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Cryptogenic rabies, bats, and the question of aerosol transmission.

Abstract
Human rabies is rare in the United States; however, an estimated 40,000 patients receive rabies postexposure prophylaxis each year. Misconceptions about the transmission of rabies are plentiful, particularly regarding bats. Most cases of human rabies caused by bat variants have no definitive history of animal bite. Three hypotheses are proposed and reviewed for the transmission of rabies from bats to human beings. They include nonbite transmission (including aerosol transmission), the alternate host hypothesis (an intermediate animal host that acquires rabies from a bat and then transmits rabies to human beings), and minimized or unrecognized bat bites. Nonbite transmission of rabies is very rare, and aerosol transmission has never been well documented in the natural environment. The known pathogenesis of rabies and available data suggest that all or nearly all cases of human rabies attributable to bats were transmitted by bat bites that were minimized or unrecognized by the patients.
AuthorsRobert V Gibbons
JournalAnnals of emergency medicine (Ann Emerg Med) Vol. 39 Issue 5 Pg. 528-36 (May 2002) ISSN: 0196-0644 [Print] United States
PMID11973559 (Publication Type: Case Reports, Comparative Study, Journal Article, Review)
Chemical References
  • Aerosols
  • Antibodies, Viral
  • Rabies Vaccines
Topics
  • Adult
  • Aerosols
  • Animals
  • Antibodies, Viral (analysis)
  • Bites and Stings (complications)
  • Carnivora
  • Chiroptera
  • Disease Reservoirs
  • Female
  • Foxes
  • Humans
  • Laboratory Infection (etiology)
  • Male
  • Mephitidae
  • Middle Aged
  • Rabies (epidemiology, mortality, transmission)
  • Rabies Vaccines (administration & dosage)
  • Rabies virus (immunology, physiology)
  • Raccoons
  • Risk Factors
  • Seasons
  • United States (epidemiology)

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