Rabies is a viral infection of the central nervous system that may be fatal. Bats and striped skunks have replaced the dog as the primary maintenance species of rabies in California. Forty-two species of bats are found in the United States, all microbats and in California alone there are up to 23 species.
Here to offer vital information regarding the prevention of bat rabies is Dr Oliver Sahagun, he is an emergency medicine physician and a member of the medical staff at Henry Mayo Newhall Hospital.
Selected Podcast
Bat Rabies and the Plague That Has Come to California
Featured Speaker:
Oliver Sahagun, MD
Dr. Oliver Sahagun, MD is an emergency medicine physician and a member of the medical staff at Henry Mayo Newhall Hospital. He is 45 years old and has been practicing for 17 years. Transcription:
Bat Rabies and the Plague That Has Come to California
Melanie Cole (Host): Rabies is a viral infection of the central nervous system that may be fatal. Bats and striped skunks have replaced the dog as the primary maintenance species of rabies in California. Forty-two species of bats are found in the United States, and in California alone, there are up to 23 species. My guest today, is Dr. Oliver Sahagun. He’s an Emergency Medicine Physician and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show, Dr. Sahagun. What is rabies?
Dr. Oliver Sahagun (Guest): Hi folks. Rabies is an infection of the central nervous system that’s centered in the brain that is contracted from the bite of an infected animal, which can be any number of animals, but we tend to hear a lot about the bites specifically from bats. Essentially, the bat is carrying the organism that causes rabies, which is essentially a virus. The virus essentially gets into your body and can cause any number of symptoms including a headache, fever, weakness. That ultimately can lead to central nervous system dysfunction, which can include seizures, delirium, agitation, tremors. It’s very common in all parts of the world, and it can even happen here in the United States.
Melanie: Well, I mentioned in the intro a little bit that we’ve heard before that dogs were what we heard had rabies, but now it’s bats and even skunks. Tell us about the animals. How do they get rabies?
Dr. Sahagun: Rabies is not uncommon. In fact, there are well over 300,000 cases of rabies documented in the world, most of which do in fact, come from domestic animals, mostly from rabid dogs. That being said, it’s exceedingly rare in the United States. Most cases of rabies in the United States are from mostly bats, but they could come from any number of animals. In the United States, we tend to see them from raccoons, skunks, foxes, larger meat-eaters. You hardly ever see that from smaller animals. The reason why is because vaccinations that occur in the United States nowadays, people vaccinate their animals that are domestic animals – cats and dogs. Because of that, the incidence of rabies specifically from a dog is exceedingly rare or approaching zero in the United States. Those cases are mostly outside of the United States.
Melanie: Are bats generally aggressive? Do they bite at random? Do you even feel a bat bit? Suppose you’re sleeping somewhere, would you even know?
Dr. Sahagun: Bats do not contract rabies any more than these other animals that we just mentioned like raccoons, and skunks, and foxes, and coyotes, but bats are just smaller animals. We are more likely to encounter bats in the everyday world than we are to encounter these other animals. When rabies affects animals, it affects the animals in the same way that it would affect humans. It can cause changes in their behavior. Bats eat at night and so if a bat were infected with rabies, it would exhibit abnormal behavior so that essentially could entail seeing the bat flying around during the day when it shouldn’t. Or they think they’re in a cave, but in fact, entered your house. Most bites from bats are noticeable. You’re going to see a bat in the house; it’s going to come flying at you. Bats don’t normally do that. If a bat bites you, then you have to be very concerned that it’s infected with the rabies virus because it’s exhibiting abnormal behavior.
Now, unfortunately, if you see a bat in your house, that likely – we have to be very suspicious that that bat actually has rabies because it shouldn’t be in your house in the first place. There are many documented cases where a person may wake up in the middle of the night or early in the morning and see a bat in the house. Although most people would feel if a bat landed on them and bit them, some bats are very sharp and it’s very possible that it could have bit a human in the middle of the night and you didn’t notice it so that if you did wake up one morning and you saw a bat in the house, then you should be very suspicious that it could have bitten you or anybody in the house. Especially infants or toddlers because normally, they sleep more soundly than adults do. You should be very suspicious if you see a bat in the house even if you didn’t witness the bat actually landing on your body because it’s very possible it could have bitten you in the middle of the night.
Melanie: And Dr. Sahagun, while people might enjoy seeing bats at night due to their appetite for mosquitos, where in the outdoors would a bite from a bat occur?
Dr. Sahagun: First of all, if you see a bat flying somewhere, you’re not going to get rabies, so there’s that misconception. The only time you should be concerned is if you actually got bitten by a bat while you were awake or if it’s the middle of the night and there’s a bat in your enclosure – whether that’s your tent if you’re camping or inside your house because that would be considered abnormal behavior and you have to be very suspicious that the bat is, in fact, infected by the rabies virus.
Melanie: What do you do if you suspect that you might have – if there’s one in your house or in your tent – and you think you might have gotten bitten, what do you do? You run to the emergency room. Is there a treatment?
Dr. Sahagun: Yes, there is. It is highly recommended that if you’re suspicious that you may have been bitten by a bat because it is in fact in your house – even though you didn’t get bitten, or maybe you did – but yes, you should definitely go to the emergency room. There is treatment. The treatment we call is post-exposure prophylaxis, so that means treatment after a suspected bite. It’s a two-part treatment, essentially. The first part is what we call passive immunization where you actually get a shot of antibodies, which are proteins that help protect against the virus once it enters your body. That’s given as a shot directly at the site where you think – or where you know you got bitten.
The second component is actually to get a vaccine. That’s a medication that’s administered in your upper arm or your thigh, and it’s a part of the rabies virus itself. It’s not live, but it’s something that your body is able to essentially notice that it’s not normal and make its own antibodies or its own protection against the virus. You should go to the emergency room immediately when you suspect that you could have been bitten or if you know you were bitten by a bat. The vaccine is given over a four-day period to occur on days zero, days three, day seven, and day fourteen.
Melanie: What are you seeing going on in California just now, Doctor?
Dr. Sahagun: Rabies cases haven’t – they’ve essentially been pretty stable. They haven’t gone up or down. There are some years where maybe more cases are reported than others, but the great thing about rabies is that it is treated once you suspect that you could have been inoculated with the virus by an infected organism whether that’s a skunk, or a raccoon, or a fox, or a coyote, or a bat in this case. There is treatment, and the moment that you suspect you could have possibly been exposed to rabies, you should immediately go to the emergency room or go see your family physician for treatment.
Melanie: Are you seeing things such as plague? People are freaked out at that word, but are you seeing that right now?
Dr. Sahagun: No, I’m not really seeing it. I have kept up to date with the plague. Of course, plague is a very terrifying disease. Most kids in grade school read about the plague, how it wiped out half of the European and Asian population in the dark ages – the 14th Century. But it’s essentially been kept at very, very low levels in the United States. In the United States, you probably see about ten cases of plague a year. In 2015, 2016 in the Southwestern States like California, Arizona, some parts of Nevada, Colorado, and New Mexico, there were increased cases, but there weren’t that many. I think there was like maybe 15 or 16 cases. The plague is a deadly disease, but if there are any suspicions for plague, it can be treated with antibiotics.
Melanie: This is such great information, and so important for listeners to hear. Dr. Sahagun, if you would wrap it up for us please with your best advice about rabies that could come from bats. What do you want people to know about possible prevention and recognition of this possibility?
Dr. Sahagun: Well, the important thing is to be safe. Wear insect repellant. Don’t handle any dead carcasses. If you’re out camping, do not pet any animals. If you see a dead carcass, stay away from it because that’s a very important way to prevent getting any sort of disease, including rabies. We have all the necessary resources to help deal with any cases of infectious disease including rabies. If people here in this community have any suspicions or concern that they may have any infectious disease including rabies, we’re more than happy to see you. Please come by the emergency department. You’ll be evaluated by very helpful staff, including physicians who can ask you questions, do an appropriate physical examination, determine your risk of exposure to rabies, and if we think that the risk is significant, we’re happy to treat you for the disease.
Melanie: Thank you so much, Dr. Sahagun, for raising awareness, today. You’re listening to It’s Your Health Radio with Henry Mayo Newhall Hospital. For more information, please visit HenryMayo.com, that’s HenryMayo.com. This is Melanie Cole. Thanks so much for listening.
Bat Rabies and the Plague That Has Come to California
Melanie Cole (Host): Rabies is a viral infection of the central nervous system that may be fatal. Bats and striped skunks have replaced the dog as the primary maintenance species of rabies in California. Forty-two species of bats are found in the United States, and in California alone, there are up to 23 species. My guest today, is Dr. Oliver Sahagun. He’s an Emergency Medicine Physician and a member of the medical staff at Henry Mayo Newhall Hospital. Welcome to the show, Dr. Sahagun. What is rabies?
Dr. Oliver Sahagun (Guest): Hi folks. Rabies is an infection of the central nervous system that’s centered in the brain that is contracted from the bite of an infected animal, which can be any number of animals, but we tend to hear a lot about the bites specifically from bats. Essentially, the bat is carrying the organism that causes rabies, which is essentially a virus. The virus essentially gets into your body and can cause any number of symptoms including a headache, fever, weakness. That ultimately can lead to central nervous system dysfunction, which can include seizures, delirium, agitation, tremors. It’s very common in all parts of the world, and it can even happen here in the United States.
Melanie: Well, I mentioned in the intro a little bit that we’ve heard before that dogs were what we heard had rabies, but now it’s bats and even skunks. Tell us about the animals. How do they get rabies?
Dr. Sahagun: Rabies is not uncommon. In fact, there are well over 300,000 cases of rabies documented in the world, most of which do in fact, come from domestic animals, mostly from rabid dogs. That being said, it’s exceedingly rare in the United States. Most cases of rabies in the United States are from mostly bats, but they could come from any number of animals. In the United States, we tend to see them from raccoons, skunks, foxes, larger meat-eaters. You hardly ever see that from smaller animals. The reason why is because vaccinations that occur in the United States nowadays, people vaccinate their animals that are domestic animals – cats and dogs. Because of that, the incidence of rabies specifically from a dog is exceedingly rare or approaching zero in the United States. Those cases are mostly outside of the United States.
Melanie: Are bats generally aggressive? Do they bite at random? Do you even feel a bat bit? Suppose you’re sleeping somewhere, would you even know?
Dr. Sahagun: Bats do not contract rabies any more than these other animals that we just mentioned like raccoons, and skunks, and foxes, and coyotes, but bats are just smaller animals. We are more likely to encounter bats in the everyday world than we are to encounter these other animals. When rabies affects animals, it affects the animals in the same way that it would affect humans. It can cause changes in their behavior. Bats eat at night and so if a bat were infected with rabies, it would exhibit abnormal behavior so that essentially could entail seeing the bat flying around during the day when it shouldn’t. Or they think they’re in a cave, but in fact, entered your house. Most bites from bats are noticeable. You’re going to see a bat in the house; it’s going to come flying at you. Bats don’t normally do that. If a bat bites you, then you have to be very concerned that it’s infected with the rabies virus because it’s exhibiting abnormal behavior.
Now, unfortunately, if you see a bat in your house, that likely – we have to be very suspicious that that bat actually has rabies because it shouldn’t be in your house in the first place. There are many documented cases where a person may wake up in the middle of the night or early in the morning and see a bat in the house. Although most people would feel if a bat landed on them and bit them, some bats are very sharp and it’s very possible that it could have bit a human in the middle of the night and you didn’t notice it so that if you did wake up one morning and you saw a bat in the house, then you should be very suspicious that it could have bitten you or anybody in the house. Especially infants or toddlers because normally, they sleep more soundly than adults do. You should be very suspicious if you see a bat in the house even if you didn’t witness the bat actually landing on your body because it’s very possible it could have bitten you in the middle of the night.
Melanie: And Dr. Sahagun, while people might enjoy seeing bats at night due to their appetite for mosquitos, where in the outdoors would a bite from a bat occur?
Dr. Sahagun: First of all, if you see a bat flying somewhere, you’re not going to get rabies, so there’s that misconception. The only time you should be concerned is if you actually got bitten by a bat while you were awake or if it’s the middle of the night and there’s a bat in your enclosure – whether that’s your tent if you’re camping or inside your house because that would be considered abnormal behavior and you have to be very suspicious that the bat is, in fact, infected by the rabies virus.
Melanie: What do you do if you suspect that you might have – if there’s one in your house or in your tent – and you think you might have gotten bitten, what do you do? You run to the emergency room. Is there a treatment?
Dr. Sahagun: Yes, there is. It is highly recommended that if you’re suspicious that you may have been bitten by a bat because it is in fact in your house – even though you didn’t get bitten, or maybe you did – but yes, you should definitely go to the emergency room. There is treatment. The treatment we call is post-exposure prophylaxis, so that means treatment after a suspected bite. It’s a two-part treatment, essentially. The first part is what we call passive immunization where you actually get a shot of antibodies, which are proteins that help protect against the virus once it enters your body. That’s given as a shot directly at the site where you think – or where you know you got bitten.
The second component is actually to get a vaccine. That’s a medication that’s administered in your upper arm or your thigh, and it’s a part of the rabies virus itself. It’s not live, but it’s something that your body is able to essentially notice that it’s not normal and make its own antibodies or its own protection against the virus. You should go to the emergency room immediately when you suspect that you could have been bitten or if you know you were bitten by a bat. The vaccine is given over a four-day period to occur on days zero, days three, day seven, and day fourteen.
Melanie: What are you seeing going on in California just now, Doctor?
Dr. Sahagun: Rabies cases haven’t – they’ve essentially been pretty stable. They haven’t gone up or down. There are some years where maybe more cases are reported than others, but the great thing about rabies is that it is treated once you suspect that you could have been inoculated with the virus by an infected organism whether that’s a skunk, or a raccoon, or a fox, or a coyote, or a bat in this case. There is treatment, and the moment that you suspect you could have possibly been exposed to rabies, you should immediately go to the emergency room or go see your family physician for treatment.
Melanie: Are you seeing things such as plague? People are freaked out at that word, but are you seeing that right now?
Dr. Sahagun: No, I’m not really seeing it. I have kept up to date with the plague. Of course, plague is a very terrifying disease. Most kids in grade school read about the plague, how it wiped out half of the European and Asian population in the dark ages – the 14th Century. But it’s essentially been kept at very, very low levels in the United States. In the United States, you probably see about ten cases of plague a year. In 2015, 2016 in the Southwestern States like California, Arizona, some parts of Nevada, Colorado, and New Mexico, there were increased cases, but there weren’t that many. I think there was like maybe 15 or 16 cases. The plague is a deadly disease, but if there are any suspicions for plague, it can be treated with antibiotics.
Melanie: This is such great information, and so important for listeners to hear. Dr. Sahagun, if you would wrap it up for us please with your best advice about rabies that could come from bats. What do you want people to know about possible prevention and recognition of this possibility?
Dr. Sahagun: Well, the important thing is to be safe. Wear insect repellant. Don’t handle any dead carcasses. If you’re out camping, do not pet any animals. If you see a dead carcass, stay away from it because that’s a very important way to prevent getting any sort of disease, including rabies. We have all the necessary resources to help deal with any cases of infectious disease including rabies. If people here in this community have any suspicions or concern that they may have any infectious disease including rabies, we’re more than happy to see you. Please come by the emergency department. You’ll be evaluated by very helpful staff, including physicians who can ask you questions, do an appropriate physical examination, determine your risk of exposure to rabies, and if we think that the risk is significant, we’re happy to treat you for the disease.
Melanie: Thank you so much, Dr. Sahagun, for raising awareness, today. You’re listening to It’s Your Health Radio with Henry Mayo Newhall Hospital. For more information, please visit HenryMayo.com, that’s HenryMayo.com. This is Melanie Cole. Thanks so much for listening.