Case #86 "The Mat Bat"
by Charlene Babcock Irvin, MD, FACEP
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I frequently travel on a medical mission
trip to the Pantanal of Brazil to care for
the indigent Indians living in remote
villages. I have always taken one of my
children on the adventure (last trip I took
2 of my children). Our team sleeps wherever
we can, usually on the floor of a generous
ranch owner who offers the space for us to
sleep. We put thin mats down, and then sleep
on them. These ranch homes are considered
luxurious as they have running water (not
hot, but when the temperature is 110F, who
wants hot water?) and a working toilet
(toilet paper not allowed—dispose of in
garbage can). They don’t have ovens, but
instead cook over fire. The windows have
wood closures (instead of glass), and on the
evenings as it’s so hot, the windows are
usually left open. (Last trip we left the
door to my area open too, until the ranch
owner warned of poisonous snakes that can
come in during the night!) I always sleep in
a bug proof tent on the floor somewhere (I
put it on top of the mat).
In contrast, Indians in the villages are
lucky if they have a hose at the corner of
the property that supplies water (otherwise
they carry water on their heads from the
river—frequently infested with piranha).
These village houses do not have toilets,
but instead the Indians dig holes around
their thatch homes for toilet purposes
(convincing them to do this 10 feet or more
from their houses has decreased the worm
infestations some). They also cook over fire
(asthma is a problem as the ventilation in
these one room thatch homes is not ideal).
On our last trip, my 15 y/o son was sleeping
on the floor but declined a bug tent (to
macho to worry about bugs). One evening my
son woke up and there was a dead bat on the
mat about 10 inches from his feet (about 10
inches from the head of our pharmacist).
When the pharmacist woke up, he didn’t have
his glasses on, and saw a black furry blob
close to his head. He initially thought it
was a spider (they have black spiders that
size….one was found about 10 feet from my
tent the same morning…according to the ranch
owner the spider ‘throws poison fur
darts…very painful, but won’t kill you). The
pharmacist’s got up very slowly, and was
pleased that it was only a dead bat and not
a live spider. The bat must have flown in
from the open window. The dentist, the
ophthalmologist, and an interpreter were
also in the room sleeping on mats. No one
reports getting bitten.
Questions:
1. Should I worry about rabies?
2. How is the infection manifest in humans?
3. How do you care for a possible bite from
a rabid animal?
4. What state is rabies free?
Click here for answers and to respond
