Post-Bat Exposure Prophylaxis Up in New York

Increased numbers of bats submitted for rabies testing, reports of exposure, and use of PEP

FRIDAY, Nov. 18 (HealthDay News) -- During a 10-year period of reporting concurrent with implementation of revised post-exposure prophylaxis (PEP) guidelines for bat rabies, there were increases in the number of bats submitted for testing, reports of exposure, and instances of human PEP, according to a letter published online Nov. 16 in the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

Millicent Eidson, from the New York State Department of Health in Albany, and colleagues investigated the effects of terrestrial and bat rabies on human PEP during the period of implementation of revised PEP guidelines (from 1993 to 2002).

The investigators found that during 1993 to 2002, the number of incidents of bat-associated rabies exposure (6,320 cases) and PEP use (11,365 cases) increased seven- and nine-fold, respectively. There was a significantly increasing trend for PEP from non-bite exposure, accounting for 88 percent of all PEP. Seven percent of PEP was due to rabies-positive bats, with a significantly decreasing trend. The increase in PEP was mainly due to untested bats (89 percent), with non-bite exposure to untested bats accounting for three quarters of administered PEP. Of the 8,244 PEP cases reported since 1998, 53.2 percent were for females. There was a four-fold increase in the number of bats submitted for testing (8,649 bats) that may have had contact with humans, and among them, 3 percent were rabies-positive, 89 percent were rabies-negative, and 7 percent had unsatisfactory testing. Bats for which non-bite contact was reported comprised 86 percent of those provided for testing.

"Although the cause and increases cannot be definitively determined, the increases were consistent with changes in guidelines and public education," the authors write.

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