Other exposure criteria to consider: Were you an unusually deep sleeper or inebriated? Because bat bites can be very hard to detect, as happened in this case, any time a person who was asleep is found with a bat in their room, that is considered a significant exposure. Public health staff found 15 family members and 100 healthcare workers (HCW) in Wyoming and the referral hospital in Utah, who had cared for this woman. Most of these deaths are from dog bites. (When I was a kid, there was a rumor that you needed twenty shots in the stomach; that’s not the way it works anymore. PEP is now administered by a series of four vaccine injections in the arm plus one dose of rabies immune globulin. Do not kill the bat as it may be a federally protected species. While bats do carry rabies, it’s still relatively rare. When not slaving over hot patients, I can be found playing with photography, friends’ dogs, or in my garden. Bats’ teeth can be small enough that you don’t notice the bite. Q: If I wake up with a bat in my bedroom and there is no sign of a bite, do I need a rabies shot? There are still 80 – 100 dogs and >300 cats with rabies each year in the U.S. Avoid wild animals and stray dogs, especially if they are exhibiting abnormal behavior. Teach your children not to play with wild animals nor to pick up and play with dead animals. From 2006 to 2012, nearly 5 million bats died of white nose syndrome, a fungal disease introduced from Europe or Asia that’s common in the Northeast and is spreading south and west. November 12, 2014. I’ll never know whether my decision to fork over $600 in ER co-pays and suffer from days of flu-like side effects was a ridiculous overreaction to a minimal risk. The CDC has more information on bats and rabies here. Yet to drive home the point of what could happen, a handful of bat cases have been deemed “cryptic” because the victims didn’t know they were bitten. One hot July night, I awoke at 3 a.m. to find two bats fluttering above my bed. By comparison, there are 59,000 deaths from rabies each year around the world, and 98 percent are from dog bites. She underwent several invasive procedures (electromyography, lumbar puncture, etc.) We encourage bats to roost and are worried about the obvious decline in their population here. Once somebody starts showing symptoms of rabies, they’re a goner. In this Wyoming case, two family members who had exposure to her saliva required treatment. Still, it’s better to have medical bills than to be dead, so this isn’t a good place to save money. I am an Infectious Disease specialist and author of Resilience: One Family's Story of Hope and Triumph over Evil and of Conducting Clinical Research, the essential guide to the topic. “Despite the perception there are more bats, their populations are in decline,” said Susan Loeb, research ecologist at the U.S. Forest Service’s southern research station. Although they had sought advice about bats before, as they routinely encountered them, no wildlife or health agency had educated them about the risks and precautions. As a result, bats now account for 90 percent of human rabies cases and in 2015 surpassed raccoons in the “wildlife most likely to be rabid” category, thanks to a recent government push to vaccinate East Coast raccoons by spreading an oral version of the vaccine hidden in marshmallows or fish bait. Wildlife experts say there’s no evidence of increased interactions between bats and humans, although bats might be more visible these days as steady housing construction encroaches on their habitat. Follow on Twitter @drjudystone, © 2020 Forbes Media LLC. The typical treatment for rabies, according to the CDC, is a shot of immune globulin—basically, antibodies that already know how to recognize the virus—along with a shot of rabies vaccine. I especially love writing about ethical issues, and tilting at windmills as I advocate for social justice. He said there are more than 2,000 laws in the U.S. regarding rabies, Centers for Disease Control and Prevention. If you get a bite, wash it thoroughly with soap and water or, if available, povidone-iodine (Betadine), which has anti-virucidal activity. In the reported cases of rabies from bats, people were generally unaware of having been bitten. Bats tend to show up indoors more often at this time of year because young bats born in the spring are now old enough to take to the air in search of food and new places to live. and was diagnosed as having Guillain-Barré syndrome. Her husband saw no bites or wounds. Part of HuffPost Wellness. The same is true for anyone who spends time with a bat and might not be aware of being bitten, or might not be able to communicate that they were. Ask your local or state health department for more information; they keep tabs on rabies infections in wildlife. on the third, seventh, and fourteenth days after getting bitten, insurance doesn’t always cover as much as you’d hope. There are occasional rabid cattle, horses, sheep and goats. With the right preparation, you will be just fine. She shooed it out, and was unaware of any direct contact with the bat. For example, the fox we saw staggering around downtown Boothbay Harbor, Maine, in broad daylight, was certainly cause for concern. “They look like you’ve been punctured with a stapler, and the marks disappear within a couple of hours,” explained Cindy Myers, bat team leader at Project Wildlife, a program of the San Diego Humane Society, who supervises about 50 bat rescues a year. Afterward she developed worsening neurologic problems. Twelve HCW required prophylaxis; another 10 wanted PEP, though they were not aware of a specific risky exposure. PEP is now administered by a series of four vaccine injections in the arm plus one dose of rabies immune globulin. Dr. Alexia Harris, lead author of this report, explained “that appropriate and timely rabies PEP is universally effective, and that those who die of rabies either receive no PEP, as in this case, or received PEP without immune globulin, with significant delays or according to schedules that differ from ACIP and WHO guidelines. If you know for certain that no one has been bitten by the bat, then you can release the bat outside. PEP is very effective. I am an Infectious Disease specialist and author of Resilience: One Family's Story of Hope and Triumph over Evil and of Conducting Clinical Research, the essential guide. “They’re not coming after you or a pet. On the eighth day of hospitalization, the family remembered that she had awakened with a bat on her neck and had swatted it off. Despite the uncertainty of who should get vaccinated, the rabies story in the United States is a major public health victory. She has written about health and science for over a decade, including two books: Outbreak! Small mammals like squirrels and chipmunks have never been known to transmit the virus. That’s in addition to the several hundred thousand bats that die annually after flying into wind turbines. Despite the recent scary press about bats, raccoons and skunks are almost equally problematic and bats are important in reducing mosquitoes and other unwanted insect pests. You can be bitten without knowing it, which is why health departments often recommend a rabies shot if you wake up with a bat in your room. But it was a risk nonetheless. and Genetics 101. He said there are more than 2,000 laws in the U.S. regarding rabies, meaning there’s no consensus among county health departments, but said people should use “critical thinking skills” in evaluating their risk of having been bitten. Bats shouldn’t be known for their risk of rabies and late-night visits. 80 – 100 dogs and >300 cats with rabies each year in the U.S. The bat can be tested for rabies, and if it didn’t have rabies, you don’t need to get the shots. I survived 25 years in solo practice in rural Cumberland, Maryland, and now work part time. Please stop trying to make it one. Get all the latest election results from across the country, with up-to-the-minute maps and more. “But we’re actively monitoring it.”. Monkey bites are a serious risk outside the U.S. Bites on the head and neck are the most rapidly fatal. Option 1. “There’s no indication they’re here yet,” said the CDC’s Wallace. Rabies can be prevented by either vaccination before an anticipated exposure, as is common among veterinarians, for example, or as post-exposure prophylaxis (PEP) after a bite. Advertisement The CDC has more information on bats and rabies here . Most commonly, the bite comes from bats, dogs or cats; foxes and raccoons are also risky. This, like red velvet cake, is not a thing. There have been only 26 human deaths due to rabies in the last decade, and half were from bats. She consulted with the hospital’s infectious disease specialist and called Yee before ordering the shots. Were children involved or someone with special needs who might be unable to communicate? At my local ER, the attending physician looked puzzled about why I was there if I didn’t have a bite mark. They’re learning to fly this time of year and finding their way around. It lends an element of endearment,” Stokes said. She was thought to have a urinary tract infection, a common cause of confusion and weakness in the elderly, and received antibiotics. An elderly Wyoming woman died of unsuspected rabies, exposing a number of family and healthcare workers to the virus and necessitating their treatment. Failure to follow these directions may result in unnecessary rabies shots. In my practice, I had a relatively low threshold for advising it, given the risk/benefit ratio. “My guess is that they’re juvenile bats. It can also present a serious risk to your health because bats can be infected with rabies. When I received my second shot, another ER doctor who was tending to actual sick people rolled his eyes, saying it was “highly unlikely” I had come in contact with rabies. Rabies isn’t a routine childhood vaccine. In the past, vaccine and rabies immune globulin standards have not been as good there. That’s counter to the CDC recommendation to seek treatment for “both bite and non-bite exposures.”. He speculated that the bats in my neighborhood north of San Diego, near Carlsbad’s Batiquitos Lagoon, are probably the Mexican free-tail or Yuma myotis species. The CDC estimates 40,000 to 50,000 people in … So if there’s even a chance that you (or your child) has been bitten, it’s probably worth getting the recommended treatment as soon as possible. She visited an emergency room for a five-day history of progressive weakness and ataxia (incoordination) after a fall. Her Wilks score is 302. They can get all sorts of nasty infections now that were not such a concern in my youth (tularemia, Ebola, etc.).