Rabies

Rabies is a viral infection that affects mammals; in B.C., bats are currently the only animal known to carry it. While it’s estimated that less than 1 per cent of bats in the province carry it, about 8 per cent of bats sent for rabies testing were found to be infected. That’s because infected bats are more likely to come in contact with humans or domestic animals.

Contact with other animals in B.C. — including dogs, cats, coyotes, skunks and racoons — does not pose a risk and does not require post-exposure prophylaxis (antibodies and rabies vaccine). However, all mammalian animal exposures that occur outside of B.C. need to be assessed individually for risk of rabies and the need for post‐exposure prophylaxis.

Bats and other wild animals deserve our respect, and should not be touched or bothered, which can lead to potentially harmful contacts. The disease can be prevented by vaccination, but the best prevention is avoidance.

Avoid contact with bats, dead or alive. Never touch a bat with bare hands. If you have direct contact with a bat, or if a bite or a scratch occurs, wash the wound immediately using soap and water and seek urgent medical attention from a health-care provider or from VCH Public Health at 604‐675‐3900.

Travelers, especially in developing countries, should avoid contact with all mammals. Worldwide, dogs are responsible for most cases of rabies. Travelers that have been exposed to rabies and started on a rabies vaccine series abroad can arrange for completion of the series by contacting VCH Public Health at 604‐675‐3900.

Travelers to high-risk areas can also purchase a rabies vaccine series prior to travel at the VCH Travel Clinic (604‐736‐9244 for appointment).

Humans can contract rabies from percutaneous or mucous membrane exposures to the saliva or neural tissue/fluid of an infected animal. Typically, this occurs through scratches or bites. However, the claws and teeth of some bat species are so small that percutaneous exposure can occur without a visible wound. For this reason, we treat all direct contact with a bat as a high‐risk exposure.

If you are bitten or scratched by an animal that you think may have rabies, you should:

• Immediately wash the wound well with soap and water under moderate pressure (e.g. a running tap) for at least 15 minutes, then flush thoroughly with water. This lessens the chance of any infection.
• Many wounds may need immediate medical attention. Visit your doctor or an urgent and primary care clinic.
• Call VCH Public Health at 604‐675‐3900 to discuss whether you may need rabies shots. Those living outside of Vancouver Coastal Health should call their local public health unit immediately (www.immunizebc.ca/finder).
• If rabies shots are received in time, rabies in humans can be prevented. If you wait until the symptoms start to appear, it is usually too late to begin effective medical treatment.

Symptoms generally appear three to eight weeks after exposure but could take up to several years. They include:

• headache
• fever
• discomfort, prickling or itching sensation at the site of the bite
• difficulty swallowing
• excessive drooling muscle spasm or weakness
• anxiety, confusion or agitation

The treatment for someone who has been exposed to rabies is a series of shots known as rabies post-exposure prophylaxis (RPEP). These shots help the body’s immune system destroy the virus infection in its early stages. Getting RPEP before symptoms appear usually prevents infection, and you are likely to recover.

RPEP has two parts, usually started at the same time:

• A shot of human antibodies against rabies, called human rabies immunoglobulin (HRIG), or sometimes referred to as Rabies Immune Globulin (RabIg).
• Rabies vaccine, given as a series of four doses over a period of 14 days. You will receive the remaining doses of vaccine three, seven and 14 days later.

If a person has been bitten or scratched by a bat, you must contact VCH Public Health (604-675-3900) or a physician for an assessment. If a pet has been in contact with a bat, the animal owner should contact their veterinarian for assessment.

If exposure to a bat occurs and the animal is dead, VCH can arrange for testing. If the bat is captured alive, it can be tested for rabies. Do not attempt to capture the bat if you have not had previous contact with it, as this will increase your chance of contact with a potentially rabid animal. If the bat is still alive, you are the exposed person, and you are comfortable catching the bat, follow these steps:

• If the bat is inside, close all doors and windows in the area.
• Put on a hat, leather or puncture-proof gloves, a long-sleeved jacket, and pants.
• Use a blanket, net, broom or towel to catch the bat (without touching it and while protecting any exposed area such as the face).
• Use gloves to put the bat in a sealable container.
• Place the container in a cool, safe place away from human or pet contact or put it into the freezer. Do not attempt to physically kill the bat.
• Dispose of gloves used to transfer the bat. Then wash your hands.

Alternatively, ask for help from a pest control specialist. VCH Public Health (604-675-3900) may also be able to suggest someone to help.

If you find a wild animal that you believe may be infected with rabies, do not touch it. Contact the BC Wildlife Veterinarian (250-953-4285). If you find an animal which is injured or orphaned (and not likely to be rabid), contact a local wildlife rehabilitation center.