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Recommendations of the Lyssavirus Expert Group Meeting 11 November 1996,
endorsed by the Communicable Diseases Network Australia New Zealand.
Background
A new Lyssavirus has been identified during 1996 in two species of bats in Australia. The two species are the Black Flying Fox (Pteropus alecto) and the Little red Flying Fox (Pteropus scapulatus). In November 1996, a woman in Queensland developed encephalitis, probably due to the virus, after being bitten and scratched by bats.
The genus Lyssavirus falls within the family Rhabdoviridae. There were six genotypes recognised within the genus. These include the classic rabies virus, Lagos bat virus, Mokola virus, Duvenhage virus and the two European bat lyssaviruses. These viruses have not previously been reported to occur in Australia. The newly identified seventh Lyssavirus is closely related to, but is distinct from, the classic rabies virus. In laboratory animals, rabies vaccine and rabies immunoglobulin are protective against this new Lyssavirus.
Non-rabies Lyssaviruses usually do not spread among terrestrial animals and human infections are rare. The newly identified Lyssavirus is currently known to infect fruit bats (flying foxes) and humans. Insectivorous bats are known to carry other Lyssaviruses overseas and therefore cannot be discounted as a potenital risk, at this stage.
Rabies virus and other Lyssaviruses are usually transmitted to humans via bites or scratches which provide direct access of the virus in saliva to exposed tissue and nerve endings. This means that most people would not be exposed to Lyssavirus through casual contact with bats.
As the bat Lyssavirus is closely related to classic rabies virus, infection may be prevented by rabies vaccine and rabies immunoglobulin. Recommendations for administering theses are provided below. Further research is being conducted into the distribution and transmissibility of the virus. Recommendations may be updated as more information becomes available.
Recommendations
Pre-Exposure Vaccination
Preexposure vaccination should be recommended to those occupationally or recreational exposed to bats, where there is a risk of being bitten or scratched, for example
- Bat carers
- Veterinarians
- Wildlife Officers (including local government officers)
- Veterinary laboratory staff
- Managers of display or research colonies
- members of indigenous communities who may catch bats for consumption
- Power lion workers who frequently remove bats from power lines.
Pre-exposure vaccination consists of three intramuscular doses of 1ml rabies vaccine given on days 0, 7 &28. Doses should be given in the deltoid area, as rabies neutralising antibody titres may be reduced after administration in other sites. In children, administration into the anterolateral aspect of the thigh is also acceptable.
Persons bitten or scratched by bats.
The wound should be scrubbed thoroughly as soon as possible with soap and water. Proper cleansing of the wound is the single most effective measure fro reducing thee transmission. Where possible, the bat should be kept for further investigation by the State veterinary laboratory.
Guidelines have been developed to aid the decision on whether to administer vaccine alone or combined with rabies immunoglobulin. Factors include the type of wound, how recent the exposure was and the behaviour of the bat. Please contact your public health authority who will provide advice on the appropriate course of action.
Contact such as patting bats or exposure to urine or faeces does not constitute an at risk exposure. Pre-exposure vaccination should be offered if the person has on-going contact with bats.
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