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Animal human infection connection

7/24/2016

 
​By Richard P. Holm MD
 
One early morning, I was walking toward the back door on my way to work when suddenly there was a big bat flying around the breakfast room, swooping around like in a Dracula movie. As it came near me, I reactively swung at it and like hitting a Nerf ball, it was thrown across the room landing on the kitchen floor a little stunned. I closed all doors to the rest of the house, locked open the exit outside, washed my hands thoroughly, and shooed the creature out into the early morning darkness.
 
Bats are a marvel of evolutionary diversity with something like 47 different species living just in the U.S. and important by their contribution to our ecosystem. Experts believe that these winged animals first developed powered flight and later the ability to chirp and recognize their echo and thus their location. This capacity for radar-like-echolocation became so refined as to allow flying at night or in a cave without light. Bats eat their weight in bugs every night, carry seeds to reforest depleted wooded areas, and pollinate plants.
 
But one percent of these little flying mammals carry a deadly virus called Rabies. Stricken with Rabies, the victim, whether bat, dog, skunk, cat, or human, turns confused, agitated, aggressive, and infectious. Although not like a movie Zombie, which has returned from the dead, those bitten by one infected with this age-old condition, left untreated will certainly die.
 
So, after striking down the bat, did I need to receive Rabies Post Exposure Prophylaxis (RPEP) to protect me from coming down with Rabies? This involves four doses of Rabies vaccine over 14 days, and one injection of active immune globulin. Checking out the last 15 cases of Rabies over five years in the U.S., nine were from bat exposure, four from dogs, one from a fox, and one unknown. All but one died, and the one survivor is neurologically disabled. This left me concerned.
 
The CDC recommendations advise having RPEP if there has been a bite or an exposure to saliva into eyes, nose, mouth, or open wound. This was unlikely in my case and official recommendations say hand-washing is extremely important.
 
So I did not seek out RPEP as I did not receive a bite, the bat was acting normally, and I washed my hands well after touching the bat, although I did have a few restless and on edge nights.
 
Still, don’t let me bite you if I start acting like a Zombie.

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