Bat sanctuary worker infected with novel poxvirus
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Key takeaways:
- A woman was infected with IsrRAPXV while caring for injured Egyptian fruit bat sucklings.
- Four other people also reported illnesses but did not seek medical care and their symptoms faded.
A bat sanctuary worker in Israel was the first person to be infected with IsrRAPXV, a poxvirus identified in Egyptian fruit bats in 2020, according to a study.
“The fact that the Egyptian fruit bat is ubiquitous in the urban environment creates a potential human-bat interaction in urban centers,” Yael Paran, MD, head of the infectious diseases unit at Tel Aviv Sourasky Medical Center in Israel, and colleagues wrote in The Journal of Infectious Diseases.
“Injured or abandoned bats are treated in shelters and in volunteers’ homes. During this rehabilitation period, volunteers routinely feed and groom these bats. ... In addition, bats are born with [a] full set of deciduous teeth, and suckling bats tend to bite and scratch their caregivers’ fingers as part of social play, all potentially increasing the risk of a zoonotic spillover event,” they wrote.
Bats are found in most regions of the world, and although they are an essential part of many ecosystems, they also play a key role in emerging infectious diseases in humans and livestock because they are a natural reservoir of zoonotic viruses, according to the researchers.
These viruses include Ebola, Marburg, rabies, Nipah and coronaviruses similar to SARS-CoV-2.
In 2020, the same research group identified the virus in an adult female Egyptian fruit bat that had developed “pox-like clinical signs” on its wing membranes. They biopsied the bat before releasing into an open colony rather than send it back to the captive colony at the Tel Aviv University where it was previously housed.
The researchers wrote at the time that that the zoonotic potential of the Israel Rousettus aegyptiacus pox virus (IsrRAPXV) was unknown and that professionals working with bats, especially if they have lesions or abrasions on their skin, should wear protective clothes and gloves when handling them.
According to the new report, on May 22, 2023, a 38-year-old bat shelter worker was hospitalized with a systemic illness and painful pox-like skin lesions on her hands. The woman told doctors that the lesions first appeared 4 days earlier and had grown in number and were larger, thicker and more painful.
On May 20, she developed influenza-like symptoms as the lesions became pustular and painful before she went to the hospital. During the woman’s hospitalization, her symptoms gradually faded, and although the lesions grew during her first 3 days of hospitalization, they also gradually resolved, leaving scars.
According to the study, the woman told doctors that she had been volunteering at the bat sanctuary for a few years, did not wear personal protective equipment and often sustained bruises from bat bites.
Interviews with her coworkers revealed that four other volunteers had similar illnesses and lesions on their hands after bat bites but did not seek medical care, and that their symptoms and lesions faded in a few weeks. The researchers noted that they also did not report the illnesses to a public health authority and were reluctant to provide more information on their unconfirmed cases.
The Egyptian fruit bat can be found in Africa, the Middle East, Pakistan and northern regions of India, and is the most common bat species in Israel, inhabiting mostly urban areas, national parks and nature reserves in close proximity to humans, according to Paran and colleagues.
The researchers wrote in the study that although the patient and her colleagues experienced only mild illness, and there was no evidence of human-to-human transmission, people working with bats should be careful.
“Our finding suggests that IsrRAPXV is zoonotic and therefore veterinarians and volunteers working in bat shelters should meticulously follow the guidelines of working with bats and use required personal protective equipment,” they wrote.
References:
- David D, et al. Vet Med Sci. 2020;doi:10.1002/vms3.233.
- Paran Y, et al. J Infect Dis. 2024;doi:10.1093/infdis/jiae427.
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