Knowledge of Bat Rabies and Human Exposure Among United Stat

[caverbill]

I recently had an argument with my local health department official about this issue. The current directive (in this part of Virginia at least) is if a bat gets in someones house, with no known contact, is to administer the post exposure series. I pointed out how ridiculous that policy is but she did provide me with the same statistics as stated above. I hate to see the re-birth of bat paranoia.

I have been bitten hundreds of times, and I am still not foaming at the mouth.

[Lynn]

Unknown to us at the time, a few years ago a grey bat had wintered over and hibernated on one of the log beams of our home. After he awoke in the spring we discovered the bat one morning near the dogs water bowl and with gloves on placed the little fellow outside. No, neither one of us wound up with the frothy mouth, either!

[Squirrel Girl]

I recently had an argument with my local health department official about this issue. The current directive (in this part of Virginia at least) is if a bat gets in someones house, with no known contact, is to administer the post exposure series. I pointed out how ridiculous that policy is but she did provide me with the same statistics as stated above. I hate to see the re-birth of bat paranoia.

I have been bitten hundreds of times, and I am still not foaming at the mouth.

I was at the 2000 convention seminar with the CDC, and after listening to that, I probably would go along with the CDC. But that's when a *bat* gets in *my house*. Not when *I* go in to a *bat's house.*

The deal is that it's out of the ordinary for a bat to come into a person's house. I don't think I'd worry too much if there were a few roosting in my attic (though I might try and rid them). But based on incidents where people died of rabies after having had bats in their house with no known contact, I'd worry about it, now, too.

That's different than bazillions of "spelunkers" going into caves and never getting rabies.

[cavedoc]

I probably would go along with the CDC. But that's when a *bat* gets in *my house*. Not when *I* go in to a *bat's house.*

The deal is that it's out of the ordinary for a bat to come into a person's house. I don't think I'd worry too much if there were a few roosting in my attic (though I might try and rid them). But based on incidents where people died of rabies after having had bats in their house with no known contact, I'd worry about it, now, too.

That's different than bazillions of "spelunkers" going into caves and never getting rabies.

What she said. There is a huge difference in rabies risk depending on whether the bat is in its normal environment doing what it ought to be doing compared to one that decides to invade someone's house. In that case, it's much more likely to be rabid. More than 75% of those tested in those circumstances were rabid in one study:

http://www.cdc.gov/ncidod/EID/vol5no3/pape.htm

Same deal with a dog etc. If it's acting normal, no big worries. If it's acting weird, way big worries if you get bit. And a lick is plenty if your skin is broken. Leave 'em alone in a cave or use gloves if you HAVE to handle them.

I got pre-exposure shots prior to an expedition, more from a fear of dogs than bats. I've been more exposed in the USA and have not checked titers or gotten boosted. The advantage to pre-exposure shots is that you have fewer shots if you're bitten and deemed to need the full course and if you get bit it's felt you have a longer cushion before getting the rest of the course is critical (read, if you get bit abroad, you have time to come home before getting the rest of your shots).

Roger Mortimer, MD

[caverbill]

After years of getting calls from people on how to get bats out of your house, lat year we bought an old fixer upper with bats in the attic.

Every now and then we hear one in the kitchen ceiling that has "lost" its path to the outside and fill find its way in. I don't think it decided to enter human habitat and they still exhibits normal behavior. Usually get the bat out within ten minutes. I can't imagine getting my whole family to take the shots simply because a bat was in my house.

But I agree that statistically this is very different than cavers entering a cave with bats.

[Squirrel Girl]

On a very slightly tangential topic.....

The teenager who was the first to survive a rabid bat bite with symptoms, but no vaccine, is doing well, and still improving:

http://www.forbes.com/home/feeds/ap/200 ... 13479.html

[Buford Pruitt]

Was she really the first rabies victim to survive the disease? I thought there was another survivor several decades ago whose doctor fought the symptoms one at a time and the victim survived.

[Squirrel Girl]

I remember talking to a doctor a long time ago about rabies. Apparently there have been something like 2-3 survivors. But the doctor said, you wouldn't want to be one of them. They were severely messed up.

The other thing is that sometimes something is reported, but when researched, it turns out it 'taint weren't so.

[Phil Winkler]

Buford,

You are correct. The young man was a Matthew Winkler near Atlanta, I think...or maybe Missouri. The doc did treat him symptomatically. His titer was over 100,000 indicating the extent of his infection.

interestingly, his doc was also named Winkler. No relations here, at all.

It made history at the time. Maybe in the 80s or mid/late 70s?

I'd bet you could google it.

[Squirrel Girl]

Ah Phil,

How did we live before Google?

"Matthew Winkler rabies":
"In 1970 Matthew Winkler was exposed [to rabies], treated [with postexposure vaccine], and because vaccines were not as good then, experienced a vaccine failure. He recovered despite the vaccine failure, which is a far different thing than catching the disease, [not being treated,] and recovering," he points out. "Some people question to this day whether that case meets all the criteria [of a human known to survive rabies without treatment]."
(from: http://www.fda.gov/fdac/features/996_rab.html )

[Buford Pruitt]

Aaaaaahhhh, thanks guys! You've renewed my faith in my memory.

What worries me, though, is that bats are being increasingly revealed as the carriers of other dreadful diseases, specifically hemorrhagic fevers like Ebola, Marbon and Tacaribe. The latter is found in the New World (Trinidad so far), so we can't be smug about not living in Africa. Betcha there are people out there sampling bats all over the world to see what else is waiting "in the wings."