By Capital News Service
ANNAPOLIS, Md. — In 2016, Nicholas Fletcher said, he was in the process of moving out of his Baltimore home when several bats swept in through the chimney and into his basement.
As Fletcher was ushering the winged creatures from his home, he was bitten on his left foot leaving a faint but potentially life-threatening red mark.
With little hesitation, Fletcher decided to get treated at the nearest emergency room, where the medical professional asked whether he had brought the bat with him so that it could be tested for rabies.
“No. Why would I bring you the bat?” Fletcher said. “I don’t have the bat. The bat’s outside living its best life.”
Fletcher endured immunizations and treatment costing at least $5,000, which his insurance covered.
Rabies treatment consists of a single immunoglobulin injection administered at the wound site and the arm followed by four vaccinations given over a 14-day period. The regimen is proven to be virtually 100% effective in preventing rabies.
“If I didn’t have health insurance, I probably would have hesitated a little bit. But at the end of the day five grand is not worth my life,” Fletcher told Capital News Service.
However, everyone in Maryland who needs to be treated for rabies exposure can get treatment.
Those seeking treatment in Maryland should go to an emergency department for medical evaluation and treatment associated with a bite or serious injury in addition to the rabies exposure, according to the state health department.
Rabies hasn’t been eradicated and still poses a public health threat that needs to be addressed, said Dr. David A. Crum, public health veterinarian for the Maryland Department of Health.
“We know rabies is here (everywhere),” Crum said, and it’s important to get medical treatment.
“Those who meet the criteria are not going to be denied the vaccine in Maryland,” Crum said.
Patients are advised “of all financial assistance programs that are available,” according to the Maryland health department in a written statement to Capital News Service. “The Department will cover the charge of the rabies biologics for those persons deemed unable to pay that meet established criteria.”
Each year, more than 10,000 animal bites are reported in Maryland, and an additional 2,000 reports are tallied of non-bite exposures.
The five-year average in the state is approximately 446 post-exposure rabies treatments every year, a media representative for the Maryland Department of Health said.
The Centers for Disease Control and Prevention estimate that 55,000 Americans receive the treatment every year. As of 2019, the average cost of rabies treatment and preventatives was $3,800, which doesn’t include an emergency department visit or wound care, according to the CDC.
There have been about 30 rabies-related deaths in the U.S. from 2009 through 2018, according to the CDC.
The only rabies fatality in Maryland during this period was in 2013 via kidney transplant, according to the CDC.
In 2018, Maryland had the seventh-largest number of positive animal rabies cases in the United States with almost 270, which ranks it above some more populated states, according to CDC data.
From 2015 through 2019, Anne Arundel, Prince George’s, Montgomery, and Baltimore Counties, and Baltimore City had the most reported cases of rabies exposure in the state.
In Maryland, among wild animals, raccoons, foxes, skunks, and bats most often carry the virus. Cats are most frequently infected among domestic animals, including livestock, according to the health department.
Rabies is usually transmitted to humans through the saliva of an animal infected with the virus, but it can also be transmitted through the brain and nervous system tissue.
Among those who are not vaccinated, the virus is nearly always fatal.
“In the rare event that rabies PEP is declined, Maryland state and local health officials and the clinician providing care would counsel the individual to ensure that they fully understand their decision,” according to the Maryland health department.