Australian Bat Lyssavirus

Overview

Australian bat lyssavirus (ABL) is a rare virus that can spread from bats to people. It affects the nervous system and can cause serious illness if not treated quickly. It is in the same family as the rabies virus, but it is found in Australia.

No. Australian bat lyssavirus is very rare. Only a few human cases have been reported since it was first identified in 1996, and they have been mostly in people who had close contact with bats without protection.

Anyone who is bitten or scratched by an infected bat can get ABL. People most at risk are those who handle bats for work, rescue, or care, and people who try to help a sick or injured bat on their own.

Symptoms

Common symptoms

• Fever and headache
• Feeling very tired or weak
• Numbness, tingling, or a prickling feeling near the bite or scratch
• Muscle weakness
• Difficulty swallowing or talking
• Feeling confused or anxious

Symptoms in children

• Children may have the same symptoms as adults. They might also be more likely to touch a bat with bare hands or put their hands near their mouth, so they can be exposed to the virus more easily.
• If a child has been near a bat, ask them about any bites or scratches and check for any marks, even tiny ones.

Symptoms in older adults

• Older adults may have the same symptoms, but they might also have other health conditions that make the illness harder to recognise. Any unusual symptoms or a known bat encounter should be checked quickly.

Causes

Main causes

• The virus is carried by some bats in Australia, including flying foxes and other bat species. The virus lives in the bat's saliva.
• People become infected when the saliva from an infected bat enters their body through a bite or scratch, or through contact with the eyes, nose, mouth, or broken skin.

Risk factors

• Handling bats with bare hands
• Rescuing or caring for sick or injured bats
• Working in wildlife rehabilitation, veterinary care, or research
• Living in or travelling to areas where bats are common

When to see a doctor

See a doctor urgently if:

• If you are bitten or scratched by a bat of any kind, wash the wound thoroughly with soap and water for at least 5 minutes and seek medical care right away, even if the wound looks small.
• If bat saliva gets into your eyes, nose, mouth, or an open wound, seek medical care immediately.

Book a routine appointment if:

• If you had any contact with a bat but are not sure if a bite or scratch happened, talk to your doctor about your risk.

Diagnosis

Doctors diagnose ABL by asking about your exposure to bats and by testing samples of saliva, blood, skin, or fluid from around the brain and spinal cord.

Tests that may be done

• A detailed interview about the bat contact
• Blood tests to look for antibodies
• PCR tests on saliva or spinal fluid to find the virus's genetic material

What to expect at your appointment

If you have had a bat bite or scratch, you will most likely be given post-exposure treatment quickly, before waiting for test results. If symptoms are already present, you will be cared for in a hospital, often in an intensive care unit.

Treatment

Treatment for ABL has two parts. If you have been exposed to the virus but have not yet developed symptoms, a quick course of protective immunisations can stop the virus from causing disease. Once symptoms appear, the disease is extremely serious, and treatment focuses on supporting the body while the immune system fights the virus.

Self-care at home

• Clean any wound from a bat bite or scratch immediately with soap and water for at least 5 minutes. This can reduce the amount of virus in the wound.
• Apply a simple antiseptic if you have one, and cover the wound with a clean bandage.
• Always see a doctor right away even after cleaning, because cleaning alone is not enough.

Medical treatments

After a bat exposure, a doctor will give you a preventive vaccine series plus protective antibodies (called immunoglobulin) to neutralise the virus. This is highly effective if started early. If symptoms have already started, hospital care includes breathing support, fluids, and medicines to manage symptoms. There is no specific drug to cure ABL once symptoms appear.

When is surgery considered?

Surgery is not a treatment for Australian bat lyssavirus.

Living with this condition

If you have been exposed to ABL and received early treatment, you will need to attend follow-up appointments to make sure the immunisation worked. Most people who receive prompt treatment feel fully well again. If someone develops the illness itself, they will need long-term hospital care and rehabilitation.

Lifestyle tips

• Get plenty of rest and follow your doctor's advice about returning to normal activities.
• Keep the bite or scratch area clean and watch for signs of infection.
• Avoid close contact with bats in the future to lower your risk.

Diet and exercise

While recovering from a bat exposure, eat balanced meals and drink plenty of fluids. Your healthcare team will advise you when it is safe to return to exercise, based on how you feel.

Mental health and emotional wellbeing

For anyone who has had a frightening bat encounter, or who is supporting someone with a serious illness like ABL, it is normal to feel anxious or stressed. Talking to a counsellor or a trusted healthcare provider can help.

Prevention

Yes. The best prevention is to never handle bats. If you see a bat, especially one that is sick or injured, leave it alone and call your local wildlife rescue service or animal control. Trained professionals should be the only people who touch bats.

Vaccines

There is a preventive vaccine for ABL, but it is not recommended for the general public. It is suggested for people whose work routinely puts them in contact with bats, such as wildlife carers, veterinarians, and researchers. Even if you have been vaccinated, you still need prompt medical care after a bat bite.

Screening programmes

Routine screening for ABL is not needed for the general public. Testing is only done when there has been a known or likely exposure.

Complications

If left untreated

• If given quickly after exposure, the preventive treatment is very effective. Without treatment, the virus can reach the brain and cause encephalitis, which is swelling of the brain.
• Untreated neurological symptoms may lead to confusion, paralysis, coma, and in many cases, death.

Long-term outlook

ABL is a very serious infection, but it is also very rare. The most important thing is to act quickly after any bat exposure. With prompt post-exposure treatment, people almost always recover and have no long-term problems. Medical research continues to improve care and treatment for viral infections of the nervous system.

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