Rabies and Bats

Bats are a leading cause of rabies exposure. Among the unusually high number of rabies-related human deaths reported by the CDC in 2021, most of the fatalities were attributed to contact with bats.1,2

Menacing looking bat in flight.

Bats Account for 70% of Human Rabies Infections in the US2

During a 5-week period in late 2021, 3 people in the US were exposed to rabies from contact with bats. One of the individuals handled the bat with bare hands. Another had bats living in their home. None of the 3 received postexposure prophylaxis. All of them contracted rabies and subsequently died from it. The CDC attributes the uptick in fatalities to a lack of awareness about the risks of exposure.1,2

These deaths are especially noteworthy given that human rabies is exceedingly rare in the US. Twenty-five cases of human rabies were reported in the US from 2009 to 2018. There were no reported cases or deaths in 2019 and 2020.2-4

“…this recent spate of cases is a sobering reminder that contact with bats poses a real health risk.”2

— Ryan Wallace, DVM, MPH

Medical professional examining the hand of a patient with a bleeding wound inflicted by a bat that may have rabies.

The Need for Medical Attention

Bat bites do not always leave a visible mark—making them harder to detect. Because bat rabies virus can replicate in epithelial cells, any contact with a bat, even superficial scratches and bites, are cause for concern.2,5,6

Learn About Human Rabies Exposure and the Need for Postexposure Prophylaxis

Human Rabies Exposure

Important Safety Information for HyperRAB® (rabies immune globulin [human])

Indication and Usage
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.

Please see 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

References

  1. Gross J. U.S. records 5 rabies deaths in 2021, highest number in a decade. The New York Times. https://www.nytimes.com/2022/01/07/health/rabies-deaths.html.
  2. Centers for Disease Control and Prevention (CDC). CDC reports increase in human rabies cases linked to bats in the U.S. Accessed January 24, 2022. https://www.cdc.gov/ media/releases/2022/p0106-human-rabies.html.
  3. Feder H, Petersen B, Robertson K, et al. Rabies: still a uniformly fatal disease? Historical occurrence, epidemiological trends, and paradigm shifts. Curr Infect Dis Rep. 2012;14:408–422.
  4. Centers for Disease Control and Prevention (CDC). Human rabies. Updated September 22, 2021. Accessed April 1, 2022. https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html.
  5. Crowcroft NS, Thampi N. The prevention and management of rabies. BMJ. 2015;350:g7827.
  6. Manning SE, Rupprecht CE, Fishbein D, et al. Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2008;57(RR-3):1-28.