Rabies and Australian Bat Lyssavirus

What is Rabies and Lyssavirus?

Rabies virus and Australian bat lyssavirus (ABLV) belong to a group of viruses called lyssaviruses. Rabies is carried by mammals such as dogs, cats, monkeys and bats, in many countries outside of Australia. Lyssavirus is carried by bats in Australia. These viruses are usually passed on to people when they are bitten or scratched by an infected animal.

Lyssaviruses are usually fatal. The World Health Organisation estimates that tens of thousands of people die each year worldwide, mainly in Asia and Africa from infection with the rabies virus.

What are the symptoms?

The early symptoms of rabies or ABLV include:

• Flu-like symptoms
• Headache 
• Fever 
• Fatigue 

The illness gets worse quickly with paralysis, confusion, and fits. Death can occur within a week or two of the start of the illness. 

It can take several days to several years for symptoms to occur after being bitten or scratched. 

How is it spread?

The Rabies virus and Australian bat lyssavirus (ABLV) is spread from infected animals to people through bites or scratches or being exposed to infected animals’ saliva through the eyes, nose or mouth.

Only mammals can be infected. Overseas, dogs are the main cause of rabies infections in people. Other animals that pass on rabies overseas include bats, monkeys, foxes, cats, raccoons, skunks, jackals and mongooses.

In Australia, ABLV infection has been found in flying foxes/fruit bats and insect-eating micro bats. It is assumed that any bat in Australia, including those in Tasmania, could carry ABLV. The way a bat looks or behaves is not an accurate guide as to if it is carrying the virus. 

Who is at risk?

People who handle bats in Australia are at risk of ABVL infection. People who come into contact with wild or domestic land mammals (eg. dogs, cats, monkeys, bats) in a country where there is rabies are at risk of getting rabies.

If there are bats that pose a risk to you or others (eg. living in the roof of your home), please do not try to remove them yourself. It is important not to handle sick or injured bats. Contact Wildlife Services to have the bats removed safely by a Wildlife Service Officer by calling 03 6165 4305 or email to [email protected].

How is it diagnosed?

Diagnosis requires laboratory tests for the presence of lyssaviruses in skin, blood, spinal fluid and nervous tissue.

How is it treated?

There is no treatment for rabies or lyssavirus once symptoms have started. If you are scratched or bitten treatments can be given to reduce your chance of dying from rabies or ABVL.

If you may have been bitten or scratched, you will require review and urgent treatment with rabies immunoglobulin and rabies vaccine as soon as possible. 

• Rabies vaccination includes a series of either 4 or 5 rabies vaccine injections over 1 month.
• Even if you have been vaccinated before you may require further doses of rabies vaccine if exposed to rabies or ABVL.

How is it prevented?

The best protection against being exposed to rabies or ABLV is to avoid: 

• handling/touching any bat in Australia or overseas

or

• any wild or domestic land-dwelling mammal (eg. dogs, cats) in a country where there is a rabies risk 

Rabies vaccine is used to protect against rabies and other lyssaviruses infection before being exposed. For those who are at increased risk of exposure eg. people whose job or other activities put them at increased risk of being bitten or scratched should speak to their GP for vaccination advice.

Rabies vaccination may also be recommended for people who travel to countries that have rabies, depending on the circumstances (see below for specific advice for travellers).

Rabies and ABVL infection risk can be reduced after an being bitten or scratched through proper wound care and risk assessment including post-exposure prophylaxis (PEP) by a medical professional – see below for advice on what to do if you may have been exposed.

Information for travellers:

Talk to your doctor about pre-travel rabies vaccination at least 1 month before travelling overseas to allow enough time to receive a full vaccine course if required. Your doctor may recommend being vaccinated depending on the places you are planning to visit, your likelihood of interacting with animals, your access to emergency medical attention while overseas, and your personal health circumstances.

• Avoid contact with all wild and domestic animals (especially dogs, cats, bats and monkeys), and even if previously vaccinated, take precautions to avoid being bitten, scratched or exposed to their saliva through your nose, eyes or mouth.

• Do not allow children to feed, pat or play with animals; their height makes them at high-risk to bites to the face, head and neck

• Avoid contact with stray dogs and cats, and remain watchful when walking, running, cycling, riding scooters, or other activities that may provoke an animal to attack

• Do not carry food while outdoors and do not feed, pat or play with animals, even in popular tourist areas where travellers may be encouraged to interact with these animals.

For further travel information go to the Smart Traveller website.

What should I do if I’ve been bitten, scratched or exposed to a potentially rabid animal?

Even if previously vaccinated, if you are bitten or scratched by a bat anywhere or by a land-dwelling mammal overseas, you should:

• immediately wash the wound thoroughly with soap and water for at least fifteen minutes – proper cleaning of the wound reduces the risk of infection
• apply an antiseptic with anti-virus action such as povidone-iodine, iodine tincture, aqueous iodine solution or alcohol (ethanol) after washing.
• seek medical attention as soon as possible to care for the wound and to assess whether you are at risk of infection and require preventive treatment.

If you are at risk of infection 

• you may need treatment with both rabies immunoglobulin and rabies vaccine (also called post-exposure prophylaxis). 
• You may also need a tetanus booster, depending on your previous tetanus vaccinations.
• If exposure occurs while overseas, wherever possible you should seek treatment as soon as possible in that country. 

If you do receive treatment while overseas 

• you should ask for a post-exposure prophylaxis (PEP) certificate from the hospital or clinic that provided your treatment. 

Certificate details to include (preferably in English):

• telephone number and email address for the clinic you attended 

• batch number and source of rabies immunoglobulin (RIG) you were given (note: equine RIG rather than human RIG may be used in some countries)

• volume (in millilitres) of RIG given to you

• name of the vaccine given to you

• vaccine batch number

• the number of vials used

• route of vaccine administration

• date(s) of RIG and/or vaccine administration.

Returning to Australia 

• you should immediately see a doctor or contact Public Health Services in Tasmania on 1800 671 738 to reassess the risk and complete the course of treatment where required. 
• Public Health Services will work with your doctor to assess your risk, and where needed, will arrange for rabies vaccines and/or immunoglobulin to be delivered to your GP.

If your exposure is to a bat in Australia 

• you should see a doctor immediately to assess the risk and commence post exposure prophylaxis (PEP) if necessary. 

Where to get help:

• Your GP 
• Urgent Care Clinic
• Hospital emergency department
• Public Health Hotline - 1800 671 738

Information for clinicians 

If your patient has had a possible exposure to rabies or other lyssavirus overseas or within Australia, please contact Public Health Services Tasmania for assistance with risk assessment and access to post-exposure prophylaxis (PEP). 

Rabies immunoglobulin and vaccine will be provided by Public Health Services Tasmania as required.

• Please call the Public Health Hotline on 1800 671 738 and ask to speak with a Clinical Nurse Consultant from Communicable Disease Prevention Unit (CDPU)