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Thread: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

  1. #1

    "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Hi All,

    Woke up about two months ago with something that looked like a scabbed bite on my hand. Texted a picture to a friend who said it looked like a snake bite. Tried to put it out of my mind for about a week, and then contacted the CDC hotline. The hotline operator told me to text a picture to her - she then told me that it looked like a "textbook" bat bite ("sharp edges and everything"), and that I should get it checked out at the ER. The ER took a look (at the picture, since the scabs were by then gone) and ordered the shots.

    We subsequently had our house checked out, and apparently there used to be a known bat problem - the people who lived in the house before us installed a one-way bat door on the roof, but it had since been broken, creating, essentially, a "two-way" bat door. There were droppings in the attic.

    I may have gotten the shots too late. After the last shot, I got a rabies titre test to ensure I was creating antibodies. It came back negative (antibodies were "absent"), and I had to get a booster. Nobody knows what to do. The hospital I went to, ranked 11th in the country, basically shrugged and said they had no data on my situation, and that I should try to work with my PCP for next steps. My PCP says I may never create antibodies, and has no idea of what to do next.

    The CDC was borderline useless - the doctor I spoke to said that if I hadn't experienced symptoms a week after the bite, I should be fine, although their own website (and everyone else's - WHO, etc.) says the incubation period is around 2-3 months. Everyone has just thrown up their hands. I'll hit two months in about a week. My husband doesn't think I was bitten by a bat (as we never actually saw one), so he doesn't feel the same sense of urgency. I hope to God I wasn't, but I can't rationalize it away. My husband was sleeping in the other room the night before I woke up with the bite as he had a bad cold and was snoring and restless. I distinctly remember leaving the door wide open and wondering if I should shut it.

    Every muscle ache is terrifying. I'm having panic attacks, which is new. I feel like I'm trying desperately to save my life and nobody cares. Thanks for listening.

  2. #2
    Join Date
    Oct 2016
    Posts
    4,185

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    I think you have to finally accept that there’s nothing else you can do, you’ve literally done everything you were asked to do and you’re ok, no physical symptoms of rabies. Will you relax once the 2m is up? Is it worth this last week of high anxiety?

    Honestly I don’t know what else to say. I can imagine that this has been a horrible experience, but still nobody actually knows if you were bitten by a bat .

    Let us know how you get on x

  3. #3

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Thanks for listening. Honestly, I might feel better after month 3 - at this point, I've read a million case studies and 20 - 90 days seems to be the usual range, with most people developing symptoms around weeks 7-8 (I think the number was 72% under week 10, for bat bites specifically). I'd feel better if I got a positive antibodies test, though.

    The one last thing I can try is getting a second test (per my PCP) and if that doesn't work, trying to convince them to hit me with immunoglobin again, but honestly, I think it's just too expensive for them to give it to me. It's something like six figures. My PCP basically said that they would probably just keep boosting me, but she's not sure how that would work since rabies can hang around for years.

    I can't stop vacillating between trying to put it out of my mind and overcome the anxiety or trying everything I can to get the medical community to work with me - I don't want to develop symptoms and know that maybe there was something I could have done to stop it. I mean they all do recognize the seriousness, it's just that nobody is an expert on rabies. That top-ranked hospital apparently talked to a bunch of infectious disease specialists who had no idea what I should do. One doctor I spoke to at an ER (you have to keep going back for the series) mentioned restarting the series of the titres were negative, but I haven't been able to find her since.

    Honestly, the only thing that's keeping me going is that you're right - nobody knows if I were bitten by a bat. The trapdoor to the attic was slightly ajar, and my door was wide open, and the CDC (!) said I'd never know it if I were bitten, but I do have cats and they're both killers. I would hope that there wouldn't be an isolated instance of one bat flying down, biting me, and us never seeing bats again, and I imagine that they'd be pretty alert to the presence of bats. But I've looked at every instance of bat rabies in the US/CAN since 1990 and I just can't stop shutting down my own hope. Thank you again for listening. It's just that the medical staff I've talked to are all curious, sympathetic, but ultimately useless, and everyone else is either annoyed or just like - "wow, yikes. Hope you don't die!"

  4. #4

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Hey, just wondering what ever happened to you. Are you all right?

  5. #5

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Hey, I'm alright. The CDC actually contacted my state and county health and human services to help me out, and my second titre test came back positive for antibodies so there's really nothing left for me to do and I'm out of the general "danger zone" when rabies seems to pop up. The epidemiologist the CDC sent basically told me that (1) there are very, VERY few rabies "experts" in the medical field - they just don't have good data and (2) they'd literally never encountered someone in my situation (i.e. date of shots to bite, and then no antibodies - people usually either get the shots right away and get antibodies, or they don't get the shots at all and they die - rabies is just so rare they don't have good case studies). About a month afterwards, my hair started falling out handfuls and they thought maybe it was the shock to my system (unfortunately, got the Covid booster a few days before the rabies shots) but after a blood test it turns out I've got hypothyroid, so it's possible that I had an unknown autoimmune condition the whole time, and that's why the shots initially didn't take. They give more to people with autoimmune issues. Thanks for asking, though. I appreciate it.

  6. #6
    Join Date
    Jun 2021
    Posts
    256

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Thank you so much for posting this follow up, I admit yours was one of the only posts I've eve seen here where I thought: "Welp, that sounds pretty gosh darn not good" -- mostly because of the CDC's response to you + the absence of antibodies (which would have freaked me right out!) I am so glad it all turned out ok, and wishing you the best with your thyroid issues (I'm hyper. Thyroids are so annoying.)

  7. #7

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    You're welcome! Honestly, at every point I kept expecting to be dissuaded of what I'd hoped was an irrational fear. I called the CDC the first time thinking/hoping they'd tell me I was just anxious, but they ended up scaring the crap out of me. Then I thought the wildlife service would find nothing conclusive, but the guy straight-up said, "Whelp, you've got bats." Fun fact: rabies antibody tests usually take about a week to turnaround because there's only two places in the US that does them (MI and Kansas) and literally, after the first test, they had a contamination in the MI lab and had to send it to Kansas. I was about going out of my mind and had a full-on breakdown when I found out I had no antibodies. I am sorry to hear about your thyroid as well! I'm fairly sure I overmedicated myself right into hyper (suddenly very hot instead of cold, but same fatigue, hair loss, and a lot of heart palpations) and I feel your pain / am waiting for the test results. I very much agree with your assessment! Wishing you the best as well!

  8. #8

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Glad you are doing well. Do you happen to have the picture of the bite still? I’m curious to see what a textbook bite looks like.

    Thanks

  9. #9

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Sure, I still have the exact picture I sent the CDC hotline on my phone. I'll post here when I get a second. I will say that it was just two tiny scabs, not swollen, red, or painful at all, and I would likely never have noticed it if it wasn't right on top of my hand. I actually got bit by a neighborhood cat this Saturday (I was dumb enough to pet a strange cat that came walking up to me), and as it wasn't up to date on its rabies vaccine the county HHS is having me go in for more titres (the owners claim they can't find the cat to quarantine it). So I'll let you guys know what my antibodies look like five months from my positive titre test.

  10. #10

    Re: "Textbook" Bat Bite per the CDC. Antibodies Absent. Terrified.

    Quick Update with some Rabies info for you all. Some people asked for pictures of the bat bite - I can't seem to get this website to log in on my phone (says it's not supported?), so I'll have to email the pics to myself and then upload but will post them here when I get around to that. I wanted to pass along some info I thought might be helpful for someone in my situation.

    I got a titre test for my stupid unvaccinated cat encounter in early November. That test came back "POSITIVE - LOW", meaning, about six months + from the last titre test where I had sufficient antibodies (early June), now an "incomplete neutralization" at 1:25. Better than ABSENT, but still not great. I was recommended to get the rabies booster (Imovax, not Immunoglobin) just in case.

    If I can tell you anything about rabies - if you DO have a legitimate potential exposure - YOUR PCP IS USELESS. THEY DON'T KNOW ANYTHING ABOUT RABIES, but they are also probably way too arrogant to admit it. My PCP outright refused to give me the titre test despite the HHS recommendation, and despite the nurse saying that my PCP could call and speak to them about it (which my PCP refused to do). My PCP said that my antibodies should be good for years. I had to jump through hoops to get a different doctor to prescribe me the test (to be fair, the HHS was trying to get me in at the county health department, its just that it was really hard to do w/in work hours since it was fairly fair from me). During my first go 'round, the county epidemiologist told me that most doctors don't know anything about rabies, which tracks with my experience. If you have questions, either call one of the rabies labs (in Michigan or Kansas) or call your local health department (in my case, the CDC also directly connected me to the people at my health department).

    Hope this helps! Feel free to ask me any questions. I have learned a lot on this stupid journey.

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