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Too close an encounter with a bat

What happens when you accidentally step on one? A lot of scary things if you don't get help quickly. One woman learns firsthand what it's like to face the risk of rabies.

October 27, 2003|Irene Wielawski | Special to The Times

I didn't set out to squish a bat with my bare foot. My mission was to turn out the kitchen light, which I noticed only after climbing into bed. My husband, Tom, was already asleep, so I figured I'd tiptoe out to the kitchen without turning on other lights.

In retrospect, Tom surely would have preferred lights blazing to the bloodcurdling scream that ended his slumber a few seconds later. This was my answer to the bat's tiny squeak as I crushed its furry, winged body in the pitch-black hallway. "B-B-B-B-AT!" I shrieked, hopping up and down on one foot.

Tom raced to my rescue, brandishing his favorite heavy object -- the 3-inch-thick Baseball Encyclopedia. One blow finished off the bat. For the rest of the night, I cowered under blankets pulled over my head. By morning, I'd decided I was being silly, and resolved to put the unnerving episode out of my mind. It never occurred to me to call my doctor or health authorities.

That sort of ignorance -- from which I was saved by knowledgeable friends and alert health workers -- is why people still die of rabies in the United States.

We don't hear much about rabies. The headliner viruses today are SARS, HIV and West Nile, even though rabies is the deadliest of them all. There is no treatment once symptoms set in -- typically one to three months after exposure -- and death is inevitable. But because human rabies deaths are rare -- only one or two a year in the United States -- public awareness remains spotty, and misunderstanding abounds.

"Some people have extremely high levels of paranoia," says Linda J. Demma, virologist and rabies expert for the national Centers for Disease Control and Prevention. Health authorities, according to Demma and others, field many calls from people propelled by unreasonable fear to demand rabies treatment. But others genuinely at risk sometimes fail to call because they don't realize the danger.

I was a perfect example of the latter group. Though diligent about vaccinating our pets, I had the idea that human rabies was largely eradicated, like smallpox. My casual attitude was encouraged by rabies' low incidence; I'd never known of anyone dying of rabies.

But there had been a rabies death in the close-knit northern suburb of New York City, to which our family moved from Los Angeles. A small child was the tragic victim, after a bat bite. It happened before we arrived, but residents still recall the extensive media coverage and the barrage of educational literature issued by health authorities and local doctors. This is why my somewhat jocular account of squishing the bat went over so badly on an outing three nights later with friends. Moira, a health lawyer, and Vicki, the town librarian, could not have been less amused.

Moira fired questions: Had I notified the county health department? What happened to the bat? Could I retrieve it for laboratory analysis? Then both women proceeded to rattle off rabies facts that put me in a cold sweat.

Health experts bluntly confirmed what my friends told me that night. Bats are the major source of human infection in the United States, and the risk is widespread: Rabies-infected bats have been found in every state except Hawaii. Though most bats are rabies-free and perform such important functions as insect control, they still are the wild card in rabies prevention, implicated in more than 90% of human rabies cases.

The reason is that bats have tiny teeth, making bites extremely hard to detect. People may not even realize they've been bitten, which would never be the case with, say, a raccoon bite, explains Dr. Richard W. Gerhold of the Southeastern Cooperative Wildlife Disease Study at the University of Georgia. Moreover, bites from larger animals usually require professional treatment, which triggers public health oversight and, when indicated, rabies inoculation. Medical experts say post-exposure rabies shots are 100% effective if promptly administered.

Although these shots are an important factor, the stunning decline in human rabies cases in the United States (from about 100 deaths annually pre-World War II to one or two today) is largely the result of aggressive vaccination of such domestic animals as dogs and cats. The nation spends about $300 million annually on these prevention measures, the CDC says.

In poorer countries, death rates are much higher because pets and livestock still transmit rabies to humans following encounters with infected wildlife (remember "Old Yeller"?).

Newly educated by Moira and Vicki, I wasted no time calling the health department. But I still harbored hopes of skating through this -- that is, avoiding shots. Early in our conversation I assured the public health nurse manning the rabies hotline that my foot looked "fine." This amateurish risk assessment failed to convince her, especially after the nurse learned how thoroughly the bat and I had connected. Did we have the bat, she asked urgently.

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