sent for testing, or people were wrongly advised to not call MDPH for advice regarding exposure. If you are in a situation where a person may have been exposed to a bat, capture the bat first if possible, and then call the Department of Public Health. If you suspect that there has been human contact with a bat, please call the MDPH for advice. If a domestic animal has been exposed to a bat, please call the Massachusetts Department of Food and Agriculture, Bureau of Animal Health, at (617) 727-3018, extension 144. An animal at high risk for rabies that has exposed people needs to be sent to the State Laboratory Institute for testing. When such an animal is released without being tested, it forces the MDPH to advise that those humans in contact with the potentially rabid animal receive rabies vaccinations. This series of shots can cost thousands of dollars, and most times it can be avoided by testing the animal or quarantining a domestic animal. For high -risk animals (see below), an exposure can be defined as: • a bite or scratch • contact with the saliva of the animal to an open cut or a person's mucous membranes (eyes, nose, or mouth); this can involve handling a domestic animal that has recently fought with a high -risk wild animal. Please keep in mind that an "exposure" does not have to be a bite or scratch. In the specific case of a bat the following situations may be considered an exposure: having the bat in the room where a person was sleeping; having a bat in the room when a person is intoxicated or otherwise unable to judge whether he or she was exposed; or having a child in a room with a bat and no adult witness. Please help us deal with the risk of rabies in a safe and cost-effective way. A public health advisor is always available to answer questions about risk and exposure of people to potentially rabid animals. Call (617) 983- 6800 during normal working hours, or (617) 522-3700 after hours. The following animals are considered "high -risk" for rabies and should be tested if there is a human or domestic animal exposure: • bats, • raccoons, • skunks, • woodchucks, • foxes, • opossums, • stray cats or dogs (quarantine if possible), • coyotes, and .• other mammals acting sick or behaving strangely. These are some of the animals found more frequently to be rabid, and any human exposure with them may require rabies shots if the aniamis are not tested, or in the case of domestic animals, quarantined. Please call with any questions. cc: Dr. Tom French, Massachusetts Department of Fisheries and Wildlife Dr. Anne Mann, Massachusetts Department of Food and Agriculture Massachusetts Department of Food and Agriculture Division of Regulatory Services Bureau of Animal Health tP, NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. YS Dogs vaccinate your pet immediately and closely observe the animal for a-MRSUe. You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal, Any animal which dies for any reason while under quarantine must be submitted for rabies testing. Animal was euthanized. DATE OF EXPOSURE: / Z Name of Address: Type of Animal: _Doug V Cat_ Other (specify) 1.t Name of Animal: <,l'Yi� �.( Breed: ��,JI" colors: , Age: Date of last rabies vaccination prior to exposure: laLl Vaccination Duration: 1 yr_3 yr Unknown Date of post exposure vaccination C( Date of Order of Quarantine �-�O _q7 (to be given to current vaccinates only) //��l 1 Name of Veterinarian: �(' owe R, \ Phone No.: 4- Le S Name of Animal ('^Inspector: ��. SLO G�f�' (^h..i�.f Town: Noa4 c ( J[ ( 1 Y� Phone No.: - 15ZA ace ( / NO CO Signature of Animal Inspector Date: See back side of this form for explanation of Isolation; Strict Confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read both sides of this document and I agree to follow the provisions described in it. Signature of Owner or Other Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed OWNER'S COPY -- This order is enforceable under MGL Chapter 129; section 21, 330 CMR 4,03. SUIBMITTER�j� m�0 Vhr, QJ-r rs �&rd 6uo(�f Agency T—Owner orAgn Who Found Anim I Street er Csmr2 r Street `Q T ,_ (--, (2 --# City/State/Zip \_ P --,r-ku \ 6-633 .'rrck r-D-?,-)9 City/State/Zip 4•r,�A _ 1. a YYlcr. Phone Co%) ��D —��' � � Phone ( ) � SPECIMEN INFO TION (use reverse side for additional Information) ANIMAL SPECIES: Breeds Age ❑ Pet Stray ❑ Wild ❑ Unknown Why is animal to be ested7 Human exposure ❑ Pet exposure ❑ Acting sick Symptoms: ❑ Aggression ❑ Ataxia ❑ Disorientation ❑ Lethargy ❑ Paralysis ❑ Salivation ❑ Seizures ❑ Unexplained wound . ❑ Found dead ❑ Other Cause of death: ❑ Natural �IAIIIed Method Q v,n V Date of death Vaccinated for rabies: ❑ Yes/ ❑ No Unknown Date of vaccination Travel out of state: ❑ Yes ❑ No POnknown Where When Bitten by another animal within 12 months; Yes ❑ No )OUnknown If yes, by what? In what I was animal to d? McA In what QQ! ? EXPOSURE INFORMATION (use reverse side for additional information) PERSON(S) EXPOSED: ANIMAL(S) EXPOSED: Name o�;��V\. Street City/State/Zip W• �c�cA� �x�9r Yrc�(��j� Phone 6p ) Tye exposure: Bite ❑ Scratch ❑ Lick ❑ Unknown ❑ Other Date of exposure _ ?— Body site � Severity of exposure Circumstance of expos re: ❑ Capture andling ❑ Specimen prep. ❑ Unprovoked atta ❑ Provoked attack ❑ Indirect exposure ❑ Other Was person previously vaccinated? es ❑ No ❑ Unknown Did 60erson receive rabie8 is after incident? ❑ Yes nknown Physician/Hospital ' V Phone L LABORATORY RESUILT A 8 u POSITIVE (RABID)TI s E COMMENTS: O N L Y Name Species Owner Street City/State/Tp Phone ( ) Type of exposure: ❑ Bite ❑ Scratch ❑ Lick ❑ Unknown ❑ Other Dale of exposure Circumstances of exposure: ❑ Fight ❑ Vicinity ❑ Dead animal contact ❑ Other Was animal's rabies vaccination up-to-date? ❑ Yes ❑ No ❑ Unknown Did animal receive rabies booster after incident? ❑ Yes ❑ No ❑ Unknown TEST TestDate SPECIMEN UNSATISFACTORY ❑ Massachusetts Department of Public Health Division of Epidemiology NOTICE OF POSSIBLE EXPOSURE TO RABIES Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized. If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement, and vaccinate the animal 1 month prior to release. _ strictly confine your pet for 6 months, and vaccinate the animal 1 month prior to release If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement vaccinate your pet immediately and closely observe the animal for 3 months You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Name of Owner: 14/16.y ) O Vie \-1 6-14 Phone No. (�&) 33q-- Address:_ U E�-J S+ Town: 1s' AX Zip: 1'of Type of Animal: Dog 'cat _, other (specify) Name of animal: �-� Breed: ll5 H Colors: Ci �Gt cLa Age:1 Date of last rabies vabcination:ZL�4 - Date of booster: 9 97 I (if given) �Y Name of veterinarian:. /F-I JF vlf n Phone No.: o , s�C«�11 Name of Animal Control official: Phone No.: Town: - Signature of Animal Control official: Date: send 1 copy each'to the Division of Epidemiology, 305 south street, Jamaica Plain, MA 02130, and to the Division'of Animal Health, 100 Cambridge Street - Floor 21, Boston, MA 02202 - Massachusetts Department of Food and Agriculture Division of Regulatory Services Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal l month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. vaccinate your pet immediately and closely observe the animal for 3 months. You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason while under quarantine must be submitted for rabies testing. .✓j.e�YA 01,,'- ,'`I Animal was euthanized. DATE OF EXPOSURE: j)n1 L yNn J ✓N ��- A hlnJ Name of Owner: TqY C�Y�CA iS ° Y� 1�O.YCY �'- \, ��V�U.�, Phone (CNo.: '�!11�1�5 l`C� ' 31v'� Address: 4'i�� li �4v���'� �i' Town: M(kV S-}1e1A Zip: Type of Animal: _Dog +Cat_ Other (specify) Name of Animal: \ ) I V'e V- Breed: 'D L. I I Colors: 131ri(.l' F? Age:­Al✓Date of last rabies vaccination prior to exposure: `ia Vaccination Duration: 1 yr /3 yr_ Unknown Date of post exposure vaccination ) �9 57 y,.� (to be given to current vaccinates only) Date of order of Quarantine Name of Veterinarian: Name of Animal Inspector: '-7`C3TT Town: M 6'1YNS�1 F�C� Phone No Phone No.: Signature of Animal Inspector Date: See back side of this form for explanation of Isolation, Strict Confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read botn sides of this document and I agree to :oi_o'w the provisions described in it. Signature of Owner or Other Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed OWNER'S COPY-- , This order is enforceable under MGL Chapter 1291 section 21, 330 CMR 4.03. REQUEST FOR RABIES EXAMINATION FOR LAB USE. ONLY State. Laboratory Institute, Virology Division Date: Received: Rabies Laboratory (6I7) 983-6385, -6387 Lab.No:4/4 SUBMITTER Agency G..p.d /{ram,, i „y c oI Owner or Person Who Found Animal /�6irTr C/,n Street S l .v, iym 1. T. Street /Slate/Zlp Li/ c� Ci ty P — %"�i/�- da o b ,>' City/Slate2ip a � o 1/!Y Phone (SIj) a6/—?jao Phone (pf) 339—y'!'Ay SPECEMEN INFORNIATION (use reverse side for additional info oration) ANIMAL SPECIES: Breed Age ❑ Pet ❑ Stray P'4Vild . ❑ Unknown Why is animal to be tested? ❑ Human exposure Pet exposure ❑ Acting sick Symptoms: ❑ Aggression ❑ Ataxia ❑ Disorientation ALethargy ❑ Paralysis ❑ Salivation ❑ Seizures 1�151­lnexplained wound ❑ Found dead ❑ Other Cause of death: ❑ Natural Xilled Method_ C4,-7 Date of death Vaccinated for rabies: ❑ Yes ❑ No Unknown Date of vaccination Travel out of state: ❑ Yes ❑ No -Unknown Where When Bitten by another animal within 12 months: ❑ Yes ❑ No Unknown If yes, by what? In what TOWN was animal found? In what COUNTY? &�Ilrz�K EXPO PERSONS) EXPOSED: Name Street City/State/Zip Phone ( ) Type of exposure: ❑ 81te ❑ Scratch ❑ Other Date of exposure Body site Seventy of exposure Circumstance of exposure: INFORMATION (use reverse side for additional information) ❑ Lick ❑ Unknown ❑ Capture ❑ Handling ❑ Specimen prep. ❑ Unprovoked attack ❑ Provoked attack ❑ Indirect exposure ❑ Other Was person previously vaccinated? . ❑ Yes ❑ No ❑ Unknown Did person receive rabies shots after incident? ❑ Yes ❑ No ❑ Unknown Physician/Hospital Phone AMNIAL(S) EXPOSED: Name Species elll , .-cif/ 12or J Owner Dorr%1 ,y tip Street c/ 9 City/State/Zip Phone (rof ) 3PS — Bea Y Type of exposure: ❑ Bile ❑ Scratch ❑ Lick Unknown ❑ Other Fro u o 3ru s+� _ Date of exposure d 0 499 Circumstances of exposure: ❑ Fight /AQ Vicinity ❑ Dead animal contact ❑ Other Was animal's rabies vaccination up-to-date? P�Yes ❑ No ❑ Unknown Di animal receive rabies booster after incident? ❑ Yes XNo XUnknown LABORATORY RESULTS - FLUORESCENT RABIES ANTIBODY TEST Test Date POSITIVE (RABID) ❑ NEGATIVE (NOT RABID)' f$ SPECIMEN UNSATISFACTORY ❑ COMMENTS: /t,c. Massachusetts Department of Food and Agriculture Division of Regulatory Services Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal l month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. vaccinate your pet immediately and closely observe the animal for 3 months. You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason hile under quarantine must be submitted for rabies testing. 1�l: Animal was euthanized. DATE OF EXPOSURE: )"( Name of Owner:�FwY �C�-\��'"C�.' Phone No.: 5 Address: 17D0 l'lr`;x S �� Town: e )C Zip: Type of Animal: _Dog �at_ Other (specify) 1 Name of Animal: 1—GOCYU X Breed: ILS)-1 Colors: Age:�'Date of last rabies vaccination prior to exposure: fJ qh VaQc,. i n Duration: 1 r_3 r_ Unknown Bey" e� k)ory- 0wv'<'( cV�cl1, •/ � ve Y y �� Date of post exposure vaccinationc'x) )dr-e <riv"Sd (to be given to current vaccinates only) Date of Order of Quarantine / � \ Name of Veterinarian: `h,lc)�)r�/( I�)nC C'1 r Hee )-'4hone No. ('>�)�) SW) � Name of Animal Znspect r: C' ;' --E_--• Town: may AS Q('U Phone No Signature of Animal Inspector Date: See back side of this form for explanation of Isolation, Strict Confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read botn sides of this document and I agree to roiio•w the provisions described in it. Signature of owner or Other Responsible Person Refused to sign, but order was Issued Animal Inspector please initial if not signed OWNER'S COPY-- , This order is enforceable under MGL Chapter 129; section 21, 330 CMR 4.03. REQUEST FOR RABIES EXAMINATION State Laboratory Institute, Virology Division Rabies Laboratory; (617) 522-3700, x1941109 SUBM=R K,,-d Agency ✓ ,/ owner or Person Who Found Animal ii, ✓cs Street S'/ /11,� sr Street /S/ City/State(Lip /40y41 City/Stateop 0Y2ov Phone (S-de) L— ZLrO Phone , — 7 ya 7 SPECIMENINFORMATION (use reverse side for additional information) ANIMAL SPECIES: lX d Breed sue— Age ❑ Pet ❑ Stray ,n Wild ❑ Unknown Why is animal to be tasted? uman exposure )Z'Pet exposure ❑ Acting sick Symptoms: ,016ggression ❑ Ataxia ❑ Disorientation ❑ Lethargy ❑ Paralysis ❑ Salivation ❑ Seizures ,, eunexplained wound ❑ Found dead ❑ Other Cause of death: ❑ Natural M'killed Method Date of death Vaccinated for rabies: ❑ Yes ❑ No WUnknown Date of vaccination Travel out of state: ❑ Yes ❑ No ffUnknown Where When Bitten by another animal within 12 months: ❑ Yes ❑ No Unknown If yes, by what? In what TOWN was animal fobf6�✓7� In what COUNIX EXPOSURE INFORMATION (use reverse side for additional information) PERSON(S) EXPOSED: Name Street _ City/StateOp Phone ( Type of exposure: ❑ Site ❑ Scratch ❑ Lick ❑ Unknown ❑ Other Date of exposure Body site Severity of exposure Circumstance of exposure: ❑ Capture ❑ Handling ❑ Specimen prep. ❑ Unprovoked attack ❑ Provoked attack ❑ Indirect exposure ❑ Other, Was person previously vaccinated? ❑ Yes' ❑ No ❑ Unknown Did person receive rabies shots after incident? ❑ Yes ❑ No ❑ Unknown Physician/Hospital Phone ANIMAL(S) EXPOSED: Name Species ✓cr i Owner Street /ll O.�/f/)w 13 City/State/Zip da ° y Phone (may ) 3?9— 7c1d7 Type of exposure: ,,.0'gite PYt crotch ❑ Lick ❑ Unknown ❑ Other Date of exposure 5'7 Circumstances of exposure: ,,O-right ❑ Vicinity ❑ Dead animal contact ❑ Other Was animal's rabies vaccination up-to-date? ❑ Yes ) "0 ❑ Unknown Did animal receive rabies booster after incident? ,51,11'es ❑ No ❑ Unknown REQUEST FOR RABIES EXAMNATION State Laboratory Institute, Virology Division Rabies Laboratory; (617) 522-3700, xi94/196 SUBMPPIER w N 0�//�f�%s Agency YONM/ -er O 7-/CC iL Street J 9 / �+/ %G/"0j%1 sT. City/StateMp W� -j � Owner or Person Who Found Animal .Te 6r, ��✓� Street /6 / 0%%3 s% City/Slate2ip /vioZs/�P, s4-,4 Dao VP Phone (rod ) 33 s — 3A s / arzt-1w,v tuse reverse sice for acmaonai mtormauon) ANIMAL SPECIES: Breed W oock,,A� Age4LL ❑ pet ❑ Stray )aWild ❑ Unknown Why is animal to be tested? ❑ Human exposure fi�Pet exposure ❑ Acting sick Symptoms: ❑ Aggression ❑ Ataxia ❑ Disorientation ❑ Lethargy ❑ Paralysis ❑ Salivation ❑ Seizures ❑Unexplained wound ❑ Found dead ❑ Other i% 6f7 Cause of death: ❑ Natural killed Method �� D� c Date of death 7 da- t? Vaccinated for rabies: ❑ Yes ❑ No gUnknown Date of vaccination Travel out of state: ❑ Yes ❑ No �"nknown Where When Bitten by another animal within 12 months: ❑ Yes ❑ No Unknown If yes, by what? In what TOWN was animal ou ? �/JZk In what; ���f/� EXPOSURE INFORMATION (use reverse side for additional information) PERSON(S) EXPOSED: Name Street City/State/Zip Phone ( ) Type of exposure: ❑ Bite ❑ Scratch ❑ Other Date of exposure Body site ❑ Lick ❑ Unknown Severity of exposure Circumstance of exposure: ❑ Capture ❑ Handling ❑ Specimen prep. ❑ Unprovoked attack ❑ Provoked attack ❑ Indirect exposure ❑ Other Was person previously vaccinated? ❑ Yes' ❑ No ❑ Unknown Did person receive rabies shots after incident? ❑ Yes ❑ No ❑ Unknown Physician/Hospital Phone ANIMALS) EXPOSED: Name Species /1/✓v, Owner 7o e Go e 7 Street /6 f c'Tis r% City/State/Zip /�i✓ <ir/</ .�I,R a /8 Phone (rgC Type of exposure: )Rlite Cl Scratch ❑ Lick ❑ Unknown ❑ Other Dale of exposure 7Z2,2 IP7 Circumstances of exposure: ,,EYfight ❑ Vicinity ❑ Dead animal contact ❑ Other Was animal's rabies vaccination up-to-date? ❑ Yes ,_�No ❑ Unknown Did animal receive rabies booster after incident? ❑ Yes ❑ No nknown REQUEST FOR RABIES EXAM[NATION State Laboratory Institute, Virology Division Rabies Laboratory; (617) 522-3700, x194/196 SUBMITTER �w ci�7>� vC✓�c� Agency /dw� i�/a �,Fi// Owner or Person Who Found Animal Street 29Street XZA d,-so.✓ V7 City/State2ip 4,A 0.1 dV ' City/Statelzip Phone (C-d P) �26/— '7339 Phone 339 —,2 yaS� NYE'CIMEIN INFORMATTION (use reverse side for additional information) ANIMAL SPECIES: Breed Age []Pet ❑ Stray Whyis animal to be tested? uman exposure (Wild El Unknown ,0"Ff p ,0'Pet exposure ❑Acting sick Symptoms: ❑ Aggression ❑ Ataxia ❑ Disorientation Lethargy ❑ Paralysis ❑ Salivation ❑ Seizures ❑Unexplained wound ❑ Found dead ❑ Other Cause of death: ❑ Natural �01illed Method Date of death ay/y7 Vaccinated for rabies: ❑ Yes ❑ No _,Mnknown Date of vaccination Travel out of state: ❑ Yes ❑ No ZfUnknown Where When Bitten by another animal within 12 months: ❑ Yes ❑ No (Unknown If yes, by what? In what TOWN was animal found? In what COUNTY? f1�XjT/ EXPOSURE INFORMATION (use reverse side for additional information) PERSON(S) EXPOSED: Name Street mot/ �G/eG✓ad0 City/State/Zip AI,ter?. � . e Phone (Sjg ) Y35;— ayas Type of exposure: ❑ Bite ❑ Scratch ❑ Lick ❑ Unknown Other Date of exposure 2 y/s2 Body site F/my�s Severity of exposure i�<....� Circumstance of exposure: [3 Capture ❑ Handling ❑ Specimen prep. ❑ Unprovoked attack ❑ Provoked attack , ]'Indirect exposure ❑ Other Was person previously vaccinated? ❑ Yes' )a'No ❑ Unknown Did person receive rabies shots after incident? ❑ Yes ;TNo ❑ Unknown Physician/Hospital Phone ANIMAL(S) EXPOSED: Name Species Owner _ Street City/State/Zip Phone (rop Type of exposure: .0Bite ❑ Scratch ❑ Lick ❑ Unknown Other, /Igccoati ¢r�c�/� Date of exposure , 7/sv�r� Circumstances of exposure: ,'Fight ❑ Vicinity ❑ Dead animal contact ❑ Other Was a imal's rabies vaccination up-to-date? J Yes ❑ No ❑ Unknown Did animal receive rabies booster after incident? ❑ Yes .No ❑ Unknown Name of Veterinarian: Massachusetts Department of rood and Agriculture Division of Regulatory Services � Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife r a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to ha it euthanized (unless animal was only exposed by proximity). If you do not, you are herey ordered to (check appropriate measure): isolate your pet for 3 months, followed by,3 months of strict confinement. Vaccina e the animal 1 month prior to release, and revaccinate between 9 and 12 months later strictly confine your pet for 6 months, andvaccinatethe animal 1 month prior to . release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 month:, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict. confinement. YS Dayys vaccinate your pet immediately and closely observe the animal for 3-meAS . You are to inform your veterinarian immediately of any unusual behavior or change n the health status of this animal. Any animal which dies for any reason while und:r quarantine must be submitted for rabies testing. J Animal was euthanized. DATE OF EXPOSURE:_ Name of Owner:_ c ,i �(111vif �t Phone No.2 : Address;—L(1�/`, Town: 4rvc�t �t�c� 't,ip:_OJU`jR' Type of Animal: _Dog _ZK)CaC Othei: (specify)_ ' lam Name of Animal: _ Breed: 10 Colors: Lfraw Age:_f N'__Date of last rabies vaccination prior to exposure: Duration: 1 yrVJ 3 yr_ Unknown Date of post exp (to be given to c Date of order of Quarantine 2' I Phone No.: -� q7;tt- (6 u Vaccination osure vaccination AM ) urrent vaccinates onl,il Name of Animal Insp/ect(or:____,ot1� 4-�GFi j Town:�V1Gi h•C �CIj _ Phone No.:_ Signature of Animal Inspector: Date: See back side of this form for explanation of Isolation, Strict Confinement, Closo Observation, Exposure by Proximity, Quarantine and Signs of Rabies. Z her7r�y cerCi y tli�t I have read both sides of this document and I agree to folk a the prov o1s de cri.bed in it. nature of'Owncr or Other >>16nsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not si.gned OWNER'S COPY -- This order is enforceable under MGL Chapter 129; section 21, 330 CMR 4.03. Massachusetts Department of Food and Agriculture Division of Regulatory Services 9 Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal l month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. vaccinate your pet immediately and closely observe the animal for 3 months. You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason while under quarantine must be submitted for rabies testing. Animal was euthanized. DATE OF EXPOSURE: Name of Owner: ( � ;�C'A ;Iv k � U Address: Phone No.: Town: IUD<1�`s3 i�P�C� zip Type of Animal: _Dog '%Cat_ Other (specify) Name of Animal: i`>�. t:VA\-Z Breed: i I Colors:T>I1i t,✓��+"�'? Age: 4LDate of last rabies vaccination prior to exposure:'-- """--"-' Vaccination Duration: 1 yr_3 yr_ Unknown Date of post exposure vaccination (to be given to current vaccinates only) Date of Order of Quarantine Name of Veterinarian: ��y-��',.:��i>1'C.. Phone No.: Name of Animal Inspector: V )c 0 1,1 ( f' 1 "I C -- T�- 1 Town: / ���dls� I F �n� Phone No.: Signature of Animal Inspector Date: See back side of this form for explanation of Isolation, Strict Confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read both sides of this document and I agree to roiiow the provisions described in it. Signature of Owner or Other Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed OWNER'S COPY-- , This order is enforceable under MOL Chapter 129; section 21, 330 CMR 4.03. Massachusetts Department of hood and Agriculture Division of Regulatory Services Bureau of Animal Health q NOTICE OF POSSIBLE EXPOSURE TO RABIES AID QUARANTINE ORDER Your pet may have been exposed to rabies as a resul': of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely ol:,serve the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vjaccinate your pet immediately followed by 3 months strict confinement, Y S�s vaccinate your pet immediately and closely observe the animal for You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason while under quarantine must be submitted for rabies testing, Animal was/ ,euthanized. DATE OF EXPOSURE: �XQ3 Name of owner)-:rm,[I�.[�(/L/r- ,l�' �)ea& j Phone No.: Addrea5.:,['�,SrIIUJST Town�7%/�t ziply't�/%� Type of Animal: _Dog Cat Other (specify) 7� Name of Animal: Breed: Breed:colors: !� Age G Date of last rabies vaccination prior to exposure:/b/Rk Vaccination Duration: 1 yto//3 yr_ Unkno� Date of post exposure vaccination tr 7 q (to be given to current vaccinaes only Date of Order of Quarantine Name of Veterinarian: Phone No.:, -, F� J - 70(? Name of Animal Inspector: _ ,�'a Town: IV415hl`N� Phone No.: Signature ofAnimal nInspector Date: See back side of this form for explanation of Isolation, Strict Confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read botri sides of this document and I agree to follow the provisi n descr'bed in it. of Owner or Other Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed 'S COPY -- order is enforceable under MGL Chapter 129; section 21, 330 CMR 4,03. Massachusetts Department of food and Agriculture Division of Regulatory Services Bureau of Animal Health �vt} • • NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement, Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated-, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinementt..�y vaccinate your pet immediately and closely observe the animal for yS3--mb=_ You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason while under quarantine must be submitted for rabies testing. Animal was euthanized. DATE OR EXPOSURE: Name of Address: Type of Animal: —Dog Cat— \II��O""taaher (specify) Name of Animal: �/, A' AKh u,-,, A. Y:o 0 Age:Date of last rabies vaccination prior to exposure: G t0 Vaccination Duration: 1 yr3 yr_ Unknown Date of post exposure vaccination Date of Order of Quarantine p- (to be given to current vaccinates only C� � 7 Name of Veterinarian: ��i_1 r�o'rri �o�n��o• :fJari- Name of Animal I1nspe tor: Town: N/�V I S�'P Signature of Animal Inspector Date: 3 ) P-1 I o M Phone No.: tS %J(o-b See back side of this form for explanation of Isolation, Strict Confinement, Close Observation, Exposure by Proximity, Qnarantine and Signs of Rabies. I hereby certify that I have read both sides of this document and I agree to follow the provisions described in it. Signature of own/ or other Responsible Person Refused to sign, but Order was Issued q,,A �� _ _Q/t. Animal Inspector please initial if not signed OWNER'S COPY-- �..� This order is enforceable under MGL Chapter 129; section 21, 330 CMR 4.03., - Massachusetts Department of Food and Agriculture Division of Regulatory Services Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal 1.month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. vaccinate your pet immediately and closely observe the animal for 3 months. You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason while under quarantine must be submitted for rabies testing. Animal waseuthanized. DATE OF EXPOSURE: (J h K-1�%Otil\\� Name of Owner:ypy; \ hcw-PS No.:(���5 )sv- %%3� Address: �� Iyy"I 65ln ::LL Phone Town: /ylsyw IC� GD070 zip: _ Type of Animal: _Dog ✓ Cat_ Other (specify) Name of Animal: N 0 Breed: 17 Si�I colors: Age: L Date of last rabies vaccination prior to exposure: 7 Vaccination ? Duration: 1 yr_3 yr_ Unknown Date of post exposure vaccination Date of Order of Quarantine (to be given to current vaccinates only) ��� \ Name of Veterinarian: I/'- �C1II�i ����.e `\S e�i'� Phone No.-2 Name of Animal Inspector: ��`O1T /_o Town: / "AGW\S �of r9 Phone No.: re of Animal Inspector Date: See back side of this form for explanation of Isolation, Strict confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read both sides of this document and I agree to Coilo'w the provisions described in it. Signature of owner or Other Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed OWNER'S COPY-- , This order is enforceable under MGL chapter 129; section 21, 330 cMR 4.03, MASSACHUSETTS STATE LABORATORY INSTITUTE RABIES LABORATORY REPORT DATE: 12/01/97 REPORT OF RABIES EXAMINATIONS. PERIOD 11/01/97 THROUGH 11/30/97 ------------------------------------------------- COUNTY I DOGS I CATS I CATTLE ---------------------- I OTHER I SKUNKS --------------------------------------------------'- I FOXES I BATS I RACCOONSI RODENTS,I OTHER I TOTALS I DOMESTICI I I I LAGO- I WILD I I I I I I MORPHS I I I BARNSTABLE I 0/ 1 I O/ 2 1 I I I O/ 1 I O/ 1 I O/ 5 BERKSHIRE ( 0/ 1 I O/ 3 1 I I I I 0/ 1 I O/ 1 I 1 O/ 6 I I BRISTOL , I I 0/ 2 I I 0/ 5 I 1 I O/ 1 I 2/ 2 I 1 'I I 0/ 1 I 1 1/ 1. I I I I 3/ 12 I DUKES I I I I I I I I I I I ESSEX I O/ 7 I 1 0/ 14 I I I I I 6/ 6 I 1 I I 0/ 2 I ( 1/ 1.- I I O/ 2 I I I I I 7/ 32 I I I FRANKLIN I I I 0/ 1 I 1 I I ( I I I I 1/ _ 1 I I O/ 1 I I 1/ 3 HAMPDEN I O/ 2 0/ 3 1 ( I 0/ 1 I I I O/ 1 I Of 7) I I HAMPSHIRE I I I I O/ 2 I I I I I I I O/ 1 I I I I I I I I O/ 3 I MIDDLESEX I I 0/ 7 I 0/ 14 I I I I 2/ 3 I 1 I I I I I I O/ 4 I I 2/ 28 I NANTUCKET I I I I I i i I I I I NORFOLK I ( 0/ 4 I I 1/ 10 I I I I 3/ 3 I 1 I I i I 0/ 1 I O/ 1 I 4/ 19 I PLYMOUTH ( I 0/ 5 1 O/ 1. I I I O/ 1 I 0/ 1 0/ 8 I I SUFFOLK I I 0/ 4 I O/ 7 I I I I I 0/ 2 I I I ( 0/ 3 I I I O/ 1 I I 0/ 2 1 0/ 19 I I I WORCESTER I ( 0/ 5 I 0/ 10 I I I I O/ 1 I I I I I O/ 1 I ( 1/ 2 I 0/ 1 I I O/ 1 I 1/ 21 I OUT OF STATE/ I I I I I I I I I I UNKNOWN I I I I I I I O/ 1 1 I O/ 1 1 ------------ i--------- * TOTAL * i--------- I 0/ 33 i--------- 1/ 76 0/ 0 i--------- {--------- I O/ 2 I 13/ 17 {--------- i--------- 0/ 2 i--------- I 1/ 8 ( 3/ 7 i--------- 0/ 13 i--------- I O/ 6 {---------{ I 18/ 164 I (In each column the number positive appears first, followed by the number examined) TOTAL NUMBER OF SPECIMENS TOTALS SINCE 01/01/97 Received 167 2950 Negative 146 2607 Positive 18 253 Unsatisfactory 3 90 Massachusetts Department of Food and Agriculture ' Division of Regulatory Services Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk d-3mestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanize, (unless animal was only exposed by proximity). If you do not, you are hereby ordered to ( heck appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, - revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. vaccinate your pet immediately and closely observe the animal for y �Q'yys You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies quarantine must be submitted for rabies testing. for any reason while under Animal was euthanized. DATE OF EXPOSURE: 1/i /g Iq 7 Name of owner: _ 5 /- ac Ll /+L(y Address: tiL- �i ,/ x)PPhone No.: ,J� —zip:— NO -Al Ilkj( '`�/I�CG/N/i' �Town: %1%NSG/eZ� — -- S/ Type of Animal: —Dog Cat_ Other (specify) Name of Animal: Breed: TL14 Colors: NCi Age: _('.pate of last rabies vaccination prior to exposure: Duration: 1 yr_3 yr_ Unknown Vaccination Date of post exposure vaccination Date of Order of Quarantine '7 (to be given to current vaccinates only) 6 Name of veterinarian: l /L �J , t- G/ �lZ /-IVf.iG(L(.- (//✓) Phone No.: SZ� o?o'/ Name of Animal Inspector: .Jtov' Town: Phone No.: Fjd��a(o�s73i-r signature of Animal Inspector Date: see back side of this form for explanation of Isolation, Strict Confinement, close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I hereby certify that I have read both sides of this document and described in it. I agree to follow the Pro described / / )-/(, -� Signature of Owner or Other) Responsible Person Refused to sign, but Order was Issued OWNER'S COPY -- Animal Inspector please initial if not signed This order is enforceable under MOL Chapter 129; section 21, 330 CM12 4.03. 'IJ , Massachusetts Department of Food and Agriculture Division of Regulatory Services lug Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. strictly confine your pet for 6 months, and vaccinate the animal l month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months, revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement. vaccinate your pet immediately and closely observe the animal for 3 months. You are to inform your veterinarian immediately of any unusual behavior or change in the health status of this animal. Any animal which dies for any reason" while un�r \ quarantine must be submitted for rabies testing.[>t' < t ,_�,�, fm i,l} Animal was euthanized. DATE OF EXPOSURE: 1(V l ����) Y% � � � 4 , Name of Owner: Cl\,V Phone No 1 Address: Town: A�.' ( 1 �� Zip. Type of Animal: Dog i% Cat_ Other (specify) Name of Animal: �lY (' Breed: Colors: Age:/Date of last rabies vaccination prior to exposure: Vaccination Duration: 1 yr_3 yr_ Unknown L, Date of post exposure vaccination Date of Order of Quarantine Name of Veterinarian: Name of Animal Inape tor: 'arc II��I C, Town: / 4Y\5 A Signature of Animal Inspector Date: (to be given to current vaccinates only) Phone No See back side of this form for explanation Observation, Exposure by Proximity, Quarantine Phone No.: L'�)� `� 1'C) l 5 i S of Isolation, Strict confinement, Close and Signs of Rabies. I hereby certify that I have read both sides of this document and I agree to roi;ow the provisions described in it. Signature of Owner or Other Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed OWNER'S COPY-- , This order is enforceable under MGL Chapter 129; section 21, 330 CMR 4.03. REQUEST FOR RABIES EXAMINATION State Laboratory Institute, Virology Division Rabies Laboratory; (617) 522-3700, x194/196 SUBMTITER sue✓✓_ a�_Ly'i�o r/d/� Agency Owner or Person Who Found Animal _d0,cy us iiC�a ✓o Street Street //3d' psTSr. City/State/Zip City/State/Zip 0 a 0 Phone (So8 ) 96 /— 730o Phone (fy) 339 — ECEWEN INFORMATION (use reverse side for additional information) ANIMAL SPECIES: F�% Breed As/'/ Age!-<_N 1'740 Pet ❑ Stray ,V Wild ;SS Unknown Why is animal to be tested? ,Human exposure ❑ Pet exposure ❑ Acting sick Symptoms: .Aggression ❑ Ataxia ❑ Disorientation ❑ Lethargy ❑ Paralysis ❑ Salivation . ❑ Seizures ❑ Unexplained wound ❑ Found dead ❑ Other Cause of death: Natural ❑ Killed Method 6%ccf Date of death 7 3As9 - 7 Vaccinated for rabies: ❑ Yes ❑ No Unknown Date of vaccination Travel out of state: ❑ Yes ❑ No 0`Unknown Where When Bitten by another animal within 12 months: ❑ Yes ❑ No ErUnknown If yes, by what? In what TOWN was animal fou�rxYl In what COUNTY? .�i s'j/ EXPOSURE INFORMATION (use reverse side for additional information) PERSON(S) EXPOSED: Name (auti% f O C6N.✓C3%Z 4&f Street ,�� L1 L/ 0 57 City/State/Zip Phone (j-og ) Ya / - So 3 / Type of exposure: ite ❑ Scratch ❑ Lick ❑ Unknown 13- Other Date of exposure Body site Severity of exposurerr.✓�S Circumstance of exposure: ❑ Capture UHandling ❑ Specimen prep. ❑ Unprovoked attack ❑ Provoked attack ❑ Indirect exposure ❑ Other Was person previously vaccinated? ❑ Yes' Pr No ❑ Unknown Did person receive rabies hots after incident? ❑ Yes ❑ No Unknown PhysicianMospital fl;;-el H. / Phone .' ANIMALS) EXPOSED: Name _ Species Owner . Street City/State2ip Phone ( Type of exposure: ❑ Bite ❑ Scratch ❑ Other Date of exposure Circumstances of exposure: ❑ Fight ❑ Vicinity ❑ Other ❑ Lick ❑ Unknown ❑ Dead animal contact Was animal's rabies vaccination up-to-date? ❑ Yes ❑ No ❑ Unknown Did animal receive rabies booster after incident? ❑ Yes ❑ No ❑ Unknown Massachusetts Department of Food and Agriculture '!! Division of Regulatory Services Bureau of Animal Health NOTICE OF POSSIBLE EXPOSURE TO RABIES AND QUARANTINE ORDER Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized (unless animal was only exposed by proximity). If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement. Vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months latter. strictly confine your pet for 6 months, and vaccinate the animal 1 month prior to release, and revaccinate between 9 and 12 months later. vaccinate your pet immediately and closely observe the animal for 6 months,.: revaccinate between 9 and 12 months later. If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict- confinement. YS bays vaccinate your pet immediately and closely observe the animal for 3-meet-pc, You are to inform your veterinarian immediately of any unusual behavior or change in�i'' the health status of this animal. Any animal which dies for ally reason while under quarantine must be submitted for rabies testing. 7 cc Animal was euthannized. /' DATE OF EXPOSURE: Name of Owner:—/�-lYl/ P / YCw(f Phone No.: �p�3i/" J7d7 Address:�rp/tk ��( Town: anf �aZip: Qa1JY� . Type of Animal: _Dog CCat_ Other (specify) 1/ p Name of Animal: Breed: colors:. Age: Date of last rabies vaccination prior to exposure:­/1 `96 Vaccination .Duration: 1 yr�L3 yr_ Unknown _ Date of post exposure vaccination- V / ? (to be given to current vaccinates only)' ` Date of Order of Quarantine Name of Veterinarian: 7iA)hlln -5,1 ke /6/41/pkN Phone No.; Name of Animal Inspect� inspector; CJfa/�" (�./ Town:. Alfie S/'i�ly Phone No.: Signature of Animal Inspector Date: See back side of this form forexplanation of Isolation, Strict Confinement, Close Observation, Exposure by Proximity, Quarantine and Signs of Rabies. I.hereby certify that I have read botri sides of this document and I agree to follow the provisions described in ewbediin it. Signat e of Owner or Cher Responsible Person Refused to sign, but Order was Issued Animal Inspector please initial if not signed OWNER'S COPY -- This order is enforceable under MGL Chapter 129; section 21, 330 CMR 4,03. t9Ydd 01.rY Ydi{. 1.d VOVd"cmrQL OI r*OQ &no AgrloulLur\ Division of Animal Health \ Massachusetts Department of Public Health Division of Epidemiology NOTICE Or POSSIBLE EXPOSURE TO RABIES Your pet may have been exposed to rabies as a result of recent exposure to wildlife or a high -risk domestic animal. If your animal is unvaccinated, you are strongly urged to have it euthanized. If you do not, you are hereby ordered to (check appropriate measure): isolate your pet for 3 months, followed by 3 months of strict confinement, and vaccinate the animal 1 month prior'to release. strictlyconfine your pet for 6 months, and vaccinate the animal month prior to release If your animal is currently vaccinated, you are hereby ordered to: vaccinate your pet immediately followed by 3 months strict confinement vaccinate your pet immediately and closely observe the animal for 3 months You are to inform Your veterinarian immediately of any unusual behavior or change in the health status of this animal. Name of Owner: SO � � i cl n i GLV01 Qr1`2Cs, Phone No.: Address: —1 Oe Ch nA in Q , _)t"l r gz Town• • Zip:Ck(l�{ Type of Animal: — Dog _�L Cat _ Other (specify) Name of animal:�'t k I( Breed: )LN �1� Colors: Age:, Date of last rabies vaccination: 3 q Date of booster - (if given) Name of veterinarian:Lr Phone No.: Cl - �11 Name of Animal Control Official: aP -1� C GA11 n c; Phone No.: l�'l3 I Town an Signature of -Anim 1 Cont­r l­Official: 4 Date: �t7 Send 1 copy each to the Division of Epidemiology, 305 South Street, Jamaica Plain, MA 021300'and to the Division of Animal Health, 100 Cambridge Street - Floor 21, Boston, MA 02202