What cottagers need to know about rabies in bats

Noah Heikoop didn’t know what bit him. The seven-year-old didn’t even know he had been bitten at all until the next morning, when his mother, Katie, was combing his hair at their Niagara-on-the-Lake, Ont., home, and saw two bleeding pinpricks in his scalp. It looked like a bite from a small animal. It was last winter, and the family had been coping with an infestation of large brown bats in their chimney. “We don’t dislike bats,” Katie emphasizes—Noah had even held a fundraiser to help save small brown bats—but they knew the bat colony had to go. No reputable animal control firm, though, would remove a colony in the dead of winter.

She got in touch with the family’s pediatrician, who looked up bat bites online. “We couldn’t guarantee that there hadn’t been a bat in his room,” she recalls. In short order, as an extreme precaution, Katie, Noah, and his sister were undergoing rabies post-exposure prophylaxis (PEP), a series of injections in different limbs and, for Noah, extra shots at the bite location.

The Heikoops have not been alone in their experience with bats and rabies fears in Canada. In August, a woman in Kawartha Lakes, Ont., was bitten by a rabid bat while asleep, and the local health unit issued a warning to be cautious around bats. One week later, a young man was bitten at Belwood Lake Conservation Area, near Guelph, a city that had logged two other recent rabid bat cases in 2017 and 2018. And in July, a bat captured in Alberta’s Jasper National Park proved to be rabid. The spike in media reports of rabid bats may have led people to think that we were in the midst of a rabid-bat epidemic. “There’s no evidence of any increase in the incidence of rabid bats in Canada,” says Brock Fenton, a renowned bat scientist and a professor emeritus of biology at Western University.

Since 2011, Canada has generally recorded about 45 to 55 confirmed rabid bat cases a year, and the data for 2018 point to another typical year. Bats, however, do remain a serious rabies concern. Of the eight Canadian fatalities since 1970 (a low figure for almost half a century, to be sure), six involved bats, with the other two attributed to dog bites while travelling in the Dominican Republic. In all, rabies from bats killed 60 people in both Canada and the United States between 1950 and 2009. The number of reported rabies cases in bats may not be increasing, but bats have become a larger proportion (about 30 per cent) of reported rabies cases in Canadian wildlife, largely because we’ve been so successful in fighting the disease in other species through oral vaccine baiting—which can’t be done with bats.

Because rabies lately has been rare to nonexistent in other wild animals in Ontario cottage country, bats are far and away the main concern there for transmission of rabies from wildlife to humans. Twenty of 56 rabid bat cases in Canada in 2017 were in Ontario. While none of the 2018 bat-bite victims developed rabies because they got immediate treatment, and overall numbers of the disease are low, rabies is still a significant public health concern. The virus is generally transmitted through saliva, through bites or scratches, and it attacks the brains and spinal cords of mammals. Without timely treatment, “it’s virtually always fatal, and the majority of patients that have survived have very serious neurological damage,” says Alan Jackson, a rabies expert and a professor in internal medicine (neurology) at the University of Manitoba.

Even though rabies deaths are mercifully rare in Canada, one particularly distressing case illustrates why cottagers should take seriously any encounter with a potentially rabid animal. In late August 2000, a Montreal family was vacationing at a rental cottage in the Laurentians that housed a bat colony. The father removed a bat that one son found flying erratically in the bathroom. A few days later, the boy’s nine-year-old brother found a lesion on his arm. It was probably a bat bite or scratch, but the family did not connect the lesion to the bat presence and did not seek medical  treatment. “In most cases, rabies occurs between 20 and 90 days after exposure, but there are documented cases of well over a year,” says Jackson, who investigated this case with Fenton. The boy’s symptoms appeared quickly, about three weeks later, and included fever, tremors, pain, hallucination, aggression, and hypersalivation. He died in a Montreal hospital shortly after, in early October.

A common theme in rabies deaths is that the exposed person does not seek treatment, which is especially true in bat cases. The mouths and teeth of most species are so tiny that people can’t be sure they have been bitten, unlike in an encounter with a dog or a raccoon. If they are asleep, they may not even be aware they’ve been in contact with a bat.

Because of the risk, health professionals err on the side of caution with human bat encounters. Ontario’s Ministry of Health and Long-Term Care recommends the PEP treatment for anyone who has had direct contact with a bat (if it touches or lands on a person) and the possibility of a bite cannot be ruled out. But because there is such uncertainty about contact (and a bite) when someone is sleeping (or if it’s a child or someone non-verbal), physicians can exercise discretion in deciding who should have the treatment, which is expensive but is covered by public health insurance. Bats have enough PR problems, and they may be overreported as potentially rabid (and killed for testing) because of an ingrained fear of them. Even among bats submitted for testing, the actual rate of the disease is very low (about four to six per cent of all brown bats submitted to the Simcoe Muskoka District Health Unit, for example). Bats also have been devastated by white-nose syndrome and need all the help they can get to recover. They perform a valuable service in dining on mosquitoes and other insects. Rabies is one more reason for frightened people to kill bats on sight or to destroy colonies that aren’t inside their cottages, but Katie Heikoop doesn’t want to see a war on bats because of her family’s experience. “I’m happy to have bats on our property,” she says.“I just don’t want them inside.”

The facts on bats

1. Bats by nature are not aggressive. They fly around with their mouths open, but not looking to bite someone—they’re using echolocation to find their insect prey. But like any wild animal, they will bite defensively.

2. A bat with rabies may display abnormal hyperactivity (out in daylight hours, especially indoors; flying erratically) and aggression, or will be lethargic, with tremors and convulsions, and can seem friendly, although they too can bite.

3. If you encounter a bat inside, give it an escape route through an open window or door, and be patient, to avoid having to handle it and risk a bite. If you have to physically remove it, use a folded towel or a broom to move it to a secure container. Wear thick gloves. If it’s clinging to a vertical surface, place a box over it then slide something like a cookie sheet under the box.

4. If you or a family member may have been in contact with a bat you suspect is rabid, go to the hospital or see your doctor as soon as possible. Your local health unit can also advise you on the steps to take. If you’re concerned about a pet, contact your vet.

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