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