MPH 610 Week 2 Practice Site Analysis Example

Practice Site Analysis: The Kessler County Rabies Prevention Program, the Residents It Actually Serves and Whether One Technician Can Carry Its Load

Student Name

Chamberlain University

MPH 610: Integrative Learning Experience (ILE) and Applied Practice Experience (APE) I

Instructor Name

Month Day, Year

Practice Site Analysis: The Kessler County Rabies Prevention Program, the Residents It Actually Serves and Whether One Technician Can Carry Its Load

The Population the Program Actually Serves

Kessler County's rabies prevention program, part of a composite health department serving roughly 180,000 residents, describes its mission as protecting the county from rabies. The people it actually serves are narrower: residents bitten or scratched by an animal, the owners of animals that bite and the clinicians who must decide whether a patient needs rabies postexposure prophylaxis. In 2025, the program received 612 bite reports, a rate of 340 reports per 100,000 residents. Reports came mostly from emergency departments and urgent care clinics, which are required by county code to report animal bites, and a smaller share from animal control and residents themselves.

Children were overrepresented. Children under 10, about one resident in eight, accounted for 21% of bite reports, a rate of about 600 per 100,000, compared with about 310 per 100,000 among residents aged 10 and older. Most bites to young children were from a dog the family knew.

Counts Turned Into Rates and Shares

Table 1

Animal Bite Reports and Program Activity, Kessler County, 2025

Note. Note. Composite figures constructed for this course from a program spreadsheet; rates use the 2025 county population estimate.

Two shares matter most. Only 53% of biting dogs and cats had documented current rabies vaccination, which means nearly half of the domestic animal bites required either a 10-day observation of the animal with follow-up or a judgment about prophylaxis. And 23% of reports generated a call for prophylaxis advice, which is the part of the work where inconsistency matters most.

The National Picture as a Benchmark

Nationally, rabies in animals is concentrated in wildlife. National surveillance counted 3,760 rabid animals in 2023, about 92% of them wild, with bats and raccoons the most frequently found rabid wild animals and cats the most frequently found rabid domestic animals (Boutelle et al., 2025). The county's two positive tests, a bat and a raccoon, fit that pattern. Prophylaxis use is not tracked nationally, and a survey of state health departments arrived at an annual national average of roughly 23,400 courses, with a wide range (Christian et al., 2009). These benchmarks show that the county's bite load is mostly low-risk domestic animal exposures, while its real rabies risk sits in a small number of wildlife contacts, especially bats.

Capacity in the Same Currency

The program's capacity can be measured in the same unit as its demand: hours. The technician estimates that a routine dog or cat bite takes about 1.5 hours from report to closure, including calls to the owner, an observation letter and a follow-up check on day 10. A wildlife or bat contact takes about 3 hours, including arranging testing and advising the clinician. At those rates, 2025's reports required about 950 hours. The technician is one full-time position, but about half of that position is assigned to other environmental health duties, leaving about 1,040 hours a year for bites. The program ran at roughly 90% of its capacity, with no slack for a busy summer month, when reports run nearly twice the winter rate, or for the technician's leave.

Where the Inconsistency Comes From

Advice on prophylaxis is given by whoever answers: the technician, the division manager or, after hours, the on-call environmental health specialist. None works from a written protocol. The division keeps a copy of the national recommendations, but staff told me they rarely open it during a call. National data suggest that prophylaxis decisions are often inconsistent with guidance in both directions, with prophylaxis given unnecessarily and sometimes withheld when it was needed (Moran et al., 2000). A written decision guide would let any staff member give the same answer to the same situation, and would let the program show the board how decisions were made.

Sources a Reader Can Check

The county figures come from the program's 2025 spreadsheet, which I cleaned and analyzed with the manager's permission; they are composite figures for this course. The population estimate is the county's 2025 estimate. National figures come from published surveillance and research cited above. Where the spreadsheet was incomplete, such as missing vaccination status for 64 animals, I counted those animals as not documented, which may understate true vaccination.

The Line to the Deliverable

The analysis supports both proposed products. The protocol addresses inconsistent advice on prophylaxis, which affects about 140 calls a year and carries the highest stakes. The quarterly report addresses the board's questions, such as vaccination status of biting animals, and will show seasonal demand, which supports a request for summer help. Neither product adds hours to the technician's load; the protocol should shorten calls, and the report will be built from data already collected.

What the Data Cannot Show

The spreadsheet records reports, not exposures. Bites treated at home, or by clinicians who do not report, are missing, so the true number of bites is higher than 612, probably most of all for minor cat scratches. The spreadsheet also does not record what clinicians decided about prophylaxis after calling, so the analysis can show how often advice was sought but not whether it was followed. Finally, 2025 is one year; the program's earlier data, from 2023 and 2024, will be added to the cleaned data set so that seasonal patterns and trends can be checked over three years rather than one.

Seasonal Demand

Reports were not spread evenly across the year. July and August together produced 148 reports, about 24% of the year's total, while January and February produced 61. Summer brings more children outdoors, more dogs off leash and more bat activity, and the program's single technician absorbs the peak without extra help. The board summary in the planned quarterly report will show this pattern, since it is the strongest argument for seasonal staffing.

References

Boutelle, C., Bonaparte, S., Orciari, L. A., Kirby, J. D., Chipman, R. B., Fehlner-Gardiner, C., Thang, C., Julien, D., Hirose, J. A. M., García, B. C., Wallace, R. M., & Blanton, J. D. (2025). Rabies surveillance in the United States during 2023. Journal of the American Veterinary Medical Association, 263(10), 1310-1317. https://doi.org/10.2460/javma.25.05.0344

Christian, K. A., Blanton, J. D., Auslander, M., & Rupprecht, C. E. (2009). Epidemiology of rabies post-exposure prophylaxis: United States of America, 2006-2008. Vaccine, 27(51), 7156-7161. https://doi.org/10.1016/j.vaccine.2009.09.028

Moran, G. J., Talan, D. A., Mower, W., Newdow, M., Ong, S., Nakase, J. Y., Pinner, R. W., & Childs, J. E. (2000). Appropriateness of rabies postexposure prophylaxis treatment for animal exposures. JAMA, 284(8), 1001-1007. https://doi.org/10.1001/jama.284.8.1001