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Bats, Cats, Attics, and Antics—Bizarre Stories of Rabies and Risks

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An NBA basketball game was interrupted on February 7, 2019, at the Bankers Life Fieldhouse in Indianapolis, Indiana, when a bat flew into the arena, causing the players to scatter off court.1 Guards, referees, and courtside officials tried to capture the bat with towels as the theme song to the 1960s Batman television series played comically in the background.

That wasn’t the first time, either, that the presence of bats resulted in the suspension of an NBA game. Visits by bats seem to be such a familiar event at the AT&T Center in San Antonio that some wonder if the bats have season tickets.2

Bizarre Basketball Bats

The AT&T stadium officials and home courtside assistants are accustomed to bat occurrences. Their team mascot is actually outfitted in a Batman jersey and mask and is quite good at capturing the little critters with a fishing net. The fact that the AT&T Center is close to Bracken Cave—home to more than 15 million bats and the largest summer bat colony in the world—and sits right in the bats’ migratory pathway—may explain the high number of run-ins (see figure).

But it’s not all fun and games. The February 7 incident at the Bankers Life Fieldhouse prompted the Indiana State Department of Health to issue a statement advising anyone who had contact with the bat to contact them or their doctor as soon as possible.3 That’s because—as you know—bats can carry the rabies virus. In fact, bat bites are the most common mode of transmission for rabies.4


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Bats continue to emerge as the leading rabid species in the US.5 The 2017 data show a 6% rabies positivity rate among tested bats. And across the contiguous US, 47 jurisdictions reported rabid bats (see figure).

1967

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1981

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20176,000

Bats

5,000

4,000

3,000

2,000

1,000

0

Year

Rab

id a

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als

Rabies Has Increased in Bats Since 19675

Rabid Bats Were Reported in 47 of the 48 Contiguous United States in 20175

Adapted from Ma 2018


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An even scarier story than the one about the basketball bats might be the recent incidents in which two women

were bitten by a stray cat that tested positive for rabies.6 The women bitten by the cat in the town of Sullivan in

Madison County, New York, received rabies postexposure prophylaxis (PEP) treatment. “Residents should be

on alert and play it safe, and avoid contact with wild animals and pets you don’t know,” said Geoffrey Snyder,

the Madison County environmental health director. That report followed only 5 days after a very similar incident

in Jacksonville, North Carolina.7 A woman feeding wild cats was bitten by one of the feral creatures. The cat

was captured following the attack, euthanized due to its neurological symptoms, and tested positive for rabies.

Then there’s the account of a haunting infestation

by a massive bat colony composed of more than

5000 bats in two Utah high schools. The discovery

of the colonies in one high school’s auditorium led to

the closing of that part of the school of a month, the

PEP treatment of approximately 50 students due to

exposure risk, and spending $350,000 to close gaps

in 2017.8-10 Interestingly, Utah is one of only 8 states

in the US where bats were the only rabies-carrying

species detected in 2017.5

Wherever the risk, awareness is key both for the public who might be exposed, and their healthcare providers,

so that prompt care and PEP can be administered after suspected exposures.

Creepy Cats

Haunting Attic Infestations

Bat Infestation at Two Utah High Schools.


S P R I N G 2 0 1 9 • I S S U E # 9

This article may be downloaded, printed, and distributed freely without copyright restriction. For more information, go to www.rabieswatch.com

©2019 Grifols May 2019 BN/HB3/0519/0061

1. Lee BY. Bat at Indiana Pacers game: Who should worry about rabies. Forbes. https://www.forbes.com/sites/

brucelee/2019/02/10/bat-at-indiana-pacers-game-who-should-worry-about-rabies/#6b06c96a6c7b. Published February

10, 2019. Accessed May 17, 2019. 2. Herring C. Why are there so many bats at Spurs games? FiveThirtyEight. https://

fivethirtyeight.com/features/why-are-there-so-many-bats-at-spurs-games/. Published March 15, 2019. Accessed May

17, 2019. 3. Indiana State Department of Health. Health officials provide update on bat at Indiana Pacers game on

Feb 7, 2019. https://calendar.in.gov/site/isdh/event/health-officials-provide-update-on-bat--at-indiana-pacers-game-

on-feb-7-2019/. Published February 9, 2019. Accessed May 17, 2019. 4. Centers for Disease Control and Prevention.

Learning about bats and rabies. https://www.cdc.gov/rabies/bats/education/index.html. Updated April 22, 2011.

Accessed April 22, 2019. 5. Ma X, Monroe BP, Cleaton JM, et al. Rabies surveillance in the United States during 2017. J

Am Vet Med Assoc. 2018 Dec 15;253(12):1555-1568. 6. Dornan E. Feral cat who bit 2 in Madison County tests positive

for rabies. Syracuse.com. https://www.syracuse.com/health/2019/04/feral-cat-bites-2-in-madison-county-tests-

positive-for-rabies.html. Published April 16, 2019. Accessed April 22, 2019. 7. Daily News staff. Cat bites person, tests

positive for rabies. JDNews.com. https://www.jdnews.com/news/20190411/cat-bites-person-tests-positive-for-rabies.

Published April 11, 2019. Accessed April 22, 2019. 8. Nielsen L. 41 West High, 7 Layton High students receiving rabies

vaccine after bat infestations. KSL.com. https://www.ksl.com/article/45969460/41-west-high-7-layton-high-students-

receiving-rabies-vaccine-after-bat-infestations. Published September 28, 2017. Accessed April 22, 2019. 9. Over 40

treated for rabies after being exposed to bats at Utah high schools. Fox News. https://www.foxnews.com/health/over-

40-treated-for-rabies-after-being-exposed-to-bats-at-utah-high-schools. Published September 29, 2017. Accessed April

22, 2019. 10. Cortex M. Utah school district to spend nearly $350K to keep bats at bay. Deseret News. https://www.

deseretnews.com/article/900054395/utah-school-district-to-spend-nearly-350k-to-keep-bats-at-bay.html. Published

February 6, 2019. Accessed April 22, 2019.

REFERENCES


S P R I N G 2 0 1 9 • I S S U E # 9

This article may be downloaded, printed, and distributed freely without copyright restriction. For more information, go to www.rabieswatch.com

©2019 Grifols May 2019 BN/HB3/0519/0061

HYPERRAB® (rabies immune globulin [human]) is indicated for postexposure prophylaxis, along with rabies vaccine, for all persons suspected of exposure to rabies.

Limitations of Use

Persons who have been previously immunized with rabies vaccine and have a confirmed adequate rabies antibody titer should receive only vaccine.

For unvaccinated persons, the combination of HYPERRAB and vaccine is recommended for both bite and nonbite exposures regardless of the time interval between exposure and initiation of postexposure prophylaxis.

Beyond 7 days (after the first vaccine dose), HYPERRAB is not indicated since an antibody response to vaccine is presumed to have occurred.

Important Safety Information

For infiltration and intramuscular use only.

Severe hypersensitivity reactions may occur with HYPERRAB. Patients with a history of prior systemic allergic reactions to human immunoglobulin preparations are at a greater risk of developing severe hypersensitivity and anaphylactic reactions. Have epinephrine available for treatment of acute allergic symptoms, should they occur.

HYPERRAB is made from human blood and may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

The most common adverse reactions in >5% of subjects during clinical trials were injection-site pain, headache, injection-site nodule, abdominal pain, diarrhea, flatulence, nasal congestion, and oropharyngeal pain.

Do not administer repeated doses of HYPERRAB once vaccine treatment has been initiated as this could prevent the full expression of active immunity expected from the rabies vaccine.

Other antibodies in the HYPERRAB preparation may interfere with the response to live vaccines such as measles, mumps, polio, or rubella. Defer immunization with live vaccines for 4 months after HYPERRAB administration.

Indication and Usage

Please see accompanying full Prescribing Information for HYPERRAB.You are encouraged to report negative side effects of prescription drugs to the

FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

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