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#1
Old 07-30-2013, 03:57 PM
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chance of being bitten by a bat without noticing it (rabies question)

So, I was car camping in Wisconsin last weekend and traipsing to and from the bathroom in pitch darkness. I noticed a pain on my shin, and upon closer inspection found two roundish shallow marks and a third small abrasion there. There was no blood, but the wounds were shallow and a little bit shiny with clear serum. The marks were a cm apart. I didn't notice any small animals or anything hitting my shin. I went to the doctor yesterday, and she didn't think it was anything (after consulting with an infectious disease expert) because I didn't notice any animals near my leg, and didn't warrant the rabies shots. I am still stressing about this though. Is it possible to get bit and not realize it? I don't remember hitting my shins anywhere enough for them to get abraded. I noticed the marks because they hurt that night.

When I noticed the marks I used a hand sanitizer that consists of 70% ethyl alcohol and kept rubbing it into the wound.

Anyway, I am embarassed about being so paranoid, and I don't know what to do now. I'd like to just go to a travel clinic and pay for rabies immunization just for peace of mind, but they are expensive. Would it help a little if I got the pre-exposure shots?

Last edited by Rusalka; 07-30-2013 at 03:59 PM.
#2
Old 07-30-2013, 04:00 PM
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Seems unlikely you could be bitten on the shin by a bat.
Were there an abundance of bats? Or other reason to suspect a bat bite?

Last edited by aNewLeaf; 07-30-2013 at 04:01 PM.
#3
Old 07-30-2013, 04:37 PM
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No, but it was dark. I don't know why I thought of bats. I usually don't think about rabies or bats and I go backpacking a lot. However, I've never had two stinging puncture like marks appear out of nowhere before either. There must be a reason I'm stressing about this.
#4
Old 07-30-2013, 05:05 PM
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The only bats I'm aware of that tend to stay low, on the ground or near it, are vampire bats, but they live in the southern hemisphere, nowhere near Wisconsin. Bats in your area are flyers, they'll be above your head.

Most likely, you bumped against a twig or some other woody obstacle in the dark, maybe something with thorns?
#5
Old 07-30-2013, 05:13 PM
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Originally Posted by Broomstick View Post
Bats in your area are flyers, they'll be above your head.
Unless they are sick and flopping around on the ground.

The shots are not painful. The trick is getting your insurance company to pay for them.
When I was bitten by a raccoon I went to the Health Department and picked the stuff up. Physicians can't afford to keep it around.

I think I'd check with my Doctor again. Probably sticks like Broomstick says, but rabies is serious stuff.
#6
Old 07-30-2013, 05:21 PM
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The pre-exposure shots are part of the treatment for post-exposure too. The difference is post exposure treatment of rabies gets an extra dose of immunoglobulins, which is not administered to those that were vaccinated.

Go to the doctor first, or again.
#7
Old 07-30-2013, 07:33 PM
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I do not think an experienced physician would find your story convincing enough for a post exposure prophylaxis regimen.
#8
Old 07-30-2013, 07:34 PM
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I've read on a couple of occasions of people being bitten by bats and not feeling it. I don't know how far apart their teeth are and I'm not a doctor. But it would seem very possible to be bitten by a bat without feeling it. (Sorry, I don't want to make you nervous.)

Did the doctor have some other hypothesis of what would have caused those marks? Did she just say "not a bat" or was there another explanation?
#9
Old 07-30-2013, 07:40 PM
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Originally Posted by Chief Pedant View Post
I do not think an experienced physician would find your story convincing enough for a post exposure prophylaxis regimen.
I agree, but can you explain why? I mean this isn't just malaria if they're wrong, it's automatic death. Even Ebola has a higher survival rate. I want to be able to sleep at night! The logical side of me says I'm being totally silly, which is why I'm embarassed.
#10
Old 07-30-2013, 07:44 PM
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Originally Posted by ratatoskK View Post
I've read on a couple of occasions of people being bitten by bats and not feeling it. I don't know how far apart their teeth are and I'm not a doctor. But it would seem very possible to be bitten by a bat without feeling it. (Sorry, I don't want to make you nervous.)

Did the doctor have some other hypothesis of what would have caused those marks? Did she just say "not a bat" or was there another explanation?
She suggested a garter snake or something, but I would have noticed a snake sooner than a bat! Bats have next to no mass. I slept in the vehicle with the windows cracked an inch. For all I know, one snuck in and bit me while I was sleeping. The spacing of the "puncture marks" is consistent with a bat bite, approx. 1 cm.
#11
Old 07-30-2013, 07:48 PM
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The spacing is also consistent with thorns. However, last weekend there was a full moon, so if any kind of were-animal or were-plant bit you then you'll be having some problems around three weeks from now.
#12
Old 07-30-2013, 07:55 PM
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Originally Posted by Rusalka View Post
For all I know, one snuck in and bit me while I was sleeping.
No.
#13
Old 07-30-2013, 07:57 PM
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Originally Posted by Rusalka View Post
She suggested a garter snake or something, but I would have noticed a snake sooner than a bat! Bats have next to no mass. I slept in the vehicle with the windows cracked an inch. For all I know, one snuck in and bit me while I was sleeping. The spacing of the "puncture marks" is consistent with a bat bite, approx. 1 cm.
It could also be consistent with a spider of some sort, or some other invertebrate. And those and snakes are more common in the setting as you described (and in the anatomical area you described) than a bat.

Yea, people can be bitten by bats and not noticed. But in many of those cases, the bite was not on the legs (IIRC around the face/upper body), and a dead (or live) bat was found nearby or a nest of bats was observed in the attic or immediate vicinity.

And considering the restrictions placed on rabies vaccine and treatment, I doubt that a travel clinic would give you a post-exposure treatment without solid recommendation from your physician (or another physician, which would include asking public health officials). And a pre-exposure vaccination is also restricted to people with specific lifestyles and risks (John Doe walking to a travel clinic and demand a rabies pre-exposure is not going to happen).

If your doctor consulted with an infectious disease doctor (and I'm assuming some public health official), then you could rest a bit easy, no?
#14
Old 07-30-2013, 08:19 PM
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Originally Posted by Rusalka View Post
I agree, but can you explain why? I mean this isn't just malaria if they're wrong, it's automatic death. Even Ebola has a higher survival rate. I want to be able to sleep at night! The logical side of me says I'm being totally silly, which is why I'm embarassed.

Relax, you'd know it if there was a rabid animal biting you.


The harm/risk of taking the post-exposure prophylactic is expected to be worse than the risk of you being bitten by a rabid animal that you didn't know about.


I think you stood on a branch and it flipped up and whacked your leg.
#15
Old 07-30-2013, 08:30 PM
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Originally Posted by Isilder View Post
Relax, you'd know it if there was a rabid animal biting you.
Are you sure?

I'm reminded of the girl in Wisconsin that got bit by a bat she was carrying outside (it had landed in the church). She was aware of the bite, but they must not have thought too much about it because they didn't get shots and she got rabies a month later.
#16
Old 07-30-2013, 08:51 PM
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Yes, but she was carrying a bat. The OP didn't see any signs of bats around your area.

Similar, some well-meaning but slightly ignorant student at my last college picked up a sick bat, which later bit him. Bat died, people in charge wisely got it tested for rabies, bat was positive for it. Student had to go through post-exposure treatment (he survived, AFAIK).

Last edited by KarlGrenze; 07-30-2013 at 08:51 PM. Reason: Confused OP with previous poster.
#17
Old 07-30-2013, 09:32 PM
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Well, I've been bitten by the Bacardi bat, and the symptoms went away after a day at work.
HTH.
#18
Old 07-30-2013, 09:38 PM
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I wonder if more people are hit by bats at ball games, or are bitten by bats each year?
#19
Old 07-30-2013, 10:12 PM
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Quote:
Originally Posted by Isilder View Post
Relax, you'd know it if there was a rabid animal biting you.


The harm/risk of taking the post-exposure prophylactic is expected to be worse than the risk of you being bitten by a rabid animal that you didn't know about.


I think you stood on a branch and it flipped up and whacked your leg.
This is absolute nonsense. First, there are many well documented cases of bat rabies in persons who never reported being bitten. Second, the harm/risk of post-exposure prophylaxis is pretty much limited to the pocket book.
#20
Old 07-30-2013, 10:29 PM
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Originally Posted by KarlGrenze View Post
Student had to go through post-exposure treatment (he survived, AFAIK).
As have I.
I told the nurse as I dropped my pants, "I apologize for anything that I have ever done that may have offended you in any way."
The injection in my buttocks did not hurt, nor did the later ones in my arm.

Go see your Doctor tomorrow.

Last edited by carnivorousplant; 07-30-2013 at 10:30 PM.
#21
Old 07-30-2013, 10:33 PM
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Originally Posted by carnivorousplant View Post
Go see your Doctor tomorrow.
OP said

Quote:
I went to the doctor yesterday,
What do you think will have changed?
"Doctor, I asked on the SDMB." "Oh, well, in that case, have an injection."

Last edited by aNewLeaf; 07-30-2013 at 10:34 PM.
#22
Old 07-30-2013, 11:43 PM
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Originally Posted by KarlGrenze View Post
Yes, but she was carrying a bat. The OP didn't see any signs of bats around your area.
Isilder seemed to be making the point that there is something about a rabid animal's bite that would be so obvious to the person getting bit that a question in GQ like this wouldn't be needed. My post was pointing out an incident where it wasn't obvious to the people involved that the bite that just happened came from a rabid animal.
#23
Old 07-31-2013, 12:16 AM
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..

Last edited by Rusalka; 07-31-2013 at 12:17 AM. Reason: double popst. sorry.
#24
Old 07-31-2013, 12:25 AM
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Originally Posted by KarlGrenze View Post
And a pre-exposure vaccination is also restricted to people with specific lifestyles and risks (John Doe walking to a travel clinic and demand a rabies pre-exposure is not going to happen).
There have been many cases of rabies where the afflicted did not report getting bitten by anything. I read too much.

As for the travel clinic, as I understand it, all I have to do is tell them I'm going into some wilderness area or overseas where rabies is common, and they'll give me the shots. I'd have to pay for them out of pocket, of course. I don't think they give you the third degree about it. If the shots are the same as the post-exposure ones, perhaps it would be worth a little peace of mind.
#25
Old 07-31-2013, 12:34 AM
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Originally Posted by Isilder View Post


I think you stood on a branch and it flipped up and whacked your leg.
The thing is, I didn't. I know what I did, I know where I was, and it wasn't a place with a lot of branches or thorny shrubs. I didn't go hiking in the woods, I was just there to sleep and use the facilities in an otherwise very expensive tourist area.

Does anyone know why they give you three shots of vaccine? Is one shot better than none, or is it an all-three-or-nothing scenario? I sent a note to my regular doctor asking her point blank if I can get the vaccine (I saw someone else yesterday).

Last edited by Rusalka; 07-31-2013 at 12:37 AM.
#26
Old 07-31-2013, 05:49 AM
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Originally Posted by Rusalka View Post
The thing is, I didn't. I know what I did, I know where I was, and it wasn't a place with a lot of branches or thorny shrubs. I didn't go hiking in the woods, I was just there to sleep and use the facilities in an otherwise very expensive tourist area.

Does anyone know why they give you three shots of vaccine? Is one shot better than none, or is it an all-three-or-nothing scenario? I sent a note to my regular doctor asking her point blank if I can get the vaccine (I saw someone else yesterday).
Because they want you to get boosters and make sure you mount a strong immune response.

The deal with the post-exposure is that it includes more shots of the vaccine and another shot of immunoglobulin. The immunoglobulin is active and ready to start blocking the rabies virus while your body makes its own defenses (including immunoglobulins).

People who have been given pre-exposure vaccines still have to be treated, they just get less shots than others, and certainly no immunoglobulin (as it is expected they already have some floating around from their vaccination).

Again, considering this product was in shortage not too long ago, there may be restrictions to its use still in some areas, and even the travel clinic may not be able to just dispense it to you, even if you pay them.

Lastly, IF it is the case that they determine you are at risk, the immunoglobulin is important, as it start working right away while your body is mounting the defense with the vaccine. And the vaccination course itself last months (vaccine boostes are spaced out).

Double check or consult with another doctor, but in most places, rabies vaccine and treatment is not something they hand out easily.
#27
Old 07-31-2013, 12:37 PM
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So why the change from the old style [was it 22 painful shots into the stomach?] and the current described here of 3 shots?
#28
Old 07-31-2013, 01:00 PM
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Originally Posted by aruvqan View Post
So why the change from the old style [was it 22 painful shots into the stomach?] and the current described here of 3 shots?
Technology got better and treatment was fine-tuned would be my better guess.

Three shots is the pre-exposure routine vaccination in the US. Post-exposure treatment includes more shots (including the immunoglobulin), but not as many as 22. Post-exposure also differs if the person was vaccinated or not against rabies.

Fine tuning treatment for rabies exposure is a bit tricky, because the outcome if it is not treated correctly is very bad.
#29
Old 07-31-2013, 06:09 PM
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Why a bat?
Why not a Rat is the campground outhouse?
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#30
Old 07-31-2013, 06:25 PM
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Originally Posted by aNewLeaf View Post
OP said



What do you think will have changed?
"Doctor, I asked on the SDMB." "Oh, well, in that case, have an injection."
I was under the impression that the OP and is/her physician did not discuss an animal bite.

I had the vaccine some fifteen years ago after an altercation with a raccoon and my cats. Some ten years later I was bitten by a neighbor's dog fleeing a storm, and was still immune upon my physician testing me.
#31
Old 08-01-2013, 06:04 PM
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Originally Posted by Bosda Di'Chi of Tricor View Post
Why a bat?
Why not a Rat is the campground outhouse?
I would have noticed a rat. Rats are massive. Teeth are bigger. Love your screen name.

I convinced my primary doctor to get me treatment. I called an epidemiologist at the public health hotline for Wisconsin and he said my concerns were valid, and told me he himself was vaccinated for a similar incident. I gave my primary doctor his number, and I think she called him because shortly thereafter she made arrangements with the pharmacist at the ER to make sure they had enough of the stuff I need. There is indeed a lack of this medication, although I read that up to 39,000 people a year get the shots. The ER physician also thought the spacing of the marks were suspicious. (how likely is it that the marks from a branch would be two small round punctures exactly 1 cm apart?) Well I'm relieved even though the treatment started 3 days too late.

6 shots in my leg, then one in each shoulder.
#32
Old 08-01-2013, 06:50 PM
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I only read the OP.

I woke up in my bedroom a couple of years ago and a bat was flying around. I came to The Dope with a similar question and several people urged me to just go get the rabies shots, which I did. The consequences of being wrong are too great to risk. By the time you have symptoms, you are a dead person.

The guy who came to spray my yard for fleas told me about a park ranger in Texas who came upon a dead mountain lion and handled the carcass without gloves. Turns out the dead animal was rabid and the guy died. My bug guy said he has handled dead animal carcasses without gloves for 40 years. Not any more.

To repeat: the consequences of being wrong are too great to risk.

Go to the CDC website and you'll see that their recommended protocol is to get the shots of there is ANY chance you might have been exposed.
#33
Old 08-01-2013, 09:35 PM
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Originally Posted by Rusalka View Post
6 shots in my leg, then one in each shoulder.
I am glad that you consulted again with another doctor or public health officer. The shots you got are obviously way more than the pre-exposure vaccine, and more than what the travel clinic could have offered you.
#34
Old 08-01-2013, 10:05 PM
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Goodness, after my possible exposure, I had a series of four shots... I think they were all in my arm. I guess one might have been in my butt. It' just not worth taking a chance and HOPING you weren't exposed.
#35
Old 08-02-2013, 05:25 AM
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Originally Posted by KarlGrenze View Post
Technology got better and treatment was fine-tuned would be my better guess.

Three shots is the pre-exposure routine vaccination in the US. Post-exposure treatment includes more shots (including the immunoglobulin), but not as many as 22. Post-exposure also differs if the person was vaccinated or not against rabies.

Fine tuning treatment for rabies exposure is a bit tricky, because the outcome if it is not treated correctly is very bad.
Makes me glad that the Navy has given me the rabies vaccinations and kept me up to date [I was working with my sheep and dealing with the feral dog population and the local dog warden recommended I get the shots]

Though if you think about it, the Mil<however it is spelled> protocols do make sense - support until the body develops antibodies and the induced coma so the patient doesn't have to deal with the pain and terror of the reaction to rabies itself. Would dialysis or actual blood replacement work to remove active virus from the body?
#36
Old 08-02-2013, 07:24 AM
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Quote:
The guy who came to spray my yard for fleas told me about a park ranger in Texas who came upon a dead mountain lion and handled the carcass without gloves. Turns out the dead animal was rabid and the guy died. My bug guy said he has handled dead animal carcasses without gloves for 40 years.
Rabies is not spread by contact. Yeesh.
#37
Old 08-02-2013, 08:38 AM
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Rabies virus is not in the blood, but in the nerves, so blood transfusion will not be a good treatment and won't remove the virus.

Rabies is not spread by contact, but if the handling involve dealing with nervous tissue (spinal cord, brain), and if the person got a nick or cut while handling it (especially without gloves), then yes, it would have been exposed. Another option is that it was aerosolized, if the ranger used a bandsaw to cut the brain/spinal cord (sending infected particles of infected brain and spinal cord matter up his nose, a nerve receptor-rich area).
#38
Old 08-02-2013, 08:56 AM
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Originally Posted by aNewLeaf View Post
Rabies is not spread by contact. Yeesh.
I knew someone would question this. Sheesh yourself. Apparently the ranger had an open cut on his hand and came in contact with the animal's blood or other bodily fluids.

I forgot to put this in my post and missed the edit window. It's okay because my officemate owes me $5.
#39
Old 08-02-2013, 08:57 AM
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Originally Posted by KarlGrenze View Post
Rabies virus is not in the blood, but in the nerves, so blood transfusion will not be a good treatment and won't remove the virus.

Rabies is not spread by contact, but if the handling involve dealing with nervous tissue (spinal cord, brain), and if the person got a nick or cut while handling it (especially without gloves), then yes, it would have been exposed. Another option is that it was aerosolized, if the ranger used a bandsaw to cut the brain/spinal cord (sending infected particles of infected brain and spinal cord matter up his nose, a nerve receptor-rich area).
Yup. I wish the edit window was a minute or two longer.
#40
Old 08-02-2013, 10:15 AM
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Originally Posted by KarlGrenze View Post
Another option is that it was aerosolized, if the ranger used a bandsaw to cut the brain/spinal cord (sending infected particles of infected brain and spinal cord matter up his nose, a nerve receptor-rich area).
Sure hope a person would use gloves and goggles for that. Maybe a face mask. Maybe not. :shrug:

Last edited by aNewLeaf; 08-02-2013 at 10:15 AM.
#41
Old 08-02-2013, 12:47 PM
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Originally Posted by aNewLeaf View Post
Sure hope a person would use gloves and goggles for that. Maybe a face mask. Maybe not. :shrug:
During my training I was specifically told that, in any rabies suspect, never to use electronic saws/devices to take the brain out (that would send nerve splatter floating around). Use manual power (handsaw, axes, machetes), and preferably away from others (and in the downdraft room). And with gloves, at the very least.

Granted, I've worked with a few rabid animals and have yet to get rabies (knock on wood). So it is entirely possible to do so, but you have to wear protection.
#42
Old 08-02-2013, 11:20 PM
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When I was bitten by a rabid cat the contact was minimal- it felt like the cat just swiped a raspy tongue over the spot on the back of my calf. Caught the (weird acting stray) cat, got it tested and the Health Department came back with "Go to the hospital and get your shots." Ah...I think it was 7 shots that day, then follow up shots totalling 11.

I was thrilled it is no longer 20-30 shots in the stomach (I've heard varying numbers, from people who had them at varying times). I'm glad you got the shots, Rusalka!
#43
Old 08-03-2013, 06:52 AM
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There seems to be a disconnect between people like the CDC saying "get your shots!" if there is any possibility of expose, and what some people experience upon going to the doctor with a suspected animal bite, which seems to be "don't worry about it".
#44
Old 08-03-2013, 08:22 AM
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The CDC itself can be more conservative than others. I know, for example, that I saw an ad mentioning how annual vaccinations for pets was useful for rabies, ignoring the fact that now, thanks to vaccine improvements and data, the recommendations are to use 3-years vaccines when possible (there are a few 1-year duration vaccines). So the recommendation is outdated (and they didn't seem to take into account veterinarians).

OTOH, the local guidelines for who gets or doesn't get the vaccine are not given by CDC, but by the state's public health officials (including doctors and epidemiologists). They are the final voice in regards to whether a patient gets or not the shots, particularly it was a couple of years ago when there was the big shortage (heh).
#45
Old 08-05-2013, 05:10 PM
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Originally Posted by Broomstick View Post
There seems to be a disconnect between people like the CDC saying "get your shots!" if there is any possibility of expose, and what some people experience upon going to the doctor with a suspected animal bite, which seems to be "don't worry about it".
Yeah, I wonder if anyone has ever died of rabies after seeing a doctor who said "Nah...!" Most of the reaction seemed to be skepticism, except for the epidemiologist who actually deals with bats and rabies...

I've had no adverse reactions to the vaccine so far. I didn't even feel the last shot I had in my shoulder. I'm relieved I got treatment.

Last edited by Rusalka; 08-05-2013 at 05:13 PM.
#46
Old 08-11-2013, 11:11 PM
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bats are sneaky

I have had a bat enter my home 3 times now, over the last 25 years or so. The first time it came in through a slit in the screen door that was no longer than about an an inch, inch and a quarter. For some reason it pushed itself in - I was sitting right nearby when I saw it fly from behind the curtain that covered that door and later found that slit in the screen. Couldn't believe it. So they can fit in through very small places.

The other two times, one being this very night, we are not sure how it entered - probably through the door to the garage being left open too long. But tonight the bat, once inside, also somehow got into another room when the door to that room was closed, so we can only assume it went under the door, where there is about an inch of space.
#47
Old 09-10-2014, 10:16 AM
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Bat Bites

I went for rabies shots this past week after waking up with an unexplained wound on the knuckle. It was hard to decide since I didn't see a bat in the house but I'm pretty sure they're roosting here, I've disregarded the droppings on the front steps for a few years now, seems late summer I wipe them up and figured it was the chipmunks under the steps. Well, the scrape on my knuckle scabbed over into 2 distinct punctures 3cm apart (wish I could attach photo). I started googling, tried to explain how I would wake up and not remember scraping my knuckle, why I didn't see a bat in my house although they're all over the entrance and tall trees out front every night. Hmmm? post pix on fb and most people think I'm crazy at this point, "a bat couldn't bite you w/o you knowing it" and so on. Well, I did the right, followed my gut and started the shots on the 4th day. I have bat inspectors coming next week, they're very busy and subsequently called the town animal control and here's what they said: it is absolutely possible that's a bat bite, you should absolutely have the rabies shot, you can't be 100% it's of what it is and rabies is always fatal. You don't get to second guess this a month down the road! I've described the dropping to 3 pest control guys on the phone and they are all pretty sure we have bats, however they can't get involved with decision on rabies shots. I did the right thing! in Mass, oh just read last week they tested a bat for rabies, came back postitive, just a mile from my home Aug 2014
#48
Old 09-14-2014, 01:03 AM
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Better safe than sorry! Was it hard to convince your doc?
#49
Old 01-11-2015, 01:47 PM
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Quote:
Originally Posted by Rusalka View Post

I convinced my primary doctor to get me treatment. I called an epidemiologist at the public health hotline for Wisconsin and he said my concerns were valid, and told me he himself was vaccinated for a similar incident. I gave my primary doctor his number, and I think she called him because shortly thereafter she made arrangements with the pharmacist at the ER to make sure they had enough of the stuff I need. There is indeed a lack of this medication, although I read that up to 39,000 people a year get the shots. The ER physician also thought the spacing of the marks were suspicious. (how likely is it that the marks from a branch would be two small round punctures exactly 1 cm apart?) Well I'm relieved even though the treatment started 3 days too late.
What did the puncture marks looks like, exactly? I have two pinprick points approximately a centimeter apart on the back of my arm.

Also, what was that number for the epidemiologist? I'm living in a house in Wisconsin that I know to have bats roosting in the attic, and I recently discovered a hole in my wall. I've heard them scratching and squeaking in the walls before, so I was wondering what the chances were that one could get in through the hole, bite me, and then get back through the hole while I was sleeping.
#50
Old 01-11-2015, 02:08 PM
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Join Date: Jul 2009
Posts: 12,056
zombie or no

you would be better off looking up a phone number since the message was from 1 1/2years ago.

if you had two pinprick points approximately a centimeter apart on the back of your arm then if they were caused by a bat then that bat would be huge.
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