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International Notes Bat Rabies -- Europe

On September 10, 1985, a woman in Denmark was bitten on the finger by an ill-appearing European house bat (Eptesicus serotinus) that was captured and later found to be rabid (1). This is the first report of rabies virus isolation in bats in Denmark. Subsequently, between September and November 1985, 34 ill bats were submitted for rabies examination to the State Veterinary Serum Laboratory. Ten were positive by fluorescent antibody techniques, and the same rabies virus strain was isolated from nine of these (1,2). All these isolates were from E. serotinus, the most common of the 14 insectivorous bat species in Denmark.

On October 29, 1985, the first human case of rabies reported in Finland since 1934 was diagnosed in a 30-year-old bat zoologist residing in Helsinki; animal rabies had last been reported in Finland in 1959. The zoologist had been bitten several times by bats while in Malaysia 4H years earlier; in Switzerland 1 year earlier; and, most recently, in Finland 51 days before the onset of neurologic symptoms. He reported no other animal bites (3,4). Although the zoologist worked with the nine bat species found in Finland, he had received neither preexposure nor postexposure immunization against rabies. A virus isolate was obtained postmortem from a brain specimen.

Before 1985, rabies virus had been isolated from only three bats (of unknown species) in Europe, all in the northern part of the Federal Republic of Germany between 1968 and 1982 (5). These virus isolates differed from common isolates found in terrestrial animals in Europe but closely resembled two rabies-like viruses from Africa, one of human origin (Duvenhage) and one of bat origin (6). Whether the viruses were inadvertently imported from Africa via migrating bats or other means has not been established.

As a result of these episodes, CDC conducted studies to characterize the Danish and Finish virus isolates and to determine whether the Danish bat virus isolates were infectious for experimental animals and whether conventional rabies vaccines could protect against them. Characterization of the European viruses by a monoclonal antibody panel indicated that the Danish isolates were different from terrestrial isolates in Europe but identical to the strains isolated from bats in Germany (6). The viruses were similar to the Duvenhage strain first isolated in Africa. Virus isolated from the brain of the Finish zoologist was also characterized by monoclonal antibodies and found to be different from both the European bat isolates and the Duvenhage strain. Experimentally, the Danish bat viruses readily infected mice by the intracerebral, footpad, and oral routes; dogs, by the intracerebral route; and cats, by the intramuscular and intracerebral routes. A human diploid cell vaccine (IMOVAX*), and an animal vaccine (RABISIN*) protected mice against challenges with the Danish bat viruses. Further characterization of the Finnish isolate is in progress. Reported by V Bitsch, DVM, State Veterinary Serum Laboratory, J Westergaard, DVM, Danish Veterinary Svcs, Copenhagen, Denmark; M Valle, MD, National Public Health Institute, Helsinki, Finland; Viral and Rickettsial Zoonoses Br, Div of Viral Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note:In 1985, 829 bats were reported rabid in the United States. In contrast, only 18 rabid bats were reported in Europe between 1954 and 1985 (1,2,5). Although the first case of bat rabies was reported in Europe in 1954, bats have not been examined routinely for rabies in European countries. The few reported cases of bat rabies may not be indicative of their importance in Europe.

Human rabies caused by exposure to insectivorous bats has been reported in Canada, the United States, and some Latin American countries (7). No cases of human rabies have been known to follow exposures to bats in Europe, with the probable exception of the recent case in Finland. Between 1977 and 1985, 30 cases of human rabies, all from sources other than bats, were reported in Europe; six were imported cases (8,9).

Because of the paucity of information on bat rabies in Europe, an informal World Health Organization (WHO) meeting was held in Marburg, Germany, in May 1986. The concensus of the representatives from Denmark, Finland, France, Germany, Poland, Switzerland, CDC, and WHO was that all persons who work with bats in Europe should receive preexposure rabies vaccination, and all persons bitten by bats should receive postexposure treatment according to previously published standard immunization schedules (10,11). Bat rabies surveillance has been initiated in all the European countries represented at the meeting.

References

  1. Mollgaard S. Bat-rabies in Denmark. In: WHO Collaborating Centre for Rabies Surveillance and Research, ed. Rabies Bull Europe. Information Surveillance Research. Geneva: World Health Organization, 1985;9(3):8.

  2. Mollgaard S. Bat-rabies in Denmark (DEN). In: Who Collaborating Centre for Rabies Surveillance and Research, ed. Rabies Bull Europe. Information Surveillance Research. Geneva: World Health Organization, 1985;9(4):11.

  3. Berger R. A human rabies case in Finland possibly of bat origin. In: Who Collaborating Centre for Rabies Surveillance and Research, ed. Rabies Bull Europe. Information Surveillance Research. Geneva: World Health Organization, 1985;9(4):12.

  4. Lumio J, Hillbom M, Roine R, et al. Human rabies of bat origin in Europe. Lancet 1986;1:378.

  5. WHO. Miscellaneous: a new case of bat rabies in Germany (DEW). Rabies Bull Europe. Information Surveillance Research. Geneva: World Health Organization, 1982;6(4):17-8.

  6. Schneider LG, Barnard BJH, Schneider HP. Application of monoclonal antibodies for epidemiological investigations and oral vaccination studies. I. African viruses. In: Rabies in the Tropics, E Kuwert, C Merieux, H Koprowski, K Bogel eds. Berlin, Germany: Springer-Verlag, 1985:47-53.

  7. WHO. Control of rabies in wildlife. Bats. In: WHO Expert Committee on Rabies. Seventh report. Geneva: World Health Organization, 1984:65 (Technical report series 709).

  8. WHO. Miscellaneous: human rabies cases in Europe. In: Who Collaborating Centre for Rabies Surveillance and Research, ed. Rabies Bull Europe. Information Surveillance Research. Geneva: World Health Organization, 1984;8(4):12.

  9. WHO. Table 2. In: Who Collaborating Centre for Rabies Surveillance and Research, ed. Rabies Bull Europe. Information surveillance research. Geneva: World Health Organization, 1985;9(4):14.

  10. WHO. Prevention of rabies in man. In: WHO Expert Committee on Rabies. Seventh report. Geneva: World Health Organization, 1984:27-34. (Technical report series 709).

  11. ACIP. Rabies prevention--United States, 1984. MMWR 1984;33:393-402, 407-8. *Use of trade names is for identification only and does not imply endorsement by the U.S. Public Health Service or the U.S. Department of Health and Human Services.

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