Pulse - January 2025 - 17

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Animal Health Advisory:
Human rabies death from a bat in California
Courtesy of AVMA
I
n the last week of November 2024, it was
reported that a woman in Fresno County died
after being bitten by a presumably rabid bat in
Merced County approximately one month earlier.
The patient was hospitalized in a Fresno
County hospital after developing clinical signs
in mid-November.
The Fresno County Department of Public Health (FCDPH)
and the Merced County Department of Public Health (MCDPH)
worked with the California Department of Public Health (CDPH)
and the Centers for Disease Control and Prevention (CDC) to
investigate this case, and evidence of rabies was confirmed by the
state's Viral and Rickettsial Disease Laboratory (VRDL).
Many local bat species are small and can inflict tiny bites that
heal quickly. Such small bites can still transmit rabies. Therefore,
never assume that the lack of a visible bite wound rules out a bat
bite. Human deaths from rabies are rare in the United States, with
fewer than 10 cases identified each year. Prior to this patient, the
last human death from rabies in California occurred in 2012 and
was associated with a bat variant. Bats continue to be the main
rabies reservoir species across the state, including in in Los Angeles
(LA) County. LA County has also reported the highest number
of rabid bats every year for over the last decade compared to other
counties in California.
In 2024, there have been 49 rabid bats detected in LA County
so far. The majority of these bats were found alive (73%) and at
private residences (88%). Three rabid bats were found at schools.
Three rabid bats were found indoors. While only a small percentage
(~1%) of bats in nature have rabies, up to 20% of the bats
reported to, and tested, by LA County Public Health have been
positive for rabies. Bats are considered protected wildlife and play a
vital role in the ecosystem by eating insects, pollinating plants, and
spreading seeds. It is illegal to keep, injure, or kill bats.
It is crucial that any bats found indoors in a home, or in areas
where people or pets could have had contact or were sleeping, are
not discarded or released. This includes bats that could have been
around children or individuals with disabilities. Any bat in this
scenario should be reported to the local animal control agency so
the bat can be retrieved and tested for rabies. Call 211 to find your
local animal control agency. Exposure risk to people and pets can
be ruled out if the bat tests negative for rabies. Rabies testing of the
bat is performed at no cost to the resident. If the bat is released or
discarded, the opportunity to test it is lost, and Public Health will
proceed with risk assessment as if the bat was rabid.
PULSE
JANUARY 2025
Each year, tens of thousands of people in the US receive preventive
treatment for rabies following a bite or other direct contact with
an animal with possible rabies. People who had potential exposure
to either a confirmed rabid bat, or a bat that was not tested, are
advised to receive rabies post-exposure prophylaxis (PEP). Rabies
PEP for people who have never been vaccinated before consists of a
series of four rabies vaccinations given over 2 weeks, plus one dose
of human rabies immune globulin (HRIG) given during the first
week. People who are already vaccinated for rabies also need rabies
PEP after a rabies exposure, but it is simpler, consisting only of
two rabies vaccines given three days apart. Pets who may have been
exposed to rabies need to be vaccinated or re-vaccinated for rabies
and placed under quarantine.
Veterinarians are advised to take the
following actions:
* All dogs and cats (including indoor-only pets) should be kept
up-to-date on rabies vaccinations.
* All pet encounters with bats should be reported to Veterinary
Public Health. Bat bites are tiny and often leave no lasting mark.
Therefore, if the pet had any potential direct or unsupervised
access to a bat, it should be reported as a potential bite. Bites
from other wildlife (e.g. raccoons, coyotes, skunks, opossums)
should be reported to Veterinary Public Health as well. Bite
reporting forms can be found on our Veterinary Public Health
website here.
* Pet owners and staff should be advised not to handle or try to
rehabilitate sick bats.
* If a resident brings a bat, alive or dead, into your clinic, be sure to
collect their name and contact information in case the bat later
tests positive for rabies. Then contact your local animal control
agency to come pick up the bat.
* Pet owners should be advised to not release a bat if it is found
indoors, because it may have bitten sleeping people and pets
while indoors and exposed them to rabies. It needs to be tested
for rabies. They should call the local animal control agency to
arrange pick-up of the bat. Call 211 to find your local animal
control agency.
* Please post and share this handout: What To Do If You Find A
Bat. http://publichealth.lacounty.gov/vet/images/RabiesOutreach/WhatToDoIfYouFindABatColorPrint.pdf
P
Veterinarians and animal health workers are encouraged to contact
us with any questions by email: vet@ph.lacounty.gov, or by phone:
213-288-7060 (Monday-Friday, 8am-5pm). Please visit our VPH webpage
for more information, http://publichealth.lacounty.gov/vet/
rabiesmap2024.htm
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http://publichealth.lacounty.gov/vet/images/RabiesOutreach/WhatToDoIfYouFindABatColorPrint.pdf http://publichealth.lacounty.gov/vet/images/RabiesOutreach/WhatToDoIfYouFindABatColorPrint.pdf http://publichealth.lacounty.gov/vet/rabiesmap2024.htm http://publichealth.lacounty.gov/vet/rabiesmap2024.htm

Pulse - January 2025

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