Bats have tiny teeth and it’s possible to be bitten without there being any visible mark. You should always go for treatment if you have had an interaction with a bat. Better safe than dying one of the worst ways possible.
The indication for testing according the CDC is a bite.
The rabies test is cheap. Could have tested the kid or the bat, but again why would they do it if there’s no indication for exposure. This was the first case in the province of someone being infected with rabies inside their own home since 1967.
When you hear hoofbeats you don’t think it’s zebras.
So the protocol, from like an insurance coverage decision-tree standpoint, in this situation, would have been to test the bat if possible and if not possible administer the vaccine?
I was under the impression that the vaccine is pretty awful and a health ordeal in itself, and that while the dose wasn’t expensive, the aftercare is.
And that is why, as I understand, the CDC protocol is only seek medical attention if there’s a visible bite.
What do you mean? Yes. They checked the kid over and saw nothing. Obviously there was an exposure that either left no mark, left a mark that appeared normal, or the parents didn’t see it.
Sounds possible. Bats are mammals, maybe it sneezed, covered, but didn’t wash it’s hands, gave the kid a high five, and then the kid wiped a booger out of his eye with it.
I looked at the CDC website before posting Aunt. It says the only indication for treatment is a bite or a scratch from species known to carry rabies. It doesn’t say anything about testing for mere exposure.
I guess I see the counterpoints.
It’s a kid.
The duration of the exposure is unknown.
Whether there was any contact is unknown.
Bat.
Bites or scratches can be invisible.
Bires or scratches could be mistaken.
What’s the scuttlebutt here, your saying in this situation to test the kid or administer a vaccine?
I’m certain the medical staff 's determination of The credibility of a fact attested to by a child is not a factor.
We’re also assuming this kid isn’t a straight up victim of healthcare inequality. The article is light on details. Perhaps the parents considered this, searched the web, searched for bites or scratches, and the cost of seeking care felt too great for this family? I didn’t catch if this happened in a civilized nation with universal health.
Fuck, this story is terrifying. Reminds me in some ways of when a kid dies in a hot car.
You can’t test the kid. What I’m saying is a lot of people in here are quick to judge the parents, but clearly even to medical professionals the situation is not cut and dry.
As I mentioned in another comment, I’ve been there. I have been through PPE, and I had to seriously advocate for myself to the ER doctor for him to go consult an infectious disease specialist before they agreed.
Post-exposure prophylaxis or testing of a bat is generally recommended after direct contact with the bat (refer to Bat Exposure) because it is very difficult to ensure that a bite did not take place
Bat exposure: Post-exposure rabies prophylaxis following bat contact is recommended when both of the following conditions apply:
There has been direct contact with a bat, AND
A bite, scratch, or saliva exposure into a wound or mucous membrane cannot be ruled out.
Direct contact with a bat is defined as a bat touching or landing on a person.
In a child, a bat landing on clothing could be considered a reason for intervention, as a history to rule out a bite, scratch or mucous membrane exposure may not be reliable.
From 1998 to 2009, NACI recommended that people who may not be aware of or able to report a bat bite (e.g., sleeping person, young child, cognitively impaired) be offered intervention if a bat was found in the room with them. This recommendation was revised (as described above) in 2009 based on the rarity of human rabies related to bats (one case in Canada reported approximately every 5 years). Analysis conducted in Canada estimated that a case of human rabies related to bedroom exposure to a bat (i.e., finding a bat in the room of a sleeping person with no recognized physical contact with the bat) is expected to occur in Canada once every 84 years. In addition, it has been determined that, to prevent one case of rabies from bedroom exposure to a bat, using a conservative estimate, 314,000 people would need to be treated.
Based on all the comments in this thread, this seems like the best course to me.
Honestly, I didn’t know much about this and didn’t have a strong opinion from the beginning. I just looked quick on Google and saw the results for America was to only seek treatment if there’s been a confirmed bite or scratch.
This Canadian advice makes way more sense. I like that last paragraph that explains the protocol from 1998 to 2009 would have required treatment of 314,000 people to prevent one case. This poor kid in the article might have been that one case.
But it seems like under the current recommendations the kid would not have been tested. It says now treatment only only after direct contact, defined as a bat touching or landing on a person. In this situation, I think they didn’t know if the bat had touched the kid at all.
No scratches, no bite. Why would they?
Bats have tiny teeth and it’s possible to be bitten without there being any visible mark. You should always go for treatment if you have had an interaction with a bat. Better safe than dying one of the worst ways possible.
Most commonly they bite you while you’re sleeping, so you don’t know
My thinking would be why risk not getting checked out? Unfortunately worst case scenario happened this time :(
The indication for testing according the CDC is a bite.
The rabies test is cheap. Could have tested the kid or the bat, but again why would they do it if there’s no indication for exposure. This was the first case in the province of someone being infected with rabies inside their own home since 1967.
When you hear hoofbeats you don’t think it’s zebras.
You can’t test the kid, only the bat. So if they didn’t catch it testing is a no go.
There’s like eleven kinds of blood tests for rabies. None of them work on people, or is it by the time they work it’s too late?
By the time it’s detectable it’s too late.
Okay that’s sort of what I thought.
So the protocol, from like an insurance coverage decision-tree standpoint, in this situation, would have been to test the bat if possible and if not possible administer the vaccine?
I was under the impression that the vaccine is pretty awful and a health ordeal in itself, and that while the dose wasn’t expensive, the aftercare is.
And that is why, as I understand, the CDC protocol is only seek medical attention if there’s a visible bite.
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As soon as a rabies test comes back positive, you have a death sentence.
How do you think the child got rabies in this situation?
Obviously they overlooked a scratch or a bite. Rabies isn’t airborne.
This you?
What do you mean? Yes. They checked the kid over and saw nothing. Obviously there was an exposure that either left no mark, left a mark that appeared normal, or the parents didn’t see it.
Maybe it drooled into their open mouth or something. Or onto their hand and later they picked their nose.
Sounds possible. Bats are mammals, maybe it sneezed, covered, but didn’t wash it’s hands, gave the kid a high five, and then the kid wiped a booger out of his eye with it.
Poor kid, never had a chance.
Heartbreaking
That’s literally the health institutions protocol now a days. Though for kids it depends how credible the kid is about not being exposed.
I looked at the CDC website before posting Aunt. It says the only indication for treatment is a bite or a scratch from species known to carry rabies. It doesn’t say anything about testing for mere exposure.
I guess I see the counterpoints.
It’s a kid. The duration of the exposure is unknown. Whether there was any contact is unknown. Bat. Bites or scratches can be invisible. Bires or scratches could be mistaken.
What’s the scuttlebutt here, your saying in this situation to test the kid or administer a vaccine?
I’m certain the medical staff 's determination of The credibility of a fact attested to by a child is not a factor.
We’re also assuming this kid isn’t a straight up victim of healthcare inequality. The article is light on details. Perhaps the parents considered this, searched the web, searched for bites or scratches, and the cost of seeking care felt too great for this family? I didn’t catch if this happened in a civilized nation with universal health.
Fuck, this story is terrifying. Reminds me in some ways of when a kid dies in a hot car.
You can’t test the kid. What I’m saying is a lot of people in here are quick to judge the parents, but clearly even to medical professionals the situation is not cut and dry.
As I mentioned in another comment, I’ve been there. I have been through PPE, and I had to seriously advocate for myself to the ER doctor for him to go consult an infectious disease specialist before they agreed.
Health Canada guidance is a bit more nuanced
Based on all the comments in this thread, this seems like the best course to me.
Honestly, I didn’t know much about this and didn’t have a strong opinion from the beginning. I just looked quick on Google and saw the results for America was to only seek treatment if there’s been a confirmed bite or scratch.
This Canadian advice makes way more sense. I like that last paragraph that explains the protocol from 1998 to 2009 would have required treatment of 314,000 people to prevent one case. This poor kid in the article might have been that one case.
But it seems like under the current recommendations the kid would not have been tested. It says now treatment only only after direct contact, defined as a bat touching or landing on a person. In this situation, I think they didn’t know if the bat had touched the kid at all.