Animal bites/bat exposures/rabies
What is an animal bite/bat exposures/rabies?
Animal bites, especially dog and cat bites, occur frequently. Animal bites that break the skin should be evaluated by a health care professional to assess the risk of bacterial infection or transmission of rabies. Bat bites can be difficult to identify and many go unnoticed. Therefore, any physical contact with a bat should be considered an exposure and be reported to public health. Rabies is a fatal viral infection that affects the nervous system of humans and other mammals. Once the rabies virus has reached the brain, the virus is shed in the saliva of the infected mammal. The few people who die of rabies each year in the U.S. are usually infected either by a bat bite or after an animal bite that occurred during international travel. As of 2024, the last human case of rabies in Colorado was in 1931. The majority of animal rabies cases in the U.S. occur in four wild animal species: raccoons, skunks, bats, and foxes. Rabies in domestic animals (like cats and dogs) occurs most years in Colorado, particularly in the eastern part of the state where skunk variant rabies is present. Rabies in rodents and lagomorphs (hamsters, guinea pigs, squirrels, and rabbits) is extremely rare. In Colorado, the primary reservoir animals for rabies are bats (throughout the state) and skunks (in the eastern part of the state).
Signs and symptoms of rabies in humans
- First signs may be flu-like, including weakness, fever, headache
- Discomfort, prickling, itching at or near the site of the bite
- Within days to weeks, symptoms of central nervous system dysfunction (anxiety, confusion, agitation, delirium, abnormal behavior, hallucinations, insomnia) will begin.
Once a person begins to exhibit signs of the disease, survival is rare. To date, fewer than 10 documented cases of human survival from clinical rabies have been reported, and only two have not had a history of pre- or post-exposure prophylaxis.
Signs and symptoms of rabies in animals
Rabies virus causes acute encephalitis in all mammals, and the outcome is almost always fatal. The first symptoms of rabies may be nonspecific and may include lethargy, fever, vomiting, and anorexia. Signs progress within days to central nervous system dysfunction and may include cranial nerve dysfunction, trouble walking, weakness, paralysis, seizures, difficulty breathing, difficulty swallowing, excessive salivation, abnormal behavior, aggression, and/or self-mutilation. A bat may be unable to fly due to rabies causing weakness or paralysis of the wings. The only way to know if an animal has rabies is to test it.
Incubation period in humans
The incubation period for rabies is usually three to eight weeks (median of six weeks) but has rarely been reported up to six years or more.
Rabies contagious period and spread
Rabies is transmitted through the saliva of infected mammals, most commonly through a bite. Transmission has been rarely documented via other routes, such as contamination of mucous membranes (i.e., eyes, nose, mouth), with infected saliva, and corneal and organ transplantations. Bat bite wounds may be unnoticeable upon examination of skin, and children may not report contact with bats to an adult. The most likely way a child at a school or child care facility would be exposed to rabies is through contact with a bat without evidence of a bite.
Public health reporting requirements
- Report all animal bite incidents or any contact with bats to the local animal control agency, local public health agency, or police department within 24 hours. Any bat found in a room, cabin, or on the ground in a fenced yard with an unattended child should be tested for rabies. Consult with your local public health agency for assistance with testing. The parents/guardians of a child bitten by an animal or found unattended with a bat must be notified.
- Occasionally children are found touching or playing with live or dead bats. If this occurs, the local or state public health agency must be notified immediately, and the bat must be tested for rabies.
Control of spread
- Teach children not to approach, attempt to pet, handle, or feed strange or wild animals.
- Any school or child care facility with a bat colony on the premises should take steps to reduce the chance of contact between children and bats.
- All dogs, cats, and ferrets should be vaccinated against rabies by a licensed veterinarian.
- A dog, cat, or ferret involved in a human bite must be observed for 10 days following the bite. The local animal control agency or police/sheriff department usually enforces this observation period. If the animal is still alive 10 days after the bite, there is no chance rabies virus was in the saliva of the animal at the time of the bite. This observation period only applies to domestic dogs, cats, and ferrets. There is no established observation period for domestic-wild hybrids (such as wolf-hybrid dogs) or any wild mammal.
Treatment
Any child with an animal bite or contact with a bat should receive medical attention. Animal bite treatment includes thorough cleaning of the wound and tetanus prophylaxis, if appropriate. Occasionally, antibiotics are prescribed to treat bacterial infections. Bite sites that develop redness, swelling, drainage, or pain should be reevaluated by a health professional. There is no treatment for rabies after symptoms begin. Rabies vaccine provides immunity when administered appropriately after an exposure. The treating health care provider and local or state public health agency will evaluate each bite incident to determine if rabies vaccine should be given. Rabies post-exposure vaccination for humans is a series of four or five rabies vaccinations over two - four weeks, and one dose of human rabies immunoglobulin given as soon as possible after the exposure. This series of vaccinations and wound care usually must be initiated in the ER of a hospital or an urgent care setting. In general, public health assumes that skunks, raccoons, foxes, and bats have rabies until proven otherwise. In Colorado, dog and cat bites usually do not require rabies vaccine prophylaxis, but they must still be reported to public health.
Exclusion
Exclusion of a student or child involved in an animal bite or bat contact is not necessary.
Role of teachers, caregivers, and family
- Provide immediate first-aid by washing the bite area thoroughly and applying a cold compress to any bruised area, and have the wound evaluated by a health professional.
- The biting animal should be captured or confined, if it is safe to do so. If the animal can not be contained safely, note the size, appearance, distinguishing features, and report immediately to animal control or local public health.
- Teach children to never feed or touch wild animals or domestic animals unknown to them and avoid any contact with stray, wild, or dead animals and to report any bats to an adult.
- Supervise all contact between children and animals.
- Maintain the health of any pet animal in a child’s environment by ensuring they are fully immunized and on recommended parasite control programs.