Bat Scratch Fever

Everything you always wanted to know about rabies -- but were afraid to touch

Although Cheshier's job entails a host of other health-related diagnostic duties, it isn't surprising that he currently has rabies on the brain.

In addition to the Oak Creek scare, word has just reached his office that a 49-year-old man has just died from rabies in a Sacramento hospital, apparently unaware that he'd been bitten by a bat. Noteworthy for its rarity (the death was the first rabies fatality in California in five years, and only the 28th in the United States in the past 10 years), the case once again points out the danger of interacting with wildlife, either intentionally or accidentally.

Craig Levy of the state Department of Health Services 
says drought is forcing more potentially rabid wildlife 
into populated areas.
Paolo Vescia
Craig Levy of the state Department of Health Services says drought is forcing more potentially rabid wildlife into populated areas.
The "Necropsy" is the center for animal autopsies at 
the state Department of Health Services.
Paolo Vescia
The "Necropsy" is the center for animal autopsies at the state Department of Health Services.

Arizonans have been lucky. "The last human rabies case in this state was in 1981," says Cheshier, "and that was imported."

According to the microbiologist, the victim apparently contracted the disease from an animal bite in Mexico before returning to the United States. (It can take from five days to a year for rabies to show up in humans; two months is the average.)

"In a case like that, where there's no hope of finding the animal and the person doesn't realize there's been contact until the onset of symptoms, there's absolutely nothing that could be done to save him."

Had the same scenario unfolded in the States, that man might still be alive today. Ideally, says Cheshier, someone who's been bitten by an animal will immediately notify authorities, who will assess the danger of the situation. If the animal is a domestic dog or cat, whose owners can provide current vaccination records, the animal may simply be quarantined for observation for a number of days.

But if someone is bitten by an undomesticated animal, say a skunk or a bat, authorities will try to find the animal for testing. (Because rabid animals that attack people are usually near death themselves, they're not nearly as hard to find as one might imagine.) If the animal cannot be found, the victim should immediately seek medical treatment. But if the animal can be found, authorities will kill it, cut its head off and send it to the state health service lab.

Because the presence of the disease can only be established by scrutinizing brain tissue samples, Cheshier's chore typically involves scalping the animal, then cutting into its skull with a bone saw. Tissue is then affixed to glass slides, then treated with a solution that glows an apple-green color if the rabies virus is present when viewed under ultraviolet light.

Since Cheshier joined the department 17 years ago, he and his small staff have examined the gray (and sometimes apple-green) matter of thousands of potential rabies carriers.

Last year, his office received the heads of 1,286 animals from around the state. In addition to bats (the main source of human rabies in the United States), the bodiless menagerie included cows, horses, raccoons, skunks, a bear, a mule and even a potbellied pig. Of those, only 43 animals tested positive for the disease. And while it's unlikely that the Phoenix lab will hit those numbers this year (in the first nine months of 2000, only 20 cases of rabies have been discovered), an inordinate number of rabies cases discovered by the Tucson lab leads experts to believe that animal rabies is on the rise within the state.

And until the end of a drought that is sending record numbers of wild animals into populated areas in search of food -- about a dozen bears have been spotted in the Valley in recent months -- observers predict that Arizona's rabies problems have just begun to bite.

"In terms of positive rabies tests, what we're seeing now is just the tip of the iceberg of what's routinely going on in wildlife areas."

So says Craig Levy, manager of the state Department of Health Services Vector-Borne and Zoonotic Disease Section, who explains that, as a result of the drought, the public is finally seeing a lot of rabid animals whose disease would otherwise go unreported.

"If a rabid bat flies over Coconino County and falls out of the sky," he says, "you're rarely going to hear about it because the bats usually wind up dying out in the middle of nowhere."

Unfortunately, says Levy, unattended deaths are a rarity when a bat happens to expire in a densely populated area. "If the same thing happens in Phoenix or Tucson, it's probably going to land in someone's yard where it will be discovered by somebody or their pet."

In one case that came to the department's attention a few years back, the diseased bat actually became the "pet." After finding a grounded bat, a young boy became so enamored of his new pal that he hauled the ailing creature to school for show-and-tell, took the animal to church and even kept it for so long after its death that its body was practically mummified before someone convinced him to have it examined for rabies. The test result? Positive.

Public health officials have never found it necessary to mount major campaigns to warn people about the dangers of playing with rattlesnakes or snacking on toadstools. So why all the foolish behavior with bats?

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