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Human rabies often caused by undetected, tiny bat bites

While being bitten by a bat is rare, people should be aware that most human rabies cases in the United States were caused by bat bites that probably were unrecognized or undetected, according to an article in the May 2002 Annals of Emergency Medicine. (Cryptogenic Rabies, Bats, and the Question of Aerosol Transmission)

In the past decade, bats were the cause of 24 of the 26 human deaths from domestically acquired rabies. Only 2 of the 24 cases attributed to bats had bites definitively reported. This led to the authors investigation of how bat rabies is likely transmitted to humans.

Robert V. Gibbons, MD, MPH, of Walter Reed Army Institute of Research in Silver Spring, Md., reviewed the 24 cases of humans with bat rabies, and medical and scientific literature. He found it is highly unlikely for bat rabies to be transmitted to humans through the air or passed to humans from an animal that was infected with bat rabies, such as a cat or dog. Instead, Dr. Gibbons concludes that bats most likely bit these individuals, but they probably did not know bat bites can transmit rabies or perhaps their bites were unrecognized or undetected.

Indigenous rabid bats have been reported from every state except Hawaii, according to the article. The most common bats in the United States, the silver-haired and eastern pipistrelle bats, weigh a third of an ounce or less and have tiny teeth; a person could potentially mistake their bites for a thorn prick, a spider bite or a bee sting, said Dr. Gibbons. These bats also may go unrecognized because they do not form large colonies and can be found alone in trees, foliage, and crevices in wood and rock. This would make evidence of being bitten and detection of a bite mark difficult, according to the articles author.

Dr. Gibbons advises the public to seek emergency care for preventive treatment for rabies if direct contact with a bat occurs, a sleeping person awakens to find a bat in the room, or if a bat is foun
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Contact: Colleen Horn
chorn@acep.org
202-728-0610
American College of Emergency Physicians
3-May-2002


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