Families need to take rabies risk seriously

Bats are our friends in the night sky, doing their part to keep the pesky mosquito population under control, but they are surely not welcome in our homes on a hot summer's night.

With bats high on the most wanted list for rabies, even a potential exposure to a wild bat requires swift and aggressive medical intervention.

My teenage patient and her unfortunate family found this out the hard way while vacationing at a friend's summer home in Wisconsin. Several bats had made their way into the cabin while the girl, her siblings and her parents slept.

The bats were seen the next day, but could not be caught, so my patient's mother called the local county health department for guidance. She was told that the entire family needed emergency medical care. Both adults and all the kids received the rabies immune globulin injection as well as the full series of five rabies shots distributed over a 28-day period.

Most pediatric offices do not stock the rabies vaccine because of infrequent use, but larger emergency rooms and some hospital infusion centers do keep a small supply of the shots on hand.

Why the rush to treat? Simply stated, because rabies is an almost universally fatal virus that attacks the body's central nervous system, causing severe disease with no effective cure. Since bats are often known to bite without disturbing their sleeping victims or leaving much of a puncture mark, experts advise treating all members of the exposed household, whether or not each individual recalls receiving a bat bite or scratch.

According to infectious disease experts at the American Academy of Pediatrics (AAP), rabies has been documented in every state except Hawaii. The disease is most often transmitted by bites from wild animals such as bats, raccoons, skunks, foxes and coyotes. These animals are generally considered rabid until proven otherwise. Approximately 75 percent of U.S. human rabies fatalities can be traced back to rabid bat exposures.

In other parts of the world where the virus is more prevalent and dogs are not routinely immunized against rabies, dogs are the primary source of human rabies disease. In this country, if a child is bitten by a dog or cat that is felt to be healthy, the animal is simply kept under close watch for the required 10-day observation period. Prophylactic vaccination is started only if the dog or cat begins to show signs of rabies.

Rabies is rarely seen in rabbits, or in small rodents such as squirrels, hamsters, chipmunks, guinea pigs, gerbils, rats or mice. If your child is bitten by any of these smaller creatures, consult your local health department to determine the likelihood of rabies exposure. It's very reassuring to note that rabies treatment is rarely indicated in such cases.

The AAP urges parents to teach children a few simple rules to decrease the risk of disease exposure. Kids should be told to avoid touching or provoking strays or wild animals, and to keep their hands off any dead animals they happen to come across. Adults are advised to keep all garbage under cover to avoid attracting unwanted animal visitors. Capping chimneys and blocking off other small openings can also help keep bats and other night creatures out of your home.

• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.