Dato Virginia M, Campagnolo Enzo R, Long Jonah, Rupprecht Charles E
University of Pittsburgh, School of Medicine, Pittsburgh, PA, United States of America.
Pennsylvania Department of Health, Bureau of Epidemiology, Harrisburg, PA, United States of America.
PLoS One. 2016 Jul 26;11(7):e0159443. doi: 10.1371/journal.pone.0159443. eCollection 2016.
In the United States and Canada, the most recent documented cases of rabies have been attributed to bat rabies viruses (RABV). We undertook this systematic review in an effort to summarize and enhance understanding of the risk of infection for individuals who have been potentially exposed to a suspect or confirmed rabid bat. United States rabies surveillance summaries documented a total of 41 human bat-rabies virus variant verified non-transplant cases between 1990 and 2015. All cases were fatal. Seven (17.1%) of 41 cases reported a bite from a bat. Ten (24.3%) cases had unprotected physical contact (UPC); these included seven cases that had a bat land or crawl on them (contact with claws) and one case that touched a bat's teeth. Seven (17.1%) cases had probable UPC. Insectivorous bat teeth are extremely sharp and highly efficient for predation upon arthropod prey. Bats also have sharp claws on the end of their thumbs and feet. One of the most common bat RABV variants has an ability to replicate in non-neural cells. Questioning individuals about unprotected contact with bat teeth and claws (including a bat landing or crawling on a person) may help identify additional exposures.
在美国和加拿大，最近记录在案的狂犬病病例均归因于蝙蝠狂犬病病毒（RABV）。我们进行了这项系统综述，以总结并加深对可能接触疑似或确诊狂犬病蝙蝠的个体感染风险的理解。美国狂犬病监测总结记录了1990年至2015年间总共41例经核实的人类感染蝙蝠狂犬病病毒变异株的非移植病例。所有病例均死亡。41例病例中有7例（17.1%）报告被蝙蝠咬伤。10例病例（24.3%）有未采取防护措施的身体接触（UPC）；其中包括7例有蝙蝠落在或爬到他们身上的情况（与爪子接触）以及1例触摸蝙蝠牙齿的情况。7例病例（17.1%）可能有未采取防护措施的身体接触。食虫蝙蝠的牙齿极其锋利，对捕食节肢动物猎物非常高效。蝙蝠的拇指和脚末端也有锋利的爪子。最常见的一种蝙蝠狂犬病病毒变异株能够在非神经细胞中复制。询问个体是否有与蝙蝠牙齿和爪子的未采取防护措施的接触（包括蝙蝠落在或爬到人身上）可能有助于识别更多的暴露情况。
