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Am I paranoid of BAT BITE?

Resolved Question:

A few months ago I had a bat fly into my face and I had to go through all the series of shots. I even had the vaccine which some people take before going to a country that is high risk.

Now last night I saw a bat flying low to the ground. I kept an eye on it while it while I was walking. It was flying erratically and flew from wall to wall in the alley. Now I lost site of it for a second and the next thing I knew it was 50 feet behind me. For some reason I thought it may have bit me in the lower thigh since i felt like I had a pinching feeling.

The bat was definitely acting bizarre and I wouldn't doubt if it bit me when my back was turned. I went home and I couldn't find an obvious bit or blood and i heard that sometimes you can't see the bit. Not sure if I'm being paranoid or should I out of caution get more shots?

The CDC is closed till Monday not sure if I should wait till then or go to the hospital. What are your thoughts?


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello. Thank you for your query at Doctorspring.com
I understand your concern and i also appreciate that you're so aware about the possibility of acquiring infectious diseases from bat bites. That automatically reduces the chances of getting a full blown disease or complications by half.
In your case i feel since you already had an exposure before, it might be a little stressful for you to see bats and each time you come close to a bat, you may feel that it is going to bite you. From the way you described, it seems a little paranoid. But i completely understand and aceept this behavior is normal because you recently got all the shots.
The thing is mostly you will be able to tell if there is an exposure, since firstly there will be a small scratch which will slowly turn red and the area will appear inflamed after a point. But as you said at times it can be unnoticeable and a small scratch can be missed.
Now you need to really think and find out, because once thing that you would have definitely felt is the actual bite like a pin prick. If you felt something like that, then you can go ahead and take the post exposure prophylaxis. The recommended shots start from Day 0, hence you can go as soon as possible. Normally previously vaccinated people are given two additional doses in their deltoid and they are never given the HRIG again. Do you remember your schedule?
The incidence of such cases actually being positive with rabies is very low, because these kind of bats bite frantically, and you should have had a lesion. So now it is upto you to actually try and recollect if the bat was in any way in contact with you.
Hope this is helpful,
Regards


Patient replied :

Thank you for your answer, to answer your question as regards to the schedule I had the several shots in the hospital and the remaining shots over the course of 28 days and that was a few months ago.
The area where I think I may have been bit does feel like a needle prick and is still sore this morning that's the only reason why I'm concered. The only thing is I didn't hear the bat close to me I'm sure I would have seen or felt it fly into my back but maybe not since they are so small .
So if I get these two more shots I'm ammune for life? Can I wait till Monday to get the free shots from the CDC?


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello. Since you have been exposed to the bat but unsure of a scratch or a bite, according to guidelines you can receive rabies post-exposure prophylaxis. It has to be started as soon as possible. You will require two shots of rabies vaccine on the deltoid muscle, on day 0 and on day 3. This is the schedule for you as you have been previously immunized against rabies. You will not the Human Rabies Immunoglobulin (HRIG) as I mentioned earlier. You need to get the first shot as soon as possible and cannot wait till Monday. Kindly go to the nearest hospital for the same. After these two shots, you are unlikely to be immune for life. Immunity after rabies vaccination varies among individuals. As long as you have an acceptable antibody level, you will likely be immune. In the future, if you are again exposed to a risk of rabies which requires vaccination, you will have to take the 2 shots. Thank you.


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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