Australian bat lyssavirus
If you have been bitten or scratched by a bat, you should seek urgent medical assessment, as post-exposure treatment is available.
Do not touch bats, even if they are injured. Instead, call a trained handler at RSPCA (1300 ANIMAL), Department of Environment and Science (1300 130 372), or local wildlife care groups. Only trained and vaccinated bat handlers should ever touch bats.
Australian bat lyssavirus (ABLV) is a virus closely related to the rabies virus and is fatal in humans. ABLV has only been reported in Australia and may be present in any Australian bat population. It should be assumed that any bat (sick, injured, or healthy) in Australia may be infected with ABLV.
The terms “exposed” and “exposure” refer to any bite or scratch from a bat that might have ABLV.
Treatment
There is no known effective treatment for ABLV disease once symptoms have started. ABLV is fatal once symptoms occur. Prevention is the only way to avoid ABLV infection. If you are bitten or scratched by a bat, seek urgent post-exposure management to prevent potential ABLV disease.
ABLV infection in humans causes paralysis, delirium, convulsions, and death. The time from exposure to the start of symptoms is variable, ranging from weeks to years. It is very important to seek urgent medical attention even if some time has elapsed since the potential exposure.
Post-exposure management following a bat scratch or bite includes:
- wound care (including tetanus vaccination)
- rabies vaccine
- human rabies immunoglobulin (HRIG) if required.
Post-exposure management is recommended for anyone who has been potentially exposed to ABLV, even if they have previously been vaccinated. This includes people who may be allergic, pregnant, or breastfeeding.
Wound care
If you are bitten or scratched, or if saliva (spit) gets into a break in the skin, immediately wash the wound gently but thoroughly with soap and clean water for at least 15 minutes to reduce the risk of infection. If available, an antiseptic with anti-virus action (e.g. povidone-iodine or ethanol) should be applied after washing. If animal saliva gets in your eyes, nose, or mouth, flush the area thoroughly with water for several minutes.
Rabies vaccine
The rabies vaccine is only effective in preventing ABLV before the symptoms start, so there should be no delay in getting medical care. A course of rabies vaccine is commenced as soon as practicable after potential ABLV exposure, ideally within 48 hours but can be given at any time following exposure.
Side effects— rabies vaccine
All medications and vaccines have side effects. Approximately 20% of people complain of redness at the injection site or a sore arm following a rabies vaccine. Other possible side effects include, fever, headache, stomach upset, muscle aches and pains and rash. A small number of people (1 in 10,000 vaccinations) can have a severe allergic reaction that causes difficulty breathing or swelling of the throat. Your doctor will ask you to stay in the clinic for at least 15 minutes after your injection to monitor you for symptoms of an allergic reaction.
Human Rabies Immunoglobulin (HRIG)
HRIG may be given at the same time as the first dose of the rabies vaccine to give short-term immunity while the vaccine takes effect. HRIG is given as soon as practicable after potential ABLV exposure. HRIG may interfere with some vaccines, and you may need to be re-vaccinated. Tell your doctor if you have had any other vaccines in the last 4 months.
Side effects—HRIG
Side effects of HRIG can include pain and discomfort at the injection site, and fever and chills. Severe allergic reactions are rare. HRIG is prepared from human blood. Australia’s blood supply is very safe. There have been no reports in Australia of any blood-borne disease in people who have received HRIG.
Transmission
ABLV is spread from bats to humans when the saliva of an infected bat enters the human body, usually by a bite or scratch, or by getting bat saliva in the eyes, nose, or mouth or onto a pre-existing break in the skin. This is known as a “potential exposure".
ABLV does not survive outside a bat or in a dead bat for very long especially in dry environments or after exposure to sunlight. Contact with bat faeces (poo), urine (wee) or blood does not pose a risk of exposure to ABLV, nor does living, playing, or walking near bat roosting areas. However, if you come in contact with bat faeces or urine hand washing is essential to protect against other diseases. There is no evidence to suggest ABLV is spread by eating fruit partially eaten by a bat.
Prevention
The best protection to avoid ABLV is to never handle bats. Teach children to not touch bats and to tell an adult if they come across an injured bat. Only people who are vaccinated, are trained in the care of bats, and wear personal protective equipment should ever handle bats.
Report injured bats to RSPCA (1300 ANIMAL), Department of Environment and Science (1300 130 372), or local wildlife care groups/rescuers/carers. Remove pets and children from the area and place a box or washing basket over the bat if it is on the ground until a trained and vaccinated handler arrives.
It is recommended not to touch a bat even if it appears to be dead. If reasonable and practical, leave a dead bat where it is. If you decide to dispose of a bat, the following steps will assist in reducing the risk of exposure to ABLV.
- Gently prod the bat first with a long tool (e.g. a shovel, broom or pole) to be sure it is dead.
- Wear gloves and use a tool to place the bat in a plastic bag that won’t tear easily. Double bag the bat by placing the first bag in a second, strong plastic bag.
- Dispose of the bag in accordance with your council’s waste disposal requirements. Contact your local council to find out what is appropriate in your area.
Further information can be found at the Department of Environment and Science
Contact your local veterinarian if you suspect that your pet might have been bitten or scratched by a bat.
Pre-exposure vaccination
Pre-exposure vaccination is recommended for anyone who plans to care for bats, or who will encounter bats at work. A course of 3 rabies vaccine injections is given over a one-month period.
People at ongoing risk of exposure (e.g. bat carers, lab staff, vet workers) should have a blood test to check their immunity and receive a booster vaccination as needed. Discuss your specific requirements with your doctor.
Other resources
Help and assistance
If you think you have been potentially exposed, or for further information, please contact your local doctor or nearest public health unit or the 13 HEALTH information line (13 43 25 84).