this post was submitted on 04 Oct 2024
152 points (99.4% liked)

Canada

7159 readers
253 users here now

What's going on Canada?



Communities


🍁 Meta


πŸ—ΊοΈ Provinces / Territories


πŸ™οΈ Cities / Regions


πŸ’ SportsHockey

Football (NFL)

  • List of All Teams: unknown

Football (CFL)

  • List of All Teams: unknown

Baseball

Basketball

Soccer


πŸ’» Universities


πŸ’΅ Finance / Shopping


πŸ—£οΈ Politics


🍁 Social & Culture


Rules

Reminder that the rules for lemmy.ca also apply here. See the sidebar on the homepage:

https://lemmy.ca


founded 3 years ago
MODERATORS
you are viewing a single comment's thread
view the rest of the comments
[–] [email protected] 16 points 1 week ago (4 children)

No scratches, no bite. Why would they?

[–] [email protected] 1 points 1 week ago (1 children)

That's literally the health institutions protocol now a days. Though for kids it depends how credible the kid is about not being exposed.

[–] [email protected] 0 points 1 week ago (2 children)

I looked at the CDC website before posting Aunt. It says the only indication for treatment is a bite or a scratch from species known to carry rabies. It doesn't say anything about testing for mere exposure.

I guess I see the counterpoints.

It's a kid. The duration of the exposure is unknown. Whether there was any contact is unknown. Bat. Bites or scratches can be invisible. Bires or scratches could be mistaken.

What's the scuttlebutt here, your saying in this situation to test the kid or administer a vaccine?

I'm certain the medical staff 's determination of The credibility of a fact attested to by a child is not a factor.

We're also assuming this kid isn't a straight up victim of healthcare inequality. The article is light on details. Perhaps the parents considered this, searched the web, searched for bites or scratches, and the cost of seeking care felt too great for this family? I didn't catch if this happened in a civilized nation with universal health.

Fuck, this story is terrifying. Reminds me in some ways of when a kid dies in a hot car.

[–] [email protected] 2 points 1 week ago

Health Canada guidance is a bit more nuanced

Post-exposure prophylaxis or testing of a bat is generally recommended after direct contact with the bat (refer to Bat Exposure) because it is very difficult to ensure that a bite did not take place

Bat exposure: Post-exposure rabies prophylaxis following bat contact is recommended when both of the following conditions apply:

  • There has been direct contact with a bat, AND
  • A bite, scratch, or saliva exposure into a wound or mucous membrane cannot be ruled out.

Direct contact with a bat is defined as a bat touching or landing on a person.

In a child, a bat landing on clothing could be considered a reason for intervention, as a history to rule out a bite, scratch or mucous membrane exposure may not be reliable.

From 1998 to 2009, NACI recommended that people who may not be aware of or able to report a bat bite (e.g., sleeping person, young child, cognitively impaired) be offered intervention if a bat was found in the room with them. This recommendation was revised (as described above) in 2009 based on the rarity of human rabies related to bats (one case in Canada reported approximately every 5 years). Analysis conducted in Canada estimated that a case of human rabies related to bedroom exposure to a bat (i.e., finding a bat in the room of a sleeping person with no recognized physical contact with the bat) is expected to occur in Canada once every 84 years. In addition, it has been determined that, to prevent one case of rabies from bedroom exposure to a bat, using a conservative estimate, 314,000 people would need to be treated.

[–] [email protected] 3 points 1 week ago* (last edited 1 week ago)

You can't test the kid. What I'm saying is a lot of people in here are quick to judge the parents, but clearly even to medical professionals the situation is not cut and dry.

As I mentioned in another comment, I've been there. I have been through PPE, and I had to seriously advocate for myself to the ER doctor for him to go consult an infectious disease specialist before they agreed.

[–] [email protected] 12 points 1 week ago (1 children)

Bats have tiny teeth and it's possible to be bitten without there being any visible mark. You should always go for treatment if you have had an interaction with a bat. Better safe than dying one of the worst ways possible.

[–] [email protected] 6 points 1 week ago

Most commonly they bite you while you're sleeping, so you don't know

[–] [email protected] 4 points 1 week ago (1 children)

How do you think the child got rabies in this situation?

[–] [email protected] 5 points 1 week ago (2 children)

Obviously they overlooked a scratch or a bite. Rabies isn't airborne.

[–] [email protected] 3 points 1 week ago (1 children)

This you?

No scratches, no bite. Why would they?

[–] [email protected] 2 points 1 week ago

What do you mean? Yes. They checked the kid over and saw nothing. Obviously there was an exposure that either left no mark, left a mark that appeared normal, or the parents didn't see it.

[–] [email protected] 2 points 1 week ago (1 children)

Maybe it drooled into their open mouth or something. Or onto their hand and later they picked their nose.

[–] [email protected] 2 points 1 week ago* (last edited 1 week ago) (1 children)

Sounds possible. Bats are mammals, maybe it sneezed, covered, but didn't wash it's hands, gave the kid a high five, and then the kid wiped a booger out of his eye with it.

Poor kid, never had a chance.

[–] [email protected] 1 points 1 week ago
[–] [email protected] 7 points 1 week ago (1 children)

My thinking would be why risk not getting checked out? Unfortunately worst case scenario happened this time :(

[–] [email protected] 7 points 1 week ago* (last edited 1 week ago) (2 children)

The indication for testing according the CDC is a bite.

The rabies test is cheap. Could have tested the kid or the bat, but again why would they do it if there's no indication for exposure. This was the first case in the province of someone being infected with rabies inside their own home since 1967.

When you hear hoofbeats you don't think it's zebras.

[–] [email protected] 1 points 1 week ago

As soon as a rabies test comes back positive, you have a death sentence.

[–] [email protected] 8 points 1 week ago (1 children)

You can't test the kid, only the bat. So if they didn't catch it testing is a no go.

[–] [email protected] 1 points 1 week ago* (last edited 1 week ago) (2 children)

There's like eleven kinds of blood tests for rabies. None of them work on people, or is it by the time they work it's too late?

[–] [email protected] 5 points 1 week ago* (last edited 1 week ago)

Rabies works by slowly working its way towards your ~~nervous system~~ brain. Its pretty slow and not really active during this time and it isnt detectable at this stage. Once it hits your nervous system though it screams into overdrive and its basically fatal from that point on. That's what makes rabies so scary.

[–] [email protected] 7 points 1 week ago (1 children)

By the time it's detectable it's too late.

[–] [email protected] 1 points 1 week ago

Okay that's sort of what I thought.

So the protocol, from like an insurance coverage decision-tree standpoint, in this situation, would have been to test the bat if possible and if not possible administer the vaccine?

I was under the impression that the vaccine is pretty awful and a health ordeal in itself, and that while the dose wasn't expensive, the aftercare is.

And that is why, as I understand, the CDC protocol is only seek medical attention if there's a visible bite.