(A) Bats are increasingly implicated as significant wildlife reservoirs for variants of rabies virus transmitted to humans. Recent epidemiologic data suggest that transmission of rabies virus may occur from minor or seemingly insignificant bites from bats.
(B) The limited injury inflicted by a bat bite (in contrast to lesions caused by terrestrial carnivores) and an often inaccurate recall of the exact exposure history may limit the ability of health care providers to determine the risk of rabies resulting from an encounter with a bat. In all instances of potential human exposures involving bats, the bat in question should be safely collected, if possible, and submitted for rabies diagnosis.
(C) (1) Rabies PEP is recommended for all persons with bite, scratch, or mucous membrane exposure to a bat, unless the bat is available for testing and is negative for evidence of rabies.
(2) PEP may be appropriate even in the absence of demonstrable bite, scratch, or mucous membrane exposure, in situations in which there is reasonable probability that such exposure may have occurred (e.g., a sleeping individual awakes to find a bat in the room, an adult witnesses a bat in the room with a previously unattended child, mentally challenged person, intoxicated individual, and the like).
(D) (1) The likely effectiveness of PEP in this setting needs to be balanced against the low risk such exposures appear to present.
(2) This recommendation, used in conjunction with current ACIP guidelines, should maximize a provider’s ability to respond to situations where accurate exposure histories may not always be obtainable, while still minimizing inappropriate PEP.
(Ord. passed 12-10-2001)