RESUMEN
Exploiting unprecedented reductions in aircraft movements caused by the COVID-19 pandemic, we investigated the relationship between air traffic volume and the frequency of wildlife-aircraft collisions, or wildlife strikes, at the 50 largest airports in the United States. During the COVID-19 months of 2020 (March-December), both air traffic volume and the absolute number of wildlife strikes were reduced. The net effect of these two movements, however, was an increase in the wildlife strike rate from May 2020-September 2020. This increase was found to be most pronounced at airports with larger relative declines in air traffic volume. We concluded that the observed increase in the wildlife strike rate was, at least in part, generated by risk-enhancing changes in wildlife abundance and behavior within the airport environment. That is, wildlife became more abundant and active at airports in response to declines in air traffic volume.
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Accidentes de Aviación , COVID-19 , Animales , Estados Unidos/epidemiología , Humanos , Animales Salvajes , Aeropuertos , Pandemias , COVID-19/epidemiología , AeronavesRESUMEN
Invasive species and their establishment in new areas have significant impacts on the ecological, economic, and social well-being of our planet. Wild pigs (Sus scrofa) are one of the world's most formidable invasive species, particularly in the United States. They cause significant damage to agriculture and ecosystems, and can transmit diseases to livestock, wildlife, and people. There is an inherent social dimension to the issue of wild pigs due in part to the fact that people hunt them. Hunting contributes to both the control and spread of this species. The objectives of this study were to: 1) determine hunters' overall tolerance for wild pigs; and 2) identify what factors predict hunters' tolerance. Results obtained from a survey of Texas hunters in 2019 indicated that 83% of hunters had a low level of tolerance for wild pigs, with approximately 63% preferring to see the population reduced and 20% preferring to see the population completely removed. Fourteen percent preferred that wild pig numbers remain the same, and 2% preferred to see numbers increase. Results from regression analysis indicated that approximately 53% of the variance in tolerance for wild pigs was explained by motivations and preferences for hunting wild pigs, level of concern for wild pig damage, and overall attitudes toward wild pigs. Results of this research are useful in expanding current knowledge about human tolerance for wildlife, including those species that are non-native and invasive, and in identifying important factors affecting how hunters perceive and interact with wild pigs. Study findings are also helpful in informing the development of effective and socially acceptable management plans for wild pigs, as well as communication efforts aimed at influencing hunters' attitudes and behaviors in the wild pig management context.
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Especies Introducidas , Sus scrofa , Animales , Animales Salvajes , Ecosistema , Porcinos , TexasRESUMEN
BACKGROUND: Wildlife damage to crops is a persistent and costly problem for many farmers in the USA. Most existing estimates of crop damage have relied on direct assessment methods such as field studies conducted by trained biologists or surveys distributed to farmers. In this paper, we describe a new method of estimating wildlife damage that exploits federal crop insurance data. We focused our study on four crops: corn, soybean, wheat, and cotton, chosen because of their economic importance and their vulnerability to wildlife damage. RESULTS: We determined crop-raiding hot spots across the USA over the 2015-2019 period and identified the eastern and southern regions of the USA as being the most susceptible to wildlife damage. We estimated lower bounds for dollar and percent losses attributable to wildlife to these four crops. The combined loss across four crops was estimated at $592.6 million. The highest total estimated losses to wildlife were incurred by soybeans ($323.9 million) and corn ($194.0 million) and the highest percentage losses were estimated for soybeans (0.87%) and cotton (0.72%). CONCLUSION: We believe the proposed method is a reliable way to evaluate geographic and temporal heterogeneity in damages for the coming years. Accurate information on damages benefits various management agencies by allowing them to allocate management resources to crops and regions where the problem is relatively severe. A better understanding of damage heterogeneity can also help guide research and development of new management techniques.
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Conservación de los Recursos Naturales , Seguro , Agricultura , Animales , Animales Salvajes , Productos Agrícolas , Agricultores , HumanosRESUMEN
African swine fever (ASF), classical swine fever (CSF) and foot-and-mouth disease (FMD) are considered to be three of the most detrimental animal diseases and are currently foreign to the U.S. Emerging and re-emerging pathogens can have tremendous impacts in terms of livestock morbidity and mortality events, production losses, forced trade restrictions, and costs associated with treatment and control. The United States is the world's top producer of beef for domestic and export use and the world's third-largest producer and consumer of pork and pork products; it has also recently been either the world's largest or second largest exporter of pork and pork products. Understanding the routes of introduction into the United States and the potential economic impact of each pathogen are crucial to (a) allocate resources to prevent routes of introduction that are believed to be more probable, (b) evaluate cost and efficacy of control methods and (c) ensure that protections are enacted to minimize impact to the most vulnerable industries. With two scoping literature reviews, pulled from global data, this study assesses the risk posed by each disease in the event of a viral introduction into the United States and illustrates what is known about the economic costs and losses associated with an outbreak.
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Fiebre Porcina Africana , Fiebre Aftosa , Enfermedades de los Porcinos , Fiebre Porcina Africana/epidemiología , Fiebre Porcina Africana/prevención & control , Animales , Bovinos , Peste Porcina Clásica/epidemiología , Peste Porcina Clásica/prevención & control , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/veterinaria , Fiebre Aftosa/epidemiología , Fiebre Aftosa/prevención & control , Ganado , Porcinos , Estados Unidos/epidemiologíaRESUMEN
The survey described in this research paper aimed to investigate the economic and health impacts of birds on dairies. Birds are common pests on dairies, consuming and contaminating feed intended for cattle. As a result, dairy operators experience increased feed costs and increased pathogen and disease risk. We surveyed dairy operators attending the 2017 Washington Dairy Conference to examine the impact of birds on dairies in Washington State. Dairy operators reported feed losses valued at $55 per cow resulting in annual losses totaling $5.5 million in the Western region of the state and $9.2 million in the Eastern region of the state. Shooting was the most commonly used bird management method and European starlings (Sternus vulgaris) were the most frequently implicated species statewide. Bird abundance greater than 10,000 birds per day was associated with larger herd size and with self-reported presence of Johne's disease and Salmonella.
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Aves , Enfermedades de los Bovinos/etiología , Industria Lechera , Alimentación Animal/microbiología , Animales , Bovinos , Enfermedades de los Bovinos/economía , Industria Lechera/economía , Industria Lechera/estadística & datos numéricos , Contaminación de Alimentos/economía , Contaminación de Alimentos/estadística & datos numéricos , Encuestas y Cuestionarios , WashingtónRESUMEN
We present a new modeling tool that can be used to maximize the impact of canine rabies management resources that are available at the local level. The model is accessible through a web-based interface that allows for flexibility in the management strategies that can be investigated. Rabies vaccination, sterilization, chemo-contraception, and euthanasia can be specified and limited to specific demographic groups. Additionally, we allowed for considerable complexity in the specification of management costs. In many areas, the costs of contacting additional dogs increases as management effort increases, and this can have important strategic implications. We illustrated the application of the model by examining several alternative management strategies in an area of Mpumalanga Province, South Africa. Our results based on this dog population suggested that puppies should be vaccinated and sterilization would not be optimal if the spatial extent of management is not large (and perhaps not even then). Furthermore, given a sufficient budget, it was evident that vaccination campaigns should be repeated annually.
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Enfermedades de los Perros/prevención & control , Rabia/veterinaria , Animales , Enfermedades de los Perros/economía , Enfermedades de los Perros/virología , Perros , Modelos Económicos , Rabia/economía , Rabia/prevención & control , Vacunas Antirrábicas/administración & dosificación , Virus de la Rabia/genética , Virus de la Rabia/inmunología , Sudáfrica , VacunaciónRESUMEN
Wild pigs (Sus scrofa) are a non-native invasive species in the United States that cause significant economic loss, transmit disease, and inflict damage upon natural resources, agriculture, livestock, and property. Geographic distribution of wild pigs in the United States has nearly tripled since 1982, with anthropogenic influences playing a significant role in the expansion. In this regard, there is speculation that a driver of the expansion may be human-mediated movement of wild pigs to new areas for the purpose of sport hunting. In response, states have implemented a variety of wild pig control policies, including legal restrictions on their transport. The success of such policies depends, in part, on their level of public support, which in turn may be influenced by individuals' attitudes concerning wild pigs, their interest in maintaining wild pig populations (e.g., for sport hunting), and their knowledge and awareness of the threats wild pigs pose. Multiple regression was used to analyze data collected from a nationwide survey concerning attitudes toward wild pigs and policies that restrict their transport. Results indicate that a majority of individuals in the United States have negative attitudes toward wild pigs and support policies that restrict their transport and penalize transgressors. Consistent with other invasive species research, findings suggest that as knowledge and awareness of wild pigs increase, so too does support for policies restricting and penalizing transport of wild pigs. Contrary to previous studies, this research also finds that hunters are more likely to support restrictions on wild pig transport than are non-hunters. Overall, these findings suggest that legal restrictions on the transport of wild pigs, even in states with large hunter populations, enjoy broad public support and may help to curb the expansion of wild pig populations.
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Especies Introducidas , Sus scrofa , Agricultura , Animales , Actitud , Humanos , Recursos Naturales , Porcinos , Estados UnidosRESUMEN
The global economic impact of canine rabies has been estimated by several studies. Asia bears a disproportionate burden of this zoonosis due to high levels of human deaths and rates of post-exposure prophylaxis (PEP), but low investment in preventative dog vaccination. The same factors that cause rabies to burden much of Asia are also present in Viet Nam. This study estimated the economic burden of canine rabies in a societal perspective including direct and indirect cost of rabies in dogs, livestock, and humans. Using data collected from personal interviews, published literature, published and supplementary reports, and primary data collection, we estimated the economic impact of canine rabies in Viet Nam over a ten year period (2005-2014). We incorporated the direct and indirect costs for PEP, dog vaccination efforts, livestock losses, and disability adjusted life years (DALYs) into the analysis. General findings from this analysis indicated that over the 10 year study period, the total economic impact of canine rabies was over $719 million USD. The largest portion of impacts (92%) were made up of PEP-related costs. Canine rabies created between 36,560 and 45,700 DALYs, measured in years of life lost (YLL). A total of 914 human deaths were reported over the study period. Deaths/100,000 people were 0.11, which is lower than the reported level for Asian countries. The cost per dog vaccinated was $1.75 USD. Our results indicate that canine rabies impacts in Viet Nam are consistent with the burden elsewhere reported in Asia, with large expenditures on PEP and very small investments in dog vaccination.
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Costo de Enfermedad , Enfermedades de los Perros/economía , Enfermedades de los Perros/epidemiología , Costos de la Atención en Salud , Rabia/epidemiología , Rabia/veterinaria , Adolescente , Adulto , Anciano , Animales , Perros , Femenino , Humanos , Masculino , Rabia/economía , Vietnam/epidemiología , Adulto JovenRESUMEN
OBJECTIVE To identify knowledge and practices related to rabies vaccination and serologic monitoring among animal care workers in the United States. DESIGN Cross-sectional survey. SAMPLE 2,334 animal care workers (ie, veterinarians, veterinary technicians, animal control workers, and wildlife rehabilitators). PROCEDURES Participants were contacted through relevant professional organizations to participate in an anonymous web-based survey. The survey collected demographic and occupational information, animal handling and potential rabies exposure information, and individual rabies vaccination and serologic monitoring practices. Comparisons of animal bite and rabies exposure rates were made between occupational groups. Multiple logistic regression was used to evaluate factors associated with rabies vaccination status and adherence to serologic monitoring recommendations. RESULTS Respondents reported 0.77 animal bites/person-year or 0.10 bites/1,000 animals handled. The overall rate of postexposure prophylaxis due to an occupational rabies exposure was 1.07/100 person-years. Veterinarians reported the highest rabies vaccination rate (98.7% [367/372]), followed by animal control workers (78.5% [344/438]), wildlife rehabilitators (78.2% [122/156]), and veterinary technicians (69.3% [937/1,352]). Respondents working for employers requiring rabies vaccination and serologic monitoring were 32.16 and 6.14 times, respectively, as likely to be vaccinated or have a current serologic monitoring status as were respondents working for employers without such policies. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that, given the high reported rates of animal bites and potential rabies exposures among animal care workers, improvements in rabies vaccination and serologic monitoring practices are needed.
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Animales Salvajes , Mordeduras y Picaduras/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Enfermedades Profesionales/epidemiología , Rabia/epidemiología , Adulto , Técnicos de Animales , Animales , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/prevención & control , Exposición Profesional , Rabia/prevención & control , Estados Unidos/epidemiología , Vacunación , VeterinariosRESUMEN
Cross-species disease transmission between wildlife, domestic animals and humans is an increasing threat to public and veterinary health. Wild pigs are increasingly a potential veterinary and public health threat. Here we investigate 84 pathogens and the host species most at risk for transmission with wild pigs using a network approach. We assess the risk to agricultural and human health by evaluating the status of these pathogens and the co-occurrence of wild pigs, agriculture and humans. We identified 34 (87%) OIE listed swine pathogens that cause clinical disease in livestock, poultry, wildlife, and humans. On average 73% of bacterial, 39% of viral, and 63% of parasitic pathogens caused clinical disease in other species. Non-porcine livestock in the family Bovidae shared the most pathogens with swine (82%). Only 49% of currently listed OIE domestic swine diseases had published wild pig surveillance studies. The co-occurrence of wild pigs and farms increased annually at a rate of 1.2% with as much as 57% of all farms and 77% of all agricultural animals co-occurring with wild pigs. The increasing co-occurrence of wild pigs with livestock and humans along with the large number of pathogens shared is a growing risk for cross-species transmission.
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Enfermedades Transmisibles Emergentes/transmisión , Enfermedades de los Porcinos/microbiología , Enfermedades de los Porcinos/parasitología , Zoonosis/transmisión , Animales , Animales Domésticos , Animales Salvajes/microbiología , Animales Salvajes/parasitología , Humanos , Ganado , América del Norte/epidemiología , Aves de Corral , Salud Pública , Gestión de Riesgos , Sus scrofa , PorcinosRESUMEN
Raccoon rabies is endemic in the eastern U.S.; however, an epizootic had not been confirmed on Long Island, New York until 2004. An oral rabies vaccination (ORV) program was initiated soon after the first rabies-positive raccoon was discovered, and continued until raccoon rabies was eliminated from the vaccination zone. The cost-effectiveness and economic impact of this rabies control program were unknown. A public health surveillance data set was evaluated following the ORV program on Long Island, and is used here as a case study in the health economics of rabies prevention and control efforts. A benefit-cost analysis was performed to determine the cost-effectiveness of the program, and a regional economic model was used to estimate the macroeconomic impacts of raccoon rabies elimination to New York State. The cost of the program, approximately $2.6 million, was recovered within eight years by reducing costs associated with post-exposure prophylaxis (PEP) and veterinary diagnostic testing of rabies suspect animals. By 2019, the State of New York is projected to benefit from the ORV program by almost $27 million. The benefit-cost ratio will reach 1.71 in 2019, meaning that for every dollar spent on the program $1.71 will be saved. Regional economic modeling estimated employment growth of over 100 jobs and a Gross Domestic Product (GDP) increase of $9.2 million through 2019. This analysis suggests that baiting to eliminate rabies in a geographically constrained area can provide positive economic returns.
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Erradicación de la Enfermedad/economía , Programas de Inmunización/economía , Vacunas Antirrábicas/economía , Rabia/veterinaria , Mapaches , Animales , Costo de Enfermedad , Análisis Costo-Beneficio , Brotes de Enfermedades/prevención & control , Monitoreo Epidemiológico , Programas de Inmunización/normas , Programas de Inmunización/estadística & datos numéricos , New York/epidemiología , Profilaxis Posexposición , Rabia/epidemiología , Rabia/prevención & control , Rabia/virología , Vacunas Antirrábicas/administración & dosificación , Vacunación/economía , ZoonosisRESUMEN
OBJECTIVE: To determine direct and indirect costs associated with raccoon rabies incidents involving cattle herds in Hampshire County, WV, in 2008 and Guernsey County, Ohio, in 2010. DESIGN: Ex post cost analysis. ANIMALS: 1 cattle herd in Hampshire County, WV, in 2008 and 1 cattle herd in Guernsey County, Ohio, in 2010. PROCEDURES: Data were collected for each incident through telephone and email interviews with 16 federal, state, and county agency personnel involved in the case investigations and coordinated responses for rabies in the cattle herds. To characterize the economic impact associated with rabies in the 2 cattle herds, cost analysis was conducted with 7 cost variables (salary and benefits for personnel involved in the response, human postexposure prophylaxis, indirect patient costs, rabies diagnostic testing, cattle carcass disposal, market value of euthanized cattle, and enhanced rabies surveillance). Estimates of direct costs were determined on the basis of agency records and other relevant data obtained from notes and reports made by agency staff at the time of the incident and from a review of the literature. RESULTS: Primary costs included the market value of euthanized cattle ($51,461 in West Virginia; $12,561 in Ohio), human postexposure prophylaxis ($17,959 in West Virginia; $11,297 in Ohio), and salary and benefits for personnel involved in the response ($19,792 in West Virginia; $14,496 in Ohio). CONCLUSIONS AND CLINICAL RELEVANCE: These results should provide a basis for better characterization of the economic impact of wildlife rabies in cattle in the United States.
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Enfermedades de los Bovinos/virología , Vacunas Antirrábicas/inmunología , Rabia/veterinaria , Mapaches , Adulto , Animales , Bovinos , Enfermedades de los Bovinos/economía , Enfermedades de los Bovinos/epidemiología , Niño , Eutanasia Animal , Femenino , Humanos , Masculino , Mephitidae , Ohio/epidemiología , Rabia/economía , Rabia/epidemiología , Rabia/prevención & control , Vacunas Antirrábicas/administración & dosificación , Vacunas Antirrábicas/economía , Salarios y Beneficios/economía , West Virginia/epidemiologíaRESUMEN
Progressive elimination of rabies in wildlife has been a general strategy in Canada and the United States; common campaign tactics are trap-vaccinate-release (TVR), point infection control (PIC), and oral rabies vaccination (ORV). TVR and PIC are labor intensive and the most expensive tactics per unit area (approximately $616/km(2) [in 2008 Can$, converted from the reported $450/km(2) in 1991 Can$] and approximately $612/km(2) [$500/km(2) in 1999 Can$], respectively), but these tactics have proven crucial to elimination of raccoon rabies in Canada and to maintenance of ORV zones for preventing the spread of raccoon rabies in the United States. Economic assessments have shown that during rabies epizootics, costs of human postexposure prophylaxis, pet vaccination, public health, and animal control spike. Modeling studies, involving diverse assumptions, have shown that ORV programs can be cost-efficient and yield benefit:cost ratios >1.0.
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Animales Salvajes/inmunología , Animales Salvajes/virología , Vacunas Antirrábicas/administración & dosificación , Vacunas Antirrábicas/economía , Rabia/veterinaria , Administración Oral , Animales , Canadá , Análisis Costo-Beneficio , Coyotes , Zorros , Humanos , Mephitidae , Modelos Económicos , Rabia/inmunología , Rabia/prevención & control , Rabia/transmisión , Mapaches , Estados Unidos , Zoonosis/transmisiónRESUMEN
Scenario-based analyses were computed for benefits and costs linked with hypothetical oral rabies vaccination (ORV) campaigns to contain or eliminate skunk-variant rabies in skunks (Mephitis mephitis) in California, USA. Scenario 1 assumed baiting eight zones (43,388 km(2) total) that comprised 73% of known skunk rabies locations in the state. Scenario 2 also assumed baiting these eight zones, but further assumed that added benefits would result from preventing the spread of skunk-variant rabies into Los Angeles County, USA. Scenarios assumed a fixed bait cost ($1.24 each) but varied campaigns (one, two and three annual ORV applications), densities of baits (37.5/km(2), 75/km(2) and 150/km(2)), levels of prevention (50%, 75%, and 100%), and contingency expenditures if rabies recurred (20%, 40%, and 60% of campaign costs). Prorating potential annual benefits during a 12-yr time horizon yielded benefit-cost ratios (BCRs) between 0.16 and 2.91 and between 0.34 and 6.35 for Scenarios 1 and 2, respectively. Economic issues relevant to potentially managing skunk-variant rabies with ORV are discussed.
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Análisis Costo-Beneficio , Brotes de Enfermedades/veterinaria , Mephitidae/virología , Vacunas Antirrábicas/economía , Rabia/veterinaria , Administración Oral , Animales , Animales Salvajes/virología , California/epidemiología , Brotes de Enfermedades/economía , Brotes de Enfermedades/prevención & control , Femenino , Masculino , Rabia/economía , Rabia/epidemiología , Rabia/prevención & control , Vacunas Antirrábicas/administración & dosificación , Virus de la Rabia/inmunologíaRESUMEN
OBJECTIVE: To conduct a benefit-cost analysis of the results of the domestic dog and coyote (DDC) oral rabies vaccine (ORV) program in Texas from 1995 through 2006 by use of fiscal records and relevant public health data. DESIGN: Retrospective benefit-cost analysis. Procedures-Pertinent economic data were collected in 20 counties of south Texas affected by a DDC-variant rabies epizootic. The costs and benefits afforded by a DDC ORV program were then calculated. Costs were the total expenditures of the ORV program. Benefits were the savings associated with the number of potentially prevented human postexposure prophylaxis (PEP) treatments and animal rabies tests for the DDC-variant rabies virus in the epizootic area and an area of potential disease expansion. RESULTS: Total estimated benefits of the program approximately ranged from $89 million to $346 million, with total program costs of $26,358,221 for the study period. The estimated savings (ie, damages avoided) from extrapolated numbers of PEP treatments and animal rabies tests yielded benefit-cost ratios that ranged from 3.38 to 13.12 for various frequen-cies of PEP and animal testing. CONCLUSIONS AND CLINICAL RELEVANCE: In Texas, the use of ORV stopped the northward spread and led to the progressive elimination of the DDC variant of rabies in coyotes (Canis latrans). The decision to implement an ORV program was cost-efficient, although many unknowns were involved in the original decision, and key economic variables were identified for consideration in future planning of ORV programs.
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Coyotes/virología , Enfermedades de los Perros/prevención & control , Vacunas Antirrábicas/administración & dosificación , Vacunas Antirrábicas/economía , Virus de la Rabia/inmunología , Rabia/veterinaria , Animales , Control de Enfermedades Transmisibles/economía , Control de Enfermedades Transmisibles/métodos , Ahorro de Costo , Análisis Costo-Beneficio , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/veterinaria , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/transmisión , Perros , Salud Pública , Rabia/epidemiología , Rabia/prevención & control , Rabia/transmisión , Estudios Retrospectivos , Texas/epidemiología , ZoonosisRESUMEN
Skunk-variant rabies is endemic in California (United States), and the development of oral vaccines and baits to vaccinate skunks is in progress. In 2003, the California Department of Public Health (CDPH) began to quantify the impacts of skunk-variant rabies and to assess the feasibility of using oral rabies vaccination (ORV) as a containment measure. The CDPH rabies case data for skunks were spatially depicted and analyzed using a geographic information system. Statewide, rabid skunks (1992-2003) primarily occurred in seven physiographic regions: Central Coast, North Coast, North Sierra, Sacramento Valley, San Francisco Bay and Delta, San Joaquin Valley, and South Sierra. Detailed analysis of rabid skunks in San Luis Obispo (SLO) and Santa Barbara (SB) counties showed that skunk rabies was endemic in the coastal plain of SLO County between 1992 and 2000, but only became epizootic in SB County during 2002. Despite the widespread distribution of striped skunks (Mephitis mephitis) throughout most of California, the skunk rabies variant has not been found in Los Angeles County since 1979. Results imply that future ORV campaigns for skunk-variant rabies in the Pacific Coastal Plain could deter spread from SLO into SB County, as well as deterring the reintroduction of skunk-variant rabies into southern California.
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Mephitidae/virología , Vacunas Antirrábicas/administración & dosificación , Rabia/veterinaria , Administración Oral , Animales , Animales Salvajes/virología , California/epidemiología , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/veterinaria , Femenino , Masculino , Rabia/epidemiología , Rabia/prevención & control , Rabia/transmisión , Virus de la Rabia/inmunología , Virus de la Rabia/aislamiento & purificaciónRESUMEN
The direct and indirect costs of suspected human rabies exposure were estimated for San Luis Obispo and Santa Barbara counties, California, USA. Clinic, hospital, and county public health records (1998-2002) were examined to determine direct costs for postexposure prophylaxis (PEP), and 55 (41%) former patients were contacted to voluntarily provide estimates of their indirect costs associated with receiving PEP. Additional costs due to public health and animal control personnel responses to rabid animals were collected, including diagnostic testing and wages. The mean total cost of a suspected human rabies exposure was $3,688, the direct costs per case were $2,564, and the indirect costs were $1,124 of that total. About one third of the total cost for suspected human rabies exposure was attributed to indirect costs (e.g., lost wages, transportation, and day-care fees), most of which were not reimbursable to the patient.