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EDITIONS
Monday, 25 November, 2002, 07:55 GMT
Q & A: Rabies
A man has died from rabies in Dundee. He is believed to have been bitten by a bat. The Public Health Laboratory Service and the Bat Conservation Trust (BCT) provide answers to some of the questions raised by the case.

What is rabies?

Rabies is an encephalitis (brain disease) caused by rabies virus, a member of the rhabdovirus family

How dangerous is rabies?

Rabies is a fatal condition but it is preventable by vaccination. It is important for people who are at risk through their work or through travelling to countries where rabies is circulating in animals to seek advice on vaccination. Once clinical rabies develops, it is almost always fatal. Those few people who have survived the infection have suffered serious long-term disability.

How do humans catch rabies?

There have been around 20 human cases of rabies imported into England and Wales since 1946. Humans generally catch rabies through being bitten by an infected animal (usually a dog). In this country, rabies has long been eliminated in the animal population, so recent human cases in the UK have all been associated with exposure to infected animals elsewhere in the world. There are no documented cases of human-to-human spread, except by the artificial route of corneal transplant. In a corneal transplant a part of the cornea is surgically removed after death and grafted into the eye of another person. Once the rabies risk from this was recognised, screening protocols were introduced and there have been no reports of rabies transmission by corneal transplant for over 15 years.

What type of rabies can be found in bats?

The rabies-related virus sometimes carried by European bats is called European bat lyssavirus (EBL). There are two strains: EBL1 and EBL2. In Continental Europe, the recorded incidence of EBL is low. The bat recorded in Britain in 1996 carried a little recorded strain known as EBL 2. In Europe, EBL 2 has been found only ten or so times, in pond bats (which are not found in the UK) and Daubenton's bats. Generally, EBL in bats is very rare in the UK. Over the past 15 years of surveillance by the Veterinary Laboratories Agency, with up to 200 bats tested each year for bat rabies, only two cases have returned positive results. Both of these cases, in 1996 and 2002, have been Daubenton's bats, which rarely live in houses and rarely come into contact with people. Bat workers and the Bat Conservation Trust work closely with health officials to monitor the risk to the public.

What are the symptoms and signs of rabies in humans?

Rabies is a very serious infection which affects the central nervous system. Initial symptoms can include anxiety, headaches and fever; later the effects of the encephalitis intensify. There are spasms of the swallowing muscles making it difficult or impossible for patients to drink (hydrophobia), and respiratory failure sets in.

How long is the incubation period?

The incubation period is generally 2-8 weeks, but very variable. On some occasions incubation periods have been several months or more.

What can be done to treat rabies?

Rabies must be prevented, because there is no treatment. This means that people should seek advice about vaccination before they travel if going to developing countries where rabies is present. When travelling they should steer clear of animals in general, but particularly stray or unattended dogs. Anyone who is bitten or scratched by a warm blooded animal such as a dog, cat or bat in a country where there is rabies should get advice immediately as rabies vaccine can be given to protect them. It works best if given as soon as possible. Within the UK, if someone is bitten by a bat they should seek medical attention as soon as possible. They can then be advised on whether they need any preventative treatment. Bat handlers and bat wardens should be vaccinated preventatively against rabies. If a person has rabies there is no specific treatment.

Is rabies spread from person to person?

No. There is no risk to other humans or animals from a patient with rabies. Despite there being tens of thousands of cases each year worldwide, there has never been a documented case of human-to-human transmission, other than the few cases resulting from corneal transplant. Despite the lack of evidence for human-to-human transmission, people who have been exposed closely to the secretions of a patient with rabies will sometimes be offered immunisation purely as a precautionary measure.

What should I do if I find a sick or injured bat?

Avoid handling the bat and contact your nearest bat worker (call BCT's bat helpline, during office hours, 0845 1300 228 for your local number). If you need to handle the bat, use gloves or a soft cloth.

See also:

19 Nov 02 | Scotland
19 Nov 02 | Scotland
02 Oct 02 | UK
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