The changing natural world at our doorsteps | Illustration and text by Patterson Clark
May 14, 2013
A bat in the bedroom leads to a lesson on rabies
Ann Hawthorne awoke at 2 a.m. on Easter to see what she described as "a shadow of a bird flying past on my ceiling."
She got up, turned on the light and saw the shadow again, flying down the hall, around her condo and back again.
A bat. With a 10-inch wingspan. Hawthorne thinks it was a little brown bat, "the color of coffee with cream in it." A gap next to a vent may have been its point of entry.
Hawthorne has no aversion to bats, rather a "long and deep affection," she said, and "respect, but no fear," which developed from her reading Randall Jarrell's "The Bat-Poet" as a youngster.
"I didn't want it hurt or frightened," she said. Realizing that the bat was too fast and agile for her to capture, she opened a window and took out the screen.
"The second that air change happened," she said, "the bat flew out my window."
The next day, she related the tale to a biologist friend, who was disturbed that Hawthorne had let the bat escape. The animal should have been tested for rabies.
"Thus began my advanced education on bats in the bedroom," said Hawthorne, an editorial and documentary photographer who lives on Capitol Hill.
"We could have been bedfellows for up to four hours," Hawthorne said, "raising the possibility that I was bitten."
A small percentage of bats carries the rabies virus. Of all weak and sick bats captured and tested for the disease, only about 6 percent have the virus. But 90 percent of human rabies cases in the United States (about one or two per year) originate from contact with bats. Some cases involved sleeping people who didn't know they were bitten, according to the Centers for Disease Contol and Prevention.
Rabies cannot be transmitted by contact with bat guano, blood or urine or by touching a bat's fur. Only saliva or neural tissue is infectious. If either of those enters the body via the mouth, eyes or nose or through a wound such as a bite, a person could be in jeopardy.
The chances are fairly high that Hawthorne's visitor wasn't rabid and that she wasn't bitten — but the chances that she could survive a bout with rabies are practically zero.
Realizing that she needed urgent medical care, Hawthorne sought treatment at an emergency room.
"I had to talk my way in," she said, "because I didn't have a wound."
She began receiving a series of vaccinations. The treatment is "not as bad as it once was," she said, "but stunningly expensive."
When Hawthorne was first reading "The Bat-Poet" in the 1960s, rabies shots were almost as frightening as the disease. The treatment consisted of an agonizing series of more than 20 injections from a large needle through the wall of the abdomen.
Although that option still exists, a newer method is preferred by the Centers for Disease Control and Prevention: Within 10 days of exposure, a patient initially receives several shots of human rabies immunoglobulin at the site of the bite (if it's known) and into muscle. The immunoglobulin binds to and disables rabies virus particles. At the same time, the patient gets a shot of rabies vaccine into the shoulder muscle, which is followed by another three vaccine injections over a 14-day period. The vaccine stimulates the body to produce its own immunoglobulin.
Although the vaccinations are supposed to be only as painful as a flu shot, their cost can sting, adding up to thousands of dollars. "A pretty cheap price for a life," Hawthorne admitted.
Her initial seven immunoglobulin shots weren't all that comfortable. It felt like "sitting on a nest of yellow jackets," Hawthorne said. She also experienced side effects, or, as she calls it, "rabies lite": aches, fever, nausea and nightmares for a few days after each shot. "I pretty much spent three weeks to a month on the sofa with bad TV and atrophy."
Hawthorne wishes that she had known more about bat risks and rabies: "I think of myself as 'nature-savvy' and levelheaded, but nonetheless I managed this badly," she said before speaking up for bats: "Remember that bats are protected — and are now in peril from white-nose syndrome. They are marvelous animals."
Anyone finding a bat at home is advised to close the doors leading to the room and contact animal control to remove the bat. If the animal had access to a bedroom overnight, alert the local health department that the bat needs testing for rabies. A negative result could prevent unnecessary distress, pain and financial hardship.
NOTE: A previous version of this article said that bat bites are rarely felt.
"People who handle wild bats on a regular basis, as I do," wrote Dianne Odegard from Bat Conservation International, "will tell you that when they have been bitten by a bat, it usually feels much like a needle jab."
"The 'undetected bat bite' theory has caused no end of panic among people who may already have an unreasonable fear of bats due to persistent myths that seem impossible to eradicate (associations with Halloween, witches, vampires and all manner of evil, plus folk tales about bats being blind or getting into people's hair). Even people who are positively inclined toward bats can fall prey to fear when bats are portrayed almost as though they are phantoms that routinely and silently attack and bite."
"There is little evidence for human rabies cases involving sleeping adults who did not know they were bitten; there is a big difference between a case of human rabies in which the victim is too sick to report how he or she was exposed, and one who is not aware of being bitten. However, children, some mentally challenged adults and other with issues, such as the use of alcohol or medication, are a different matter. Finding a bat in a room with a sleeping child is always cause for capturing and testing the bat; if that is not possible, the possibility of post-exposure vaccinations should be discussed with a medical professional immediately."
Centers for Disease Control and Prevention, Medstar Georgetown University Hospital, North Dakota Department of Health