How Careful Do You Want To Be About Bats and Rabies?

Last week's column resulted in a lot of phone calls and several rabies vaccinations, especially for cats. I would like to explore the threat of rabies a little further.

Consider a situation where a cat is found in the presence of a sick or dead bat. If the bat is tested for rabies, and is negative, there is little cause for concern. If the bat tests positive, what then? What if the bat is not available for testing? If it has been flushed down the toilet, or frozen, or the brain damaged, Public Health Officials recommend assuming it had rabies.

If the cat has had a current rabies vaccination they recommend a rabies booster and quarantine or confinement at home for 45 days. If the cat has not been vaccinated, the recommendation is 6 months quarantine in an approved facility or immediate euthanasia.

If we take these drastic measures with a cat who was merely found in the presence of a bat that is not available for testing, what about other stray cats? What about any outdoor cat, for that matter? Bats are nocturnal and very common. Cats also commonly hunt at night. Is a cat who happens to be found in the presence of a bat significantly more likely to have been exposed to a rabid bat than any other outdoor cat?

I reviewed information from the U.S. Center for Disease Control (CDC), a Washington State Dept of Health Fact Sheet, the National Association of Public Health Veterinarians Compendium of Animal Rabies Prevention and Control, 2005, and a paper from the Northwest Center for Public Health Practice, and found the following information:

Worldwide, 50,000 humans die from rabies each year, almost all in other countries from dog bites.

In the U.S. from 1 - 6 humans die per year from rabies, most from "bat rabies" and many were exposed in other countries. According to statistics from the CDC, from 1990 to 2004 there were 45 deaths from rabies in the U.S and in 29 of those cases the means of exposure was unknown. And here's something to think about - 4 deaths were due to rabies infections acquired from a transplanted organ. That means the donors had rabies when they died and no one knew about it. That would seem to suggest that perhaps many more people die from undiagnosed rabies. Perhaps from casual contact with bats or cats?

In recent years in the state of Washington 8% of the bats tested were positive for rabies and there was one human death from rabies in 1997 and one in 1995, both from "bat rabies" and no known exposure.

I think contact is pretty common between cats and bats whether there is a human there to see it or not. And yet few humans die from rabies every year in the entire U.S. So how careful do we need to be, or want to be? (There is a rabies vaccination for humans.) If you woke up some night to find your vaccinated indoor cat in the living room wrestling with a bat, and your spouse flushed the bat down the toilet, (this actually happened) would you quarantine your cat for 45 days? If the cat were not vaccinated, would you quarantine him for 6 months or have him euthanized?

It's a little bit like the threat of another "9/11" terrorist attack. How much inconvenience will we put up with, and how much freedom will we give up, for a little more assurance that it won't happen again? Would you kill your cat to avoid a miniscule risk of rabies?