In July of this year a client presented a pipistrelle bat at
my practice. My professional obligations required that I administer to the
welfare needs of the animal. My statutory obligations[i]
required, that as a protected species, the bat should be tended to and released
when no longer disabled; or humanely destroyed if it had no reasonable chance
of survival.
I double gloved with heavy, latex examination gloves before
performing a preliminary examination. Other than identifying several small
perforations to the membranes of both wings the animal appeared to be free of
any obvious injuries.
The first priorities were to attend to the bat’s hydration
status and to reduce the stress of it being captive; later focusing on its
nutritional needs. I contacted the Bat Conservation Trust so that I could pass
the bat into the care of one of their representatives. It was during one of the
feeding sessions that I was bitten twice on the finger through the doubled
gloves.
On hearing of the incident a member of the Trust contacted
me at my practice. He was anxious that I seek medical attention and receive a
rabies post-exposure prophylaxis course. After several phone calls to various
NHS facilities I was finally directed to the virology department of Leeds
General Infirmary. The unit could not have been more helpful. They prepared a
rabies immunoglobulin – tailored to my body weight – and a course of vaccines.
The urgency of treatment was explained to me; the immunoglobulin
was heat labile and, despite being on ice, would be inactivated in a few hours.
The virology unit liaised with my GP surgery and arranged for a doctor to
administer the injections. The immunoglobulin was administered intramuscularly
in four sites; I was also given a vaccination intramuscularly. The vaccines are
to be repeated on days three, seven, fourteen and twenty-eight.
As a veterinary legal researcher I was naturally curious as
to the health and safety implications to the practicing veterinary surgeon that
emanate from the double obligations imposed by the RCVS and Parliament.
Section 2 of the Health and Safety Act[ii]
outlines the general duties of the employer towards their employees. In
particular, section 2(2)(b) relates to the making of reasonable and practical
arrangements that ensure the absence of
risks to health in the handling of articles. My interpretation of this section
leads me to the conclusion that veterinary staff should be protected from the
risk of rabies by means of routine, pre-exposure vaccination.
Pet travel, to and from Europe is becoming more popular;
over one million pets have already travelled by Eurotunnel[iii] and
this only accounts for 65% of the animals entering the U.K. With the relaxation
in the previous safety checks that were necessary for the issuing of a
pet-passport, there are undoubtedly many animals entering the U.K. without
protective titres of rabies antibodies. In my own practice, when blood testing
was required prior to the issuing of a passport, between five and ten percent
of animals failed to achieve the required antibody levels after the first
inoculation.
With this in mind I wanted to ascertain the diagnosed
incidence of rabies in the whole of the European Union. The figures[iv] reveal
that between 2002 and 2012 there have been 27,974 confirmed cases of rabies in
the E.U. recorded across all species. When restricted to just domestic animals
the numbers fall to 4,791 reported cases. When further restricted to just cats
and dogs, the species that veterinary surgeons in this country could potential
come into contact with, the number of reported cases is 2,990.
The annual reported incidence of canine and feline rabies in
the E.U. has diminished gradually from 420 cases in 2002 (with a high of 482 in
2003) to 127 cases in 2012 (with a low of 92 in 2011).
A worrying aspect is that, in Romania, this trend is being
reversed. In 2002 there were 28 cases of rabies in cats and dogs and in 2012
there were 82 confirmed cases. In the first six years of the last decade Romania
reported 327 cases; in the last five years there were 406 cases. In the last
five years Romania, alone, has accounted for 55% of the E.U.’s rabies in cats
and dogs. It should be borne in mind that Romania becomes a full member of the
E.U. on the January 1st 2014; many Romanians will want to come to
the U.K. and many of those will want to bring their pets with them.
Arranging to be vaccinated against rabies is a simple
process[v]. Contact
your GP’s surgery and tell them you are a veterinary surgeon. Advise the doctor
that you are obligated, as a matter of professional and legislative duty, to
administer to the welfare needs of any bat that is presented to you. Also
advise the doctor that due to changes in the U.K. quarantine laws and the
relaxation in monitoring the efficacy of canine and feline rabies inoculations,
rabies is becoming an emergent disease. The doctor will then instruct a nurse
to administer the course of vaccination; she/he will then ask you for £120-£150
for the service (it is not available on the NHS).
It is ethically wrong for a State to single out a group in
society and compel them to be placed in the front line of vigilance against a
potentially lethal disease; remove the safeguards that have been in place for
more than a century; multiply the risk factor by extending free movement of
people and their pets, and then tell them that the State will not offer any
protection – you must pay for it yourselves. I would call on the bodies that
represent the veterinary profession in this country to unite and have this
issue raised in Parliament.
