title: Potential Exposures to Australian Bat Lyssavirus Notified in Queensland, Australia, 2009-2014.
abstract: BACKGROUND
  Australian bat lyssavirus (ABLV) belongs to the genus Lyssavirus which also includes classic rabies virus and the European lyssaviruses. To date, the only three known human ABLV cases, all fatal, have been reported from Queensland, Australia. ABLV is widely distributed in Australian bats, and any bite or scratch from an Australian bat is considered a potential exposure to ABLV.
  
  
  RESULTS
  Potential exposure to ABLV has been a notifiable condition in Queensland since 2005. We analysed notification data for potential exposures occurring between 2009 and 2014. There were 1,515 potential exposures to ABLV notified in Queensland, with an average annual notification rate of 5.6 per 100,000 population per year. The majority of notified individuals (96%) were potentially exposed to ABLV via bats, with a small number of cases potentially exposed via two ABLV infected horses and an ABLV infected human. The most common routes of potential exposure were through bat scratches (47%) or bites (37%), with less common routes being mucous membrane/broken skin exposure to bat saliva/brain tissue (2.2%). Intentional handling of bats by the general public was the major cause of potential exposures (56% of notifications). Examples of these potential exposures included people attempting to rescue bats caught in barbed wire fences/fruit tree netting, or attempting to remove bats from a home. Following potential exposures, 1,399 cases (92%) were recorded as having appropriate post-exposure prophylaxis (PEP) as defined in national guidelines, with the remainder having documentation of refusal or incomplete PEP. Up to a quarter of notifications occurred after two days from the potential exposure, but with some delays being more than three weeks. Of 393 bats available for testing during the reporting period, 20 (5.1%) had ABLV detected, including four species of megabats (all flying foxes) and one species of microbats (yellow-bellied sheathtail bat).
  
  
  CONCLUSIONS
  Public health strategies should address the strong motivation of some members of the public to help injured bats or bats in distress, by emphasising that their action may harm the bat and put themselves at risk of the fatal ABLV infection. Alternative messaging should include seeking advice from professional animal rescue groups, or in the event of human contact, public health units. Further efforts are required to ensure that when potential exposure occurs, timely reporting and appropriate post-exposure prophylaxis occur.
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
authors.forename: Damin
authors.initials: D
authors.lastname: Si
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Marquess
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
authors.forename: Ellen
authors.initials: E
authors.lastname: Donnan
authors.affiliation: Forensic and Scientific Services, Queensland Health, Brisbane, Australia.
authors.forename: Bruce
authors.initials: B
authors.lastname: Harrower
authors.affiliation: Metro South Public Health Unit, Metro South Hospital and Health Service, Queensland Health, Brisbane, Australia.
authors.forename: Bradley
authors.initials: B
authors.lastname: McCall
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
authors.forename: Sonya
authors.initials: S
authors.lastname: Bennett
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, Australia.|UQ Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lambert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001733:Bites and Stings / Q000821:virology; D002648:Child; D002675:Child, Preschool; D002685:Chiroptera / Q000821:virology*; D005260:Female; D006736:Horses / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018114:Lyssavirus; D008297:Male; D008875:Middle Aged; D056990:Post-Exposure Prophylaxis; D011634:Public Health; D011793:Queensland / Q000453:epidemiology; D018353:Rhabdoviridae Infections / Q000453:epidemiology* / Q000662:veterinary; D055815:Young Adult; D015047:Zoonoses / Q000821:virology*