Bats in the Bedroom, Bats in the Belfry: Reanalysis of the Rationale for Rabies Postexposure Prophylaxis

Background. We assessed the scientific basis and practical implications of recommendations made since the late 1990s to offer rabies postexposure prophylaxis (RPEP) for occult bat encounters, including recommendations to offer RPEP to persons with bedroom exposure to a bat while sleeping without evi...

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Bibliographic Details
Published in:Clinical infectious diseases 2009-06, Vol.48 (11), p.1493-1499
Main Authors: De Serres, Gaston, Skowronski, Danuta M., Mimault, Pierre, Ouakki, Manale, Maranda-Aubut, Renée, Duval, Bernard
Format: Article
Language:English
Subjects:
Analysis
Animal bites
Animals
Articles and Commentaries
Bats
Bedrooms
Biological and medical sciences
Canada - epidemiology
Chiroptera
Disease prevention
Human viral diseases
Humans
Immunization
Incidence
Infectious diseases
Medical sciences
Physical contact
Population estimates
Preventive medicine
Rabies
Rabies - economics
Rabies - epidemiology
Rabies - prevention & control
Rabies - transmission
Recommendations
Single status
United States - epidemiology
Vaccination
Viral diseases
Viral diseases of the nervous system
Zoonoses - transmission
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Summary:Background. We assessed the scientific basis and practical implications of recommendations made since the late 1990s to offer rabies postexposure prophylaxis (RPEP) for occult bat encounters, including recommendations to offer RPEP to persons with bedroom exposure to a bat while sleeping without evidence of direct physical contact. Methods. The number needed to treat after bedroom exposure to a bat was calculated as the percentage of population exposed multiplied by the inverse of crude rabies incidence. Bedroom exposure was estimated in a population survey of 14,453 households. Incidence was based on reported human cases in Canada and the United States, 1990–2007. Results. In the population surveyed, bedroom bat exposure while sleeping and without known physical contact occurred at an annual rate of 0.099%. We estimate that
ISSN:1058-4838
1537-6591
DOI:10.1086/598998