The most unusual order for the rabies series from the ED doc (well – I thought it was unusual)was because a woman opened her patio umbrella and a bat flew out and away from her without ever making contact. The ED doc said there was a chance she could’ve been exposed via airborne contamination. Something about aerosol spraying of saliva from bat.

I had the rabies series based on two puncture wounds I had even though I never saw the bat. Took me to the last day to do it and I did it because the punctures looked like what I saw on some patients and after reading about the hideous death from rabies ..I didn’t want to chance it. I honestly don’t know if I did the right thing, but we do have bats flying around the pond and over the pool and yard at night. And last I knew rabies was in the area. At that point in time they had been tracking it from the south coming up north.

This is a gruesome thought …but, for some reason …cracked me up. Yeah …like you don’t have enough to do and so now you and ED staff have to add decapitation of squirrels to your job descriptions. Might be questionable on a resume though.

Anyway, I can understand people being freaked out about rabies, because it’s not only very deadly, but it had excellent PR for decades thanks to “Old Yeller”.

As an aside, my cat used to love to bring half-dead rodents into the house (squirrels, mice, chipmunks). I’ve had more than one bite while trying to get shoo these animals out of the house – and I never even considered getting rabies shots. Because rodents don’t transmit rabies to humans.

the only animals you can observe cause we know the disease progression in these 3 only.

It’s unlikely the child gets rabies from a squirrel. Note, *UNLIKELY*, not impossible. Last I searched, there were documented cases in Europe of people getting rabies from rodents, even if we don’t have any documented here. Some of that may be from fewer rodents infected on our continent.

From WhiteCoat’s perspective, it’s unlikely enough to ignore. Look for Horses not Zebras. From a general policy perspective, it’s probably not a good use of resources to treat every squirrel-bite patient for rabies, he may never see an actual rabies case in his entire career.

On the other hand, I don’t want my memorial to be “First US case of rabies transmitted by rodent”. It’s a potential exposure to a disease which by the time you find out you did get it, your lifetime is measured in days or weeks – and it’s a pretty miserable way to go. So from an individual perspective, it makes sense to endure pain and expense to preclude it.

If it’s the patient paying for it, there is no reason to object to an expense that makes little sense from a societal point of view (and unlike antibiotics, overuse of rabies vaccine does not create uber-rabies). But these days when everyone expects someone else to pick up the tab for their medical expenses, we have to face decisions made for the benefit of the society rather than the individual.