Exposed to rabies? Here’s what treatment for people looks like (+ how much it costs)

Modern medicine makes rabies, a fatal disease, easily preventable.

So medical and wildlife experts want to make one thing clear — if you’ve made any kind of physical contact with a bat or other wild animal, seek treatment immediately.

The News & Observer spoke with Dr. Abhi Mehrotra of the UNC Department of Emergency Medicine and Falyn Owens of NC Wildlife Resources Commission to learn more about available treatments to prevent rabies. We also sought out information about treatment costs.

Here’s what we learned.

When should you seek treatment for rabies?

Because rabies is a fatal disease, medical professionals recommend seeking treatment whenever contact with a potentially rabid animal is possible — particularly if that animal is a bat.

“Given the risk of rabies, if you are in a room with a bat and you can’t determine whether you have had exposure to a bite, scratch, or mucous membrane, you should seek evaluation and treatment,” Mehrotra said.

For bats, this can include situations like waking up to find a bat in your bedroom or in a child’s room.

How is rabies treated?

The first step is to capture the wild animal and get it tested, Owens said. The vast majority of the time, the rabies test will come back negative. But if the test is positive, it’s important to begin rabies treatment immediately.

“It’s so important to get treated because once symptoms develop, you have almost a 100% chance of death. But that’s very, very preventable,” Owens said.

“You have to treat it early and before symptoms develop. If you get special shots, there’s nearly a 100% chance the symptoms will not prevent themselves, and you will not develop the disease.”

Post-exposure treatment consists of one dose of immune globulin and four doses of rabies vaccine over a 14-day period, according to the Centers for Disease Control and Prevention.

That’s five injections total. They are administered through your arm just like a flu or tetanus shot.

Immune globulin is used to prevent infections or make an infection less severe. It contained antibodies that make your immune system stronger, and it can only be administered by a medical professional, according to the Mayo Clinic.

“Any time that there is a potential for contact between a bat and a human, we treat with post-exposure prophylaxis — the immune globulin and the vaccine,” UNC’s Mehrotra said.

“This means giving antibodies (the immune globulin) to provide immediate protection and the vaccine to allow for the patient to develop their own antibodies, which take time to be able to fight possible infection.”

Rabies treatment — which should begin as soon after exposure as possible — is highly effective and relatively painless, says Bat Conservation International.

How expensive is rabies treatment?

UNC Health did not provide information about the current cost of rabies treatment.

“Unfortunately the pricing piece is difficult, as it depends upon insurance coverage and the charge for administration, which varies by facility. It is quite expensive though,” Mehrotra said.

The Washington Post reported in September that vaccine costs for the disease can range from $1,200 to $6,500. And NPR reported the treatment costs range from about $4,800 to $5,900, citing drug-pricing website GoodRx. (But the cost of administering the drugs was not included in these figures, likely making patients’ bills even higher.)

In 2018, the CDC estimated the treatment cost between $3,000 and $7,000, Vox reported at the time, noting treatment can “sometimes be closer to $10,000.”

How many bats have rabies?

Only between 1% and 3% of “suspected bats” that are treated for rabies in North Carolina return positive, Owens said.

“Even out of suspected bats, a very tiny amount have rabies. But because you can’t know just by looking, it’s safer to just assume each one could have rabies.”

A total of 56 human cases of rabies have been identified in the United States between 1990 and 2018, Mehrotra shared. Over 90% of those were acquired from bats.

How do I know if I’ve been bitten by a bat?

It can be tricky. Bats have tiny, razor-sharp teeth, meaning bat bites might be unnoticeable and may not even bleed, Owens said.

Unless you can undoubtedly prove that you did not have contact with a bat in your home, it’s best to seek treatment.

“Anyone in the medical field will call this a potential rabies exposure. At that point, they will first test the bat for rabies, and if that test is positive, they will begin immediate treatment to prevent rabies,” Owens said.

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