Rabies Concerns After Bat Encounter: Should You Get Vaccinated?

Q: Rabies Concerns After Bat Encounter: Should You Get Vaccinated?

Dear Ms. <br>Kiki：<br>1. <br>According to the regulations announced by the Centers for Disease Control (CDC) in Taiwan on May 3, 2019, exposure to wild mammals (such as weasels, civets, Taitung city money mice, bats, etc.) classified as Category II or above requires immediate med

Rabies-related issues?

Hello Dr.
Hsiao,
Three days ago, I accidentally stepped lightly on a bat that was crawling and unable to fly (it appeared to be an adult bat) while on the road.
My father used a toothpick he had to touch the bat's claws to check if it was alive, intending to move it to a bush.
The bat then crawled away, half flying and half crawling.
Shortly after, my father forgot that the toothpick had touched the bat and used it again to clean his teeth, coming into contact with his mouth.
By the time I noticed, it was too late to stop him.
I found information online regarding bats and their association with rabies virus and Lyssavirus.
Since there was no direct bite from the animal, I am unsure if this indirect contact poses any risk of infection.
We live in Fengyuan, Taichung, and are not clear if this area is considered an outbreak zone.
I would like to ask if we need to make an appointment at a family medicine clinic to receive the rabies vaccine.
Thank you very much!

Kiki, 20~29 year old female. Ask Date: 2019/06/11

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
Kiki:
1.
According to the regulations announced by the Centers for Disease Control (CDC) in Taiwan on May 3, 2019, exposure to wild mammals (such as weasels, civets, Taitung city money mice, bats, etc.) classified as Category II or above requires immediate medical attention and vaccination.
If the animal tests negative, vaccination can be discontinued.
(You may refer to the CDC website for more information.)
2.
Category II definition: Minor bites with broken skin, superficial scratches, or abrasions without bleeding.
3.
Category III definition: Single or multiple bites or scratches that penetrate the dermis, licking of broken skin by the animal, or contamination of mucous membranes by the animal's saliva, including bites or scratches from bats or contact of wounds or mucous membranes with their saliva or other secretions.
4.
For individuals who do not meet the criteria for vaccination (such as bites from other wild animals), vaccination may be offered at their own expense if vaccine supply is stable.
5.
With the exception of money mice, exposure to wild mammals is applicable nationwide.
6.
In your father's case, it is impossible to determine which bat may have rabies or whether the bat's claws came into contact with its saliva or were contaminated with the rabies virus.
Therefore, it is recommended that your father promptly visit a medical facility that can provide vaccination and discuss the situation in detail with a physician before making a decision.

Reply Date: 2019/06/11

More Info

When it comes to concerns about rabies after an encounter with a bat, it is essential to understand the risks and the appropriate steps to take. Rabies is a viral disease that is primarily transmitted through the saliva of infected animals via bites or scratches. Bats are known carriers of rabies, but not all bats are infected with the virus. In your case, the situation involves indirect contact with a bat, which raises questions about the potential for rabies transmission.

Firstly, it is important to note that rabies is not transmitted through casual contact or touching a bat. The primary concern arises when there is a bite or scratch that breaks the skin, allowing the virus to enter the body. In your scenario, since your father used a toothpick to touch the bat and later used it in his mouth, the risk of rabies transmission is extremely low, especially if there was no visible bite or scratch on the skin.

According to the Centers for Disease Control and Prevention (CDC), rabies vaccination is recommended for individuals who have been bitten or scratched by a potentially rabid animal. However, in cases of mere contact without a bite, the need for vaccination is not typically warranted. The CDC also emphasizes that rabies is not transmitted through saliva unless it enters the bloodstream through a wound.

Given that you live in Taichung, which is not considered a high-risk area for rabies in bats, the likelihood of encountering a rabid bat is relatively low. In Taiwan, rabies cases have been reported, but they are primarily associated with wild animals such as raccoons and ferrets, rather than bats. The risk of rabies transmission from a bat that was not aggressive or did not bite is minimal.

However, if there are any concerns about your father's health or if he experiences any unusual symptoms, it is advisable to consult a healthcare professional. They can provide a thorough assessment and determine if any further action is necessary. If there is any doubt about whether the bat was rabid or if there were any potential injuries that were not noticed, it is always better to err on the side of caution and seek medical advice.

In summary, based on the information provided, it is unlikely that rabies vaccination is necessary in this situation. The indirect contact with the bat, especially without any bites or scratches, poses a very low risk for rabies transmission. However, if there are lingering concerns or if your father experiences any symptoms, it would be prudent to consult a healthcare provider for further evaluation. Always prioritize safety and health, and when in doubt, seeking professional medical advice is the best course of action.

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