Bat Bite| Management of Human-Bat Encounters Animal Bites and Rabies Risk:
Bat Bite, Rabies virus is a neurotropic viral pathogen that causes fatal encephalitis in humans and domestic animals worldwide. Although bats are considered natural hosts of rabies virus, human infection due to contact with infected bats is rare. In contrast, bat bites account for up to 30% of reported cases of animal bite exposures in some areas of North America. While most human rabies infections occur via dog bites, bat rabies represents a significant public health concern because bats are often overlooked as potential sources of zoonotic disease transmission. This article provides guidance regarding the management of human-bat encounters and bat bites, including assessment of the need for rabie PEP following a bat exposure.
Bat encounters and bat bites
Most people who have been bitten or scratched by a bat report a sting or needle prick sensation. Bat bites may not be noticeable, especially if the person is sleeping, and bat bites may cause little or no damage to skin. Because bats are known carriers of several viruses, including rabies, it is important to take precautions against being bitten or scratched by a wild animal.
If you encounter a bat, do not try to catch it. Do not run away from the bat. Instead, make yourself comfortable and remain calm. Try to determine whether the bat is rabid, and if it is, notify local authorities immediately. If the bat does not seem rabid, call your doctor or seek medical attention.
If you are bitten or scratched by a mammal, such as a cat or dog, wash the area thoroughly with soap and water. If the bite or scratch involves broken skin, cleanse the wound carefully with soap and water. Contact your healthcare provider promptly to obtain appropriate treatment.
When should a bat be submitted for rabies testing?
In most states, bats are considered wild animals and do not require rabies vaccination unless you know for certain that the animal has come into close contact with another domestic pet. If you suspect that someone has been bitten or has any physical contact with a rabid bat, you must submit it for rabies testing within 24 hours. You can call your local health department directly or go online to www.cdc.gov/rabies/contactus.html.
How to capture a bat and submit it for testing
The Centers for Disease Control and Prevention (CDC) recommends that anyone who finds a bat in their home catch it alive and immediately contact local health officials. If you are bitten by a bat while handling one, see a physician immediately.
Assessment of the need for rabies PEP following a bat encounter
Rabies virus is present in approximately one-third of North American bats. In most cases, bats do not bite humans; however, some species bite people occasionally. There are three different types of rabies exposures that occur in the United States: bites from rabid animals, scratches from rabid animals, and exposures from bats. These exposures usually involve close contact such as handling, petting, or feeding.
The incubation period for rabies varies depending on the type of exposure. Bites from rabid animals typically begin with symptoms occurring anywhere from 7 to 21 days later. Scratches from rabid animals often start showing signs of illness around 14 days after being scratched. Bat exposures rarely show signs of disease because the virus does not replicate well in the body. However, it takes about 10 days for the virus to reach the brain where it causes infection. This is why it is important to seek medical advice immediately after a bat encounter.
There are four phases of treatment for rabies: prevention, postexposure prophylaxis (PEP), acute management, and long term follow up. Prevention involves the use of vaccines to prevent the development of clinical disease. Postexposure prophylactic medications must be given within 72 hours of the exposure to reduce the risk of developing clinical disease. Acute management includes providing hydration and pain control. Long term follow up consists of monitoring the patient for neurological complications.