Whom should I bite first?

June 30, 2010 6:45 PM

Am I going to get rabies? I found a little brown bat on the floor of my house this evening (~9 pm). It was curled up on the floor so I thought it was a leaf. Anyway I scooped it into a mesh wastebasket and it immediately fluttered up to the top of the inverted basket.

Its wingtip brushed my finger just then, and again when I took it outside and released it. After I let it go (and it was kind of slow to get out of the basket), I read on WebMD that fluttering (let alone curled up) on the floor is not the healthiest bat behavior.
I don't want to get a rabies shot if I don't have to (and neither does Mr. Doodley, and nor do the five Doodley cats), but I also don't want to get rabies.
How likely is it that any of us got rabies from a bat we didn't even know was in here? And how likely is it that being lightly brushed by a wing (I didn't feel a scratch) constitutes a significant exposure?
How long do I have after a notional exposure to notice initial symptoms (flulike symptoms and malaise, helpfully enough) to get the vaccine and still have it work?

posted by toodleydoodley to health & fitness (33 answers total)

Uh, you'll be fine. Rabies is transmitted through mucous-membrane contract or straight into the blood stream. Unless you had a gaping wound on your finger and the bat spit into it, you'll be okay.
posted by InsanePenguin at 6:48 PM on June 30, 2010 [1 favorite]

Also, if it was rabid, it would have been freaking right the fuck out.
posted by InsanePenguin at 6:50 PM on June 30, 2010

Rabies is a virus. This is kind of like saying "Can I get HIV by bumping into someone who has it?".
posted by rancidchickn at 6:50 PM on June 30, 2010

If you're not scratched, your chances of rabies are extremely minimal. If you have health insurance, feel free to call the nurse line, if they have one to check. Even with sick bats, rabies is fairly rare. You can read up at the Mayo Clinic website and decide for yourself, but what they say is that if you are certain you haven't been bitten [i.e. you were not asleep and woke up with a bat in your room] or scratched you are okay. That said, once you're showing real symptoms, if you really had rabies, it's too late, so you'll have to do your own risk assessment. If it were me [and I grew up around bats] I think I'd call my doctor and if he said not to worry about it, not worry about it.
posted by jessamyn at 6:53 PM on June 30, 2010 [1 favorite]

Fur can hide scratches so I would get the cats updated rabies shots just in case.
posted by silkygreenbelly at 6:56 PM on June 30, 2010 [1 favorite]

Also, if it was rabid, it would have been freaking right the fuck out.

There's a difference between an animal that is carrying the virus and one that is exhibiting the symptoms of late state rabies. The big deal with rabid animals is that they've got a nervous system vurus and they're incredibly thirsty [because their throat is paralyzed and they can't drink water] which is one of the reasons animals that might otherwise stay away from human are in your house. They're not necessarily going crazy or anything else. When I was a kid we had some rabid bats in our silo and my mom needed to fight tooth and nail with the health department to even convince them that bats could be rabid. The bats in our house were not freaking out, but they also weren't staying outside.
posted by jessamyn at 6:56 PM on June 30, 2010 [1 favorite]

You may want to vaccinate your cats if there was a chance any of them were "playing" with the bat before you noticed it on the floor.
posted by castlebravo at 7:00 PM on June 30, 2010 [1 favorite]

Bat didn't bite you or scratch you? You have no open wounds? You're fine.

As far as the bats freaking out goes, my vet says that there are two symptom sets for rabies. It doesn't always involve foaming at the mouth etc.—it can be 'dumb' rabies, where the animal just kind of shuts down.

So you are fine so far, but if that bat turns up again, call the DNR.
posted by bricoleur at 7:14 PM on June 30, 2010

I agree with castlebravo. How likely is it that you would find a semi-injured rodent on the ground in a house with 5 cats and none of them had anything to do with it? I'd get the cats checked out but you're probably fine.
posted by cranberrymonger at 7:16 PM on June 30, 2010

Your fear of rabies shots may be out of date. Time was when rabies vaccine had to be directly injected painfully deep into the abdomen, but that's not the case any longer. Now they do it in the arm just like a flu shot. And it doesn't put you out of commission, either.

A lady I used to date got bitten by a stray cat and had to go through a rabies vaccination sequence. It didn't slow her down at all. She hardly noticed it.
posted by Chocolate Pickle at 7:18 PM on June 30, 2010

You're totally fine. The cats are also probably fine, but they should be vaccinated against rabies anyway, especially if they ever go outside. Keeping your cats' rabies shots current is the law in many states.
posted by Metroid Baby at 7:33 PM on June 30, 2010

FWIW: cranberrymonger, bats are not rodents. Bats are in the order Chiroptera, not Rodenta.

The point stands, though, that "lying on the floor" is not the normal behavior for a bat. You are almost certainly fine, as you have to have a bite or other fluid contact with mucus membranes to be at risk. Was the bat bleeding? It's pretty unlikely that it would be in good shape if your cats got hold of it. But if you want to be 100% safe, updated rabies shots for the animals.

Also: "waiting for symptoms" is not something you do with rabies. In the entire history of Western medicine, there have been SIX reported human survivors of rabies after the onset of symptoms, and of those 5 had been vaccinated or otherwise treated prior to the onset of symptoms. It is one of my favorite medical pieces of trivia that until 2004 there was only one known case in all of medical science of a human survivor of rabies where the person didn't receive some form of treatment before symptoms started. Using the treatment developed in that case, 2 others have now been saved.
posted by griffey at 7:33 PM on June 30, 2010 [2 favorites]

A scared bat trapped in a house will often make itself small and hide.
posted by L'Estrange Fruit at 7:38 PM on June 30, 2010

Ooops! Thanks for the proper facts, griffey!

I would assume a bat is still appealing in the eyes of a cat, though, as it's quick and small. Unless your cats are of the "scaredy" variety...
posted by cranberrymonger at 7:48 PM on June 30, 2010

Are you probably fine? Yes. However, I am not as sure as others here that you should dismiss the threat outright. Bats can bite you without you knowing it, especially if you were sleeping while the bat was in your house, and bat bites are the second most common cause of human rabies cases (after dogs). This wikipedia article claims there's even some evidence bats can transmit rabies even without a bite. You might talk to your GP for a more expert opinion than you'll get here. As others have said, once a human shows symptoms of rabies, death is a certainty.

(FWIW, I was bitten by a family dog last year, but didn't realize it until I got home, and didn't have the owners' information. My doctor said that while there was obviously some chance of exposure, it was small enough to forgo the shots, which cost like $2000. I suspect you'll be in the same boat, but I would still talk to a doctor.)
posted by deadweightloss at 8:25 PM on June 30, 2010

There are financial reasons why you wouldn't take rabies shots unnecessarily - I have heard from animal workers that the vaccinations can cost thousands of dollars.
posted by Earl the Polliwog at 8:51 PM on June 30, 2010

I had rabies shots after a bat incident, a bit more drastic than yours, involving an actual scratch, but it is worth realising that if you get sick, that is it. I'm way too much of hypochondriac to deal with that - I got the shots (in the arm over a month) and I still convinced myself I had it about eight times. Everyone I spoke to at the hospital agreed I should get the shots, so I'd let that be your yardstick.
posted by poissonrouge at 9:23 PM on June 30, 2010

I went through the post-bite rabies shots as well, after being woken up by a bat that I (stupidly) didn't catch for testing. Was probably never touched the bat, but I didn't want to take the chance. While it's true that they don't administer the immunoglobulin shot in the stomach any more, it's still a lot of fluid that they need to inject near the bite site.

Even with health insurance, it wasn't exactly cheap, and I had to go to an ER to get the initial shots since they apparently don't normally stock them at clinics around here.
posted by strange chain at 10:14 PM on June 30, 2010

I'm sure you're totally fine, but if you decide to get shots just for peace of mind, I'd understand that too.

But next time (and for anyone else who may stumble on this thread in the future), always use caution when handling any wild animal. In particular, always wear the thickest gloves you have on hand.

And Douglas Adams was right: a thick bath towel is very useful. Toss gently over bat; scoop up carefully (their wings are very delicate) and relocate outside.

Bats are our friends, and also are awesome. But any animal can panic and bite or scratch when frightened.
posted by ErikaB at 10:28 PM on June 30, 2010

Bats have a hard time taking off from flat ground, give them a toss or use a balcony to release.
posted by hortense at 11:39 PM on June 30, 2010

I would call your local immunization clinic. There have been cases where someone was around a bat but didn't even realize they had been bitten (or *scratched) and ended up dying from rabies. Also, once symptoms appear the horse has already left the barn and it's pretty much too late for treatment. As someone mentioned above, someone has lived after experiencing symptoms but how they were physically and mentally afterwards, I'd really be surprised if they ever recovered 100%. As far as onset of symptoms, I've heard of rare cases where it took years for the initial symptoms to develop. But again, by the time symptoms develop, it's pretty much a done deal. Definitely get the cats vaccinated and call your local immunization clinic. Rabies is a very serious virus and warrants a call to the clinic.

*It is believed that humans have been infected from scratches since bats will put their nails in their mouth thus covering them with saliva.
posted by GlowWyrm at 1:37 AM on July 1, 2010

It's astounding to me how confidently people on Ask Metafilter can give out uninformed, completely incorrect medical information, yet provide no background or preface.

toodleydoodley, obviously I am not your physician and you are not my patient, and we have no doctor-patient relationship. I never provide anything but medical information here, as providing medical advice would be unprofessional and inappropriate. It's likely very hard for ANYONE to correctly answer most of your questions. You are not wrong or silly in wondering about rabies in bats, like some posters' tones here seem to imply.

Rabies: eMedicine Overview:

Cases from nonbite exposures now are more common in the United States than bite exposures. Unfortunately, most patients with rabies are interviewed after encephalitis symptoms have begun, which complicates ascertaining history. Nonbite exposures include being scratched, being licked over an open wound or mucus membrane, or exposure to brain tissue or cerebrospinal fluid (CSF) of a rabid animal. Nonbite exposures from bats are the exception, and respiratory exposure from bats is a growing concern.

Rabies prophylaxis is now recommended for any routine contact with at-risk animals. Intact skin contact with urine, blood, or feces of an animal has not been shown to constitute exposure, except in bats.

A total of 19 of the 34 reported cases (1997) have been associated with bats. The silver-haired bat (Lasionycteris noctivagans) accounted for 13 (68%) of 19 bat-related rabies cases. This bat is found throughout the United States, except in the southern coastal regions; it lives in trees and shrubs and can migrate overseas. In a study of 7047 bats in New York State, only 25 (0.4%) were silver-haired, and only 2 of these were rabid. These low figures are difficult to reconcile with the high incidence of the silver-haired bat rabies variant in documented human cases. History of a bite wound has only been documented in 1 of the 19 cases of bat-related human rabies. Eight of the remaining cases reported physical contact. No history of bat contact could be found for the remaining 10 cases.

posted by gramcracker at 3:34 AM on July 1, 2010 [4 favorites]

The poster's question is really this: How likely is it that any of us got rabies from a bat we didn't even know was in here?

Lets review using gramcracker's numbers above: There have been 34 cases of rabies in humans since 1997. That's about five cases every two years. Of those, 19 (55%) were "associated" with bats. Of those 19, half reported physical contact and half had "no history of bat contact" (which sounds an awful lot like "we're going to blame the bat living in their chimney because we can't figure out anything else that could be the cause").

To put those numbers in context, there are about 115 million households in the US. Thus, over the past 13 years, an average of about one in every two hundred and thirty million households (not residents, households) was affected by rabies which was possibly transmitted by a bat during any given 2 year period. In comparison, the odds of being struck by lighting in any given year are 1/500,000.

Gramcracker, I respect the point you're trying to make above, but -- especially given that in 10 out of your 19 "bat associated" cases noted above, no one really knows how the patient contacted the disease -- but I think the reason so many of us are saying "no, you're fine" is because, statisitcally, they are fine. The odds of the poster getting rabies from this contact are not zero, but they are so vanishingly small as to be very close to random chance. Note that the Mayo clinic only recommends the vaccine if you've been exposed "by a bite, scratch, or lick".
posted by anastasiav at 5:34 AM on July 1, 2010

I'm a little surprised at the people talking about how to put the bat outside humanely... I assume best practice here is to cage the bat so it can be killed and tested, no?
posted by deadweightloss at 5:51 AM on July 1, 2010 [1 favorite]

right, and I wouldn't even have this problem if I had just kept the bat caged and then taken it to the county extension the next day. but stupidly my first thought was, "It's alive, I have to put it outside."

anyway, I feel pretty secure that neither I nor my husband have been significantly exposed. I don't think a wing-brush on my finger-pads constitutes a scratch. I did not let it get near my face/mucous membranes).

Of the three cats inside, only one hunts (the others, at 16 years old, are on emeritus - sleeper - duty) and she had her rabies booster right on a year ago. I'm looking now to see if there's a rabies clinic so I can get everybody shot for $10, since, honestly, the money is the biggest factor in this - well, after not dying of encephalitis.
posted by toodleydoodley at 6:36 AM on July 1, 2010

thanks all for your excellent responses.
posted by toodleydoodley at 6:36 AM on July 1, 2010

but I think the reason so many of us are saying "no, you're fine" is because, statisitcally, they are fine.

Not to derail or belabor the point, but this is true of almost all of medicine. Why do we put people on blood pressure medicines, when most of them will, statistically, never have a heart attack? Why do give people a course of anti-retrovirals after a needlestick injury? I mean, their risk is only 0.1%. Statistically, we're all fine.
posted by gramcracker at 7:03 AM on July 1, 2010

just to jump in here, since I read obsessively about rabies last night. even though a crapload of the known infections were idiopathic, they were mostly to people who were not competent to know whether they'd been bitten, ie: small children, very elderly, mentally handicapped and asleep.

and, the 2005 survivor (Milwaukee Protocol), Jeanna Giess, was bitten and knew it (open wound, which they cleaned with peroxide), but her family chose not to vaccinate her.

we live in an old hunting cabin in the sticks, and our house is full of insects, spiders, scorpions and whatnot. if I went to the doctor every time something bit me, I'd have to move into the debtor's prison. we both had to get tetanus shots last year from rusty nail encounters, but that, at least, was a $50 shot at the walk-in clinic. I'm hearing that the rabies vax for people is going to cost like 4x what I pay in property tax annually, and without health insurance (or a job at the moment - fulltime student), that's a huge consideration when it seems the risk is extremely small.

I am looking into shots for the cats, because I can't interview them and see if they're sure they weren't bitten, and also because their shots will be like $10/each if I can get the county clinic. which brings me to the obvious - why can't I just go to the county clinic every five years or so and get a $10 jab?
posted by toodleydoodley at 7:43 AM on July 1, 2010

It's astounding to me how confidently people on Ask Metafilter can give out uninformed, completely incorrect medical information, yet provide no background or preface....You are not wrong or silly in wondering about rabies in bats, like some posters' tones here seem to imply.

I couldn't agree more. And, I still recommend placing a (free) call to your local immunization clinic. They will review what happened with you and tell you if you need to come in or not.
posted by GlowWyrm at 12:23 PM on July 1, 2010

I think you actually can get a rabies vaccine and it's much cheaper than the treatment they give you after you've been exposed to rabies. It's normally only given to people at high risk of rabies exposure (people going on wilderness trips to areas of high rabies, animal control officers, etc.), but if you feel you might be at high risk for rabies due to the rural location of your home you should definitely ask your doctor about the possibility of getting a preexposure vaccine.
posted by phoenixy at 2:29 PM on July 1, 2010

update: we took *five* cats to the vet today to be shot. We had to put two in one carrier and the fifth one in a laundry hamper with the top taped shut. thankfully they took our money and shot them fast. lots of yowling and dirty looks. my scratches have scratches.

I feel better. thank you everyone.
posted by toodleydoodley at 7:44 PM on July 1, 2010

Toss gently over bat; scoop up carefully (their wings are very delicate) and relocate outside.
posted by ErikaB at 10:28 PM on June 30 [+] [!]

and I wouldn't even have this problem if I had just kept the bat caged and then taken it to the county extension the next day. but stupidly my first thought was, "It's alive, I have to put it outside."
posted by toodleydoodley at 6:36 AM on July 1 [+] [!]

Just wanted to point out here in case some one comes along, that relocating bats is not really the best idea when confronted with the possibility of exposure.
If possible, keep it caged and bring it to the county examiner to test for rabies. In most of the "There was a bat, do I have rabies?" stories I've heard (and had one myself), most of the stress would have been eliminated had the bat been kept for testing.
posted by silkygreenbelly at 9:27 AM on July 6, 2010

final update:

thanks all - cats were all shot timely and no symptoms. We decided we had not been exposed (see descriptions above) and did not get shot ourselves. We have had no symptoms at this point.

Final note - the decision not to get a rabies shot for myself was difficult, since I had touched the bat. However, as I said before, I didn't feel that a light brush of my fingertips constituted significant exposure.

I find it upsetting that the human rabies vaccine/immunoglobulin series is ludicrously expensive ($2k - $7k per person, according to the ND dept of health) and hard to find, even though people in suburban and rural areas are frequently exposed (or suspected of exposure).

I don't think this is a decision that should hinge so heavily on cost, but that amount of money would sink most people. I understand that I'm supposed to weigh that cost against the cost of getting an almost invariably fatal disease, but still. If the pre-exposure vaccine were widely available (walk-in clinic) and cost $200 or less, I would have done it. That's just a final note for any of you out there in TeeVee land involved in policy or legislation.
posted by toodleydoodley at 3:07 PM on July 31, 2010