Most camps view bats in their environment as beneficial — eating large numbers of mosquitos and often providing important lessons for campers on relationships in the natural world. However, within the past two years, some camps have received strong warnings from local health department officials about the risks associated with bats and the possibility of rabies infection.
Sparked by a change in recommendations and guidelines from the national Centers for Disease Control (CDC), some state and local animal control and health department officials have taken steps that have affected camps. Reports have come to ACA from camps in California, North Carolina, and New York of actions ranging from written guidelines for camps on bats to forced enclosure of open-air structures to keep out bats.
Background
Rabies is a viral infection transmitted in the saliva of infected mammals. The virus enters the central nervous system of the host, and, once contracted, is almost always fatal. Regulations and practices regarding vaccines for domestic animals have resulted in a substantial decrease in the likelihood of human exposure to rabies from dogs, cats, etc.
However, rabies among wildlife — especially raccoons, skunks, and bats — has become more prevalent since the 1950s. Rabies among wildlife occurs throughout the continental U.S.; only Hawaii remains consistently rabies-free. According to the CDC, a total of twenty-one (58 percent) of the thirty-six human cases of rabies diagnosed in the U.S. since 1980 have been associated with bat variants.
Rabies Vaccine
Although rabies among humans is rare in the U.S., every year approximately 16,000 – 39,000 persons receive postexposure prophylaxis (PEP) — due to possible rabies exposure. For previously unvaccinated persons, PEP involves a series of shots (inter-muscular, deltoid area) on days 0,3,7,14, and 28.
The Problem with Bats
The CDC reports that recent epidemiologic data suggest that transmission of rabies virus can occur from minor, seemingly unimportant or unrecognized bites from bats. The limited injury inflicted by a bat bite (in contrast to lesions caused by carnivores such as dogs, skunks, etc.) and an often inaccurate recall of the exact exposure history might limit the ability of health-care providers to determine the risk of rabies resulting from an encounter with a bat. In several cases of human rabies, no exposure to bats was reported, but an undetected or unreported bat remains the most plausible hypothesis.
As a result, the CDC recommends postexposure prophylaxis (PEP) for all persons with bite, scratch, or mucous membrane exposure to a bat, unless the bat is available for testing and is negative for evidence of rabies. In addition, the CDC recommends that in instances in which a bat is found indoors and there is no history of bat-human contact, the likely effectiveness of PEP must be balanced against the low risk such exposures appear to present. Of particular concern are persons who were in the same room as the bat and who might be unaware that a bite or direct contact had occurred. CDC guidelines give as examples ". . . a sleeping person awakens to find a bat in the room or an adult witnesses a bat in the room with a previously unattended child, mentally disabled person, or intoxicated person . . ." If rabies cannot be ruled out by testing the bat, PEP should be considered.
Impact on Camps
Discussion with officials from the CDC indicate that steps to prevent exposure to bats are most important. The main issue appears to be keeping bats out of sleeping areas. In some parts of the country, camps have had to screen previously open-air shelters to meet local health directives. In other areas, local officials have recommended that camps inspect sleeping facilities for possible entry points and repair as necessary. In addition, staff should check sleeping facilities frequently for any evidence of bats.
If a bat is found in a sleeping area, safe removal is recommended — following local guidelines. If children have been sleeping in a structure in which a bat is found, the camp should follow local recommendations regarding possible safe capture and testing of the bat. In addition, local authorities may recommend notification of parents and physician to determine whether PEP should be considered.
Children should be educated about the dangers of contact with bats (and any other animals indigenous to the area that may carry rabies). Campers should be advised not to handle bats and to report any contact with bats to camp staff. Camp staff must be trained in the camp’s protocol for handling such incidents. In some states, testing is available at no cost through animal control or the health department.
Since states have interpreted the CDC recommendations at varying levels, camps are advised to be aware of state and/or local guidelines regarding bats. Current CDC recommendations concerning the risk of rabies in bats and other animals and rodents can be found on their Web site at www.cdc.gov/ncidod/dvrd/rabies or by phone at 404-639-1050.
Originally published in the 2001 Winter issue of The CampLine.