this post was submitted on 04 Oct 2024

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157

Child dies from rabies after bat found in room, Canada officials say. (www.cbsnews.com)

submitted 1 month ago by BonesOfTheMoon@lemmy.world to c/canada@lemmy.ca

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[–] ininewcrow@lemmy.ca 55 points 1 month ago* (last edited 1 month ago) (3 children)

I can blame the parent for bad parenting and call myself informed and everyone else should be ... because I know about bats carrying rabies

But I also know that most people have no clue that any of this can happen .... it's the first case of someone dying from rabies in Ontario from an infection that originated in Ontario since 1967 .... people have no clue that this is even possible in this day in age

https://www.cbc.ca/news/canada/hamilton/rabies-death-1.7341335

About eight or ten years ago I woke up one night in my cottage to a bat flying around my place. It was dark inside and I saw this thing fluttering around in my room. I opened a window and let it out and never thought anything of it. About a year later, I happened to be reading some stuff about rabies .... the hair in the back of my neck went up and it's freaked me out since.

After that bat in my room, I never went for treatment, I never got checked out and I never thought anything of it. It's been about ten years and I keep worrying that some day I'll start feeling the effects of it. I think most people in Ontario would do the same because everyone thinks we got rid of rabies decades ago or that it is a third world disease that isn't possible here.

I feel terrible for that parent .... death from rabies is a horrible way to die and it happened to this child with their parents watching it all happen.

I wouldn't wish that on my worst enemy ... let alone someone I would accuse of bad parenting.

[–] Whitebrow@lemmy.world 42 points 1 month ago* (last edited 1 month ago)

Quick heads up that we do have effective treatments UNTIL you start exhibiting symptoms, after that you can’t really be cured anymore and would just have to live with it (and manage the symptoms until it kills you shortly after)

[–] wildbus8979@sh.itjust.works 14 points 1 month ago

I can blame the parent for bad parenting and call myself informed and everyone else should be ... because I know about bats carrying rabies

Most provinces and the federal's health protocols no longer recommend automatic treatment for "bat in room" situations. Only if there's reasonable doubt of having been bitten. I've been there and I really had to advocate to the ER doctor that there was no way for me to know.

[–] Mouselemming@sh.itjust.works 8 points 1 month ago (1 children)

The CDC guidelines are a bit confusing too, like is just being in a house common behavior, as in the part about keeping bats out, or a sign of rabies as in an earlier part? Should you check for physical contact or just go get tested? (And in the US, will your insurance cover the test without symptoms showing?) Should you get the fucking plague beast out of your house while avoiding contact, or try to catch it for testing?

https://www.cdc.gov/rabies/prevention/bats.html

[–] barsquid@lemmy.world 14 points 1 month ago (2 children)

I thought by the time it is detectable in tests on a person, that person is already terminal. My understanding is if you have any chance of exposure from an animal you skip the tests and go get the shots. IDK about insurance.

[–] maniii@lemmy.world 6 points 1 month ago (2 children)

Get shots, pay health insurance. Dont get shots, life insurance pays your loved ones.

Macabre and sadly true.

[–] Nogami@lemmy.world 4 points 1 month ago

Or be in Canada and just get shots to be safe. It’s $250 as a precautionary shot before travel but if you have suspected exposure it will be free.

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[–] Mouselemming@sh.itjust.works 3 points 1 month ago* (last edited 1 month ago)

I agree and I was just being cynical about health insurance companies denying care for cruelly stupid reasons. Although I remember some old TV shows where "if the animal can be quickly caught and it tests negative for rabies, the child won't have to undergo the painful series of abdominal shots." Not sure if the treatment is still as miserable as portrayed.

[–] LesserAbe@lemmy.world 31 points 1 month ago (1 children)

Horrible. Understandable that a parent may not know the risk involved.

Only reason I know was when I worked at a summer camp they hammered into us that if a bat was found in a cabin we had to catch it for testing, or else everyone staying in that cabin would get rabies shots.

[–] Spacehooks@reddthat.com 15 points 1 month ago* (last edited 1 month ago) (1 children)

I assume we would be ok if it didn't bite us?

Edit: no get tested. Apparently they attack when humans are sleeping and can leave no trace.

[–] LesserAbe@lemmy.world 17 points 1 month ago

Yeah, state of the art may have changed since then, but since you can't see the bite and a test on a human wouldn't show anything until it's too late, the options were either have a lab test the bat or get precautionary rabies shots.

[–] folkrav@lemmy.ca 22 points 1 month ago (12 children)

I try not to judge, but I’m also utterly confused as to why the parents wouldn’t immediately have brought the child in for the shot after finding the bat, visible bite or not…

[–] BCsven@lemmy.ca 26 points 1 month ago

To tell the truth I wouldn't have thought about it. A stray deranged dog or racoon would raise alarm bells, but we set bats here at night always, and didn't consider the risk. Oops

[–] JustZ@lemmy.world 19 points 1 month ago (4 children)

No scratches, no bite. Why would they?

[–] Drusas@fedia.io 13 points 1 month ago (1 children)

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.

[–] delirious_owl@discuss.online 6 points 1 month ago

Most commonly they bite you while you're sleeping, so you don't know

[–] Polkira@lemmy.ca 7 points 1 month ago (1 children)

My thinking would be why risk not getting checked out? Unfortunately worst case scenario happened this time :(

[–] JustZ@lemmy.world 7 points 1 month ago* (last edited 1 month ago) (2 children)

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.

[–] wildbus8979@sh.itjust.works 8 points 1 month ago (1 children)

You can't test the kid, only the bat. So if they didn't catch it testing is a no go.

[–] JustZ@lemmy.world 1 points 1 month ago* (last edited 1 month ago) (2 children)

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?

[–] wildbus8979@sh.itjust.works 7 points 1 month ago (1 children)

By the time it's detectable it's too late.

[–] JustZ@lemmy.world 1 points 1 month ago

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.

[–] Backlog3231@reddthat.com 5 points 1 month ago* (last edited 1 month ago)

Rabies works by slowly working its way towards your ~~nervous system~~ brain. Its pretty slow and not really active during this time and it isnt detectable at this stage. Once it hits your nervous system though it screams into overdrive and its basically fatal from that point on. That's what makes rabies so scary.

[–] delirious_owl@discuss.online 1 points 1 month ago

As soon as a rabies test comes back positive, you have a death sentence.

[–] brrt@sh.itjust.works 4 points 1 month ago (1 children)

How do you think the child got rabies in this situation?

[–] JustZ@lemmy.world 5 points 1 month ago (2 children)

Obviously they overlooked a scratch or a bite. Rabies isn't airborne.

[–] brrt@sh.itjust.works 3 points 1 month ago (1 children)

This you?

No scratches, no bite. Why would they?

[–] JustZ@lemmy.world 2 points 1 month ago

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.

[–] Mouselemming@sh.itjust.works 2 points 1 month ago (1 children)

Maybe it drooled into their open mouth or something. Or onto their hand and later they picked their nose.

[–] JustZ@lemmy.world 2 points 1 month ago* (last edited 1 month ago) (1 children)

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.

[–] Mouselemming@sh.itjust.works 1 points 1 month ago

Heartbreaking

[–] wildbus8979@sh.itjust.works 1 points 1 month ago (1 children)

That's literally the health institutions protocol now a days. Though for kids it depends how credible the kid is about not being exposed.

[–] JustZ@lemmy.world 0 points 1 month ago (2 children)

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.

[–] wildbus8979@sh.itjust.works 3 points 1 month ago* (last edited 1 month ago)

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.

[–] saigot@lemmy.ca 2 points 1 month ago (1 children)

Health Canada guidance is a bit more nuanced

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.

[–] JustZ@lemmy.world 1 points 1 month ago

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.

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[–] MataVatnik@lemmy.world 17 points 1 month ago (1 children)

Little known fact groundhogs are also rabies vectors

[–] delirious_owl@discuss.online 18 points 1 month ago* (last edited 1 month ago)

He just popped out, saw his shadow, pulled out a switchblade, and then started running straight towards us

[–] Nogami@lemmy.world 10 points 1 month ago

Only a handful of people (20ish) have ever survived without getting an antiviral shot before symptoms presented.

And it’s a pretty horrific way to die (absolutely dehydrated and needing fluid but gagging and choking if offered a drink).

If I ever got it I’d want to be put in a coma while my immune system tried to knock it out and euthanized if I didn’t recover reasonably.

[–] Yezzey@lemmy.ca 5 points 1 month ago

When I was young the fear was put into us by my parents. The Cugo movie really reinforced it.

[–] wildbus8979@sh.itjust.works 2 points 1 month ago* (last edited 1 month ago) (1 children)

A lot of people have a lot of strong opinions around here so, as someone who's been in a bat in room situation with ambiguous contact potential let me point you to Quebec's Health Ministry's Post Exposition Prophylaxis guidelines:

Vacciner les personnes ayant eu une exposition significative à une source potentiellement rabique.

Une exposition significative est une morsure, une griffure ou un contact de la salive ou du LCR d’un mammifère potentiellement rabique avec une plaie fraîche (ayant saigné ou suinté depuis moins de 24 heures) ou avec une muqueuse.

L’exposition significative se définit comme suit :

Chauve‑souris : présence des 2 conditions suivantes :

Contact physique reconnu avec la chauve‑souris; Morsure, griffure ou contact de la salive de la chauve‑souris avec une plaie fraîche (ayant saigné ou suinté depuis moins de 24 heures) ou avec une muqueuse non exclu. La PPE n’est pas indiquée en l’absence de contact physique reconnu (ex. : chauve‑souris trouvée dans la maison sans qu’on ait eu connaissance d’un contact physique avec l’animal). Si la description des faits ne peut être obtenue auprès d’une personne fiable (ex. : jeune enfant ou personne intoxiquée), il faut chercher à savoir si des éléments de l’histoire laissent croire à un tel contact, comme des cris ou des pleurs soudains ou inhabituels ou bien une lésion cutanée compatible avec une morsure de chauve‑souris (plaie punctiforme comparable à la piqûre d’une aiguille hypodermique, d’un diamètre inférieur ou égal à 1 mm, peu ou pas douloureuse).

https://www.msss.gouv.qc.ca/professionnels/vaccination/piq-vaccins/rage-vaccin-contre-la-rage/

Translation of the bold section: PPE is not indicated in the absence of known physical contact (ex: a bat found in the house without knowledge of physical contact).