As a veterinarian in Queensland, you may be required to manage incidents involving contact between animals (often dogs or cats) and bats. This would include minimising the potential for domestic animals to acquire and transmit Australian bat lyssavirus (ABLV) infection. Managing the ABLV-risk may include using the rabies vaccine.

The following information is provided to assist veterinarians in managing these incidents:

• the complete document, ABLV—Information for veterinarians
• 5 short, how-to guides for easy access to answers addressing common queries.

The complete document, ABLV—Information for veterinarians, includes information on:

• Australian bat lyssavirus (ABLV)
• pre-exposure prevention of disease due to ABLV
• what to do if a person is bitten or scratched
• post-contact management of options of potential exposure to ABLV in animals, including
  • how to assess if transmission of ABLV may have occurred
  • 3 options for managing the risk of infection in a clinically well animal (euthanasia, monitor and report, and/or post-exposure vaccination).

The set of 5 short, how-to guides for common actions to assess and minimise ABLV risk:

• Submitting to the laboratory for ABLV testing
• Determining if a bat or other animal was infectious by clinical observation
• Vaccination protocol for animals post-ABLV exposure
• Accessing the Nobivac® rabies vaccine
• Advising owners on managing Australian bat lyssavirus risks (includes information checklist for advising owners on managing ABLV risk).

Apply to use the rabies vaccine for ABLV risk management

Complete the application form to use Nobivac rabies vaccine (PDF, 103KB) for post-exposure prophylaxis following potential exposure to ABLV.

Submit your application by email to ChiefVetOffice@daf.qld.gov.au or fax to (07) 3087 8328.

Also consider...

• Read the Australian bat lyssavirus disease overview.
• Find out more about Australian bat lyssavirus and your general biosecurity obligation.
• Search for PER14236 on the APVMA website.
• Read the national guidelines for rabies and other lyssavirus (including ABLV) exposures and infections from the Department of Health, Disability and Ageing.
• Find information on ABLV and handling bats from Workplace Health and Safety Queensland.

Safety advice

When dealing with an animal suspected to be infected with a lyssavirus, including ABLV or rabies virus (RV), take the following precautions:

• Whenever reasonable, only rabies-vaccinated persons should handle, euthanase, or remove the head or brain of a bat or other lyssa-suspect animal.
• Take all reasonable steps to avoid being bitten or scratched (see section 3.3 of ABLV—Information for veterinarians).
• Wear appropriate personal protective equipment (see section 3.4 of ABLV—Information for veterinarians).
• If bitten or scratched, immediately wash (do not scrub) the wound, apply a disinfectant, and seek urgent medical advice.

Urgent testing

If testing is urgent (for example, if the start of post-exposure vaccination is being delayed pending the result, or if you suspect lyssavirus disease in an animal other than a bat):

• contact the laboratory on (07) 3708 8762 to arrange for urgent testing
• provide an after-hours phone number.

What to submit for lyssavirus testing

To exclude lyssavirus infection definitively, brain tissue must be tested.

Tests cannot exclude lyssavirus infection (including ABLV and RV) in a live animal. Specifically, serology cannot exclude lyssavirus infection in a live animal. Live animals will need to be euthanased, and preferably refrigerated, before transport.

For safety reasons, where reasonable, submit whole, dead animals for testing.

If the animal is small enough to fit in an esky (e.g. a bat), submit the whole, refrigerated animal.

If the whole animal is too large, but the head of the animal can fit in an esky, submit the whole, refrigerated head.

If the head is too large to fit in an esky, remove the brain, divide longitudinally and submit:

• half the brain fresh (refrigerated)
• half the brain fixed (in 10% buffered neutral formalin).

Euthanasing a live bat for ABLV exclusion

Bats must be killed humanely. One humane option is to administer an intraperitoneal injection as follows:

1. Dilute ~0.5ml lethobarb® or similar into 2.5-3ml of water or saline.
2. Inject diluted lethobarb® into the peritoneal cavity. Avoid the kidney, liver and gravid uterus. Do not inject:
   • into the heart of a conscious animals (unjustifiably painful)
   • concentrated lethobarb® into a conscious animal (unjustifiably painful).
3. Leave bat in a cage for at least 5 minutes.
4. Gently prod the bat with a long instrument. If the bat is responsive, wait a bit longer.
5. Once the bat is unresponsive, remove it from the cage. If the bat is anaesthetised but not dead, intracardiac administration of a small volume of diluted lethobarb® will hasten death.

Packaging the sample

Follow these guidelines when preparing a bat or other species for transport to the BSL.

• Double bag each bat/animal. Place the bat/animal in a plastic bag, then place bag containing the bat/animal in a second bag.
• Refrigerate, rather than freeze, fresh animal tissues.
• If more than one animal is submitted, identify each animal (for example, attach a foot tag, or write on the bag containing animal).
• Complete a specimen advice sheet and attach it to the outside of the esky.
  Do not contaminate documentation by placing it inside the esky.
• Indicate on the form the reason or reasons for requesting testing, for example:
  • clinical signs consistent with ABLV (describe these signs)
  • potentially infectious contact with another animal (describe the circumstances and provide animal/s and owner/s details)
  • other (describe circumstances and signs)
• If you know or suspect that the bat or animal has had potentially infectious contact with a person, describe the circumstances and provide the person's details.

Laboratory contact details

Email: bslclo@daf.qld.gov.au
Phone: (07) 3708 8762 (Mon–Fri: 9am–5pm)
After hours: phone the Emergency Animal Disease Hotline on 1800 675 888.

Postal address

Biosecurity Sciences Laboratory
Health and Food Science Precinct
PO Box 156
ARCHERFIELD BC  QLD  4108

Delivery address

Specimen Receipt (Loading Dock 12)
Biosecurity Sciences Laboratory
Health and Food Science Precinct
39 Kessels Road
COOPERS PLAINS  QLD  4108

Also consider…

• Read more information about lyssavirus testing in ABLV—Information for veterinarians.
• Find more information about submitting samples to the Biosecurity Sciences Laboratory.
• Download the Biosecurity Sciences Laboratory user's guide for submitting laboratory samples or email bslclo@daf.qld.gov.au to request a copy.

You should only use clinical observation to determine if a bat was infectious for Australian bat lyssavirus (ABLV) when it is reasonable under the circumstances. A bat showing progressive clinical signs clearly suggestive of Australian bat lyssavirus, should be euthanased and tested for animal welfare reasons and to inform risk assessment.

Conditions for clinical observation

Clinical observation allows you to assess the likelihood that a bat was infectious at a particular point in time (for example, at the time of a potentially infectious contact). It may be reasonable to make this assessment clinically (rather than via laboratory testing) if:

• there are no clinical or behavioural signs clearly suggesting ABLV
• the carer is rabies-vaccinated and experienced in handling bats safely (avoiding bites and scratches)
• the carer agrees to:
  • use appropriate personal protective equipment when in contact with the bat
  • hold the bat in a separate enclosure (no direct contact with other bats or animals) for 10 days post-contact
  • contact the veterinarian urgently (as soon as reasonable, and at least within 24 hours) if the bat becomes unwell, dies or warrants euthanasia
  • support euthanasia and testing of the bat if the veterinarian decides the bat is clinically consistent with ABLV
  • contact the veterinarian to report the bat's clinical status 10 days post-contact.
• the carer is aware of their general biosecurity obligation in relation to bats and ABLV.

Interpreting the outcome of observation

If the bat survives for 10 days post-contact

If the bat survives for 10 days after contact without showing clinical signs suggesting ABLV, you can reasonably assume that the bat was not infectious at the time of contact and didn't transmit ABLV to other animal(s).

The bat, and all animals that had potential contact with the bat, may be released to normal care or rehabilitation. The bat may be released to the wild once adequately rehabilitated.

If other animals had received a vaccination pending the outcome of observation, the second vaccination (Day 7_PV) is not necessary. You may discontinue the vaccination protocol.

Note: If the bat survives to Day 10 post-contact, it doesn't mean the bat was not infected (subclinically) at the time of contact, but it does mean that the bat was not infectious at the time of contact. A bat incubating ABLV may progress to clinical disease and become infectious in the following months or years but wouldn't have been infectious months or years earlier.

If the bat dies within 10 days of contact

If the bat dies, or is euthanased, within 10 days of contact and laboratory tests show the bat was ABLV-infected, or if tests do not exclude ABLV, you should:

• assume the bat was infectious at the time of contact
• consider any in-contact person or animal as exposed and potentially infected.

Your response may include advising the owner to initiate or complete the post-exposure vaccination protocol.

Also consider...

• Read the Australian bat lyssavirus disease overview.
• Find out more about Australian bat lyssavirus and your general biosecurity obligation.
• Read the national guidelines for rabies and other lyssavirus (including ABLV) exposures and infections from the Department of Health, Disability and Ageing.
• Find information on ABLV and handling bats from Workplace Health and Safety Queensland.

From the time of potential contact to Day 35_PV (residual risk period)

Isolate the potentially exposed animal and minimise contact between it and people and other animals until the post-exposure protocol has been completed. Ideally, only people with a history of rabies vaccination, and a recently demonstrated titre of >2 IU, should have contact with the animal; however, this may not be reasonable.

To isolate and minimise contact:

• confine the animal to the house or yard, preferably in a section of the property not used by people or other animals (for example, the garage, laundry or fenced section of yard)
• prevent contact with children. If contact with children cannot consistently be prevented at a specific place, consider sending either the animal or children to another location for the residual risk period
• confine the animal at night – don't allow it to roam the house or sleep with people
• don't take the animal to off-leash areas, parties, or other situations where the animal may have contact with people or other animals
• take all reasonable steps to prevent unauthorised access and contact (for example, consider putting up warning signs and locking doors and gates).

Take all reasonable steps to avoid being bitten or scratched during the residual risk period. Everyone should wear appropriate personal protective equipment (PPE) whenever contact with the animal is possible. PPE may include:

• long-sleeved shirt
• long pants
• closed shoes
• puncture-resistant gloves
• a hat
• glasses (preferably safety glasses)

If the animal shows signs suggestive of ABLV

If, at any point, an animal shows behavioural or clinical signs suggesting ABLV, isolate it (if safe to do so) and contact Biosecurity Queensland.

Day 0_PV

Administer the first vaccination with Nobivac® rabies vaccine

If the animal is not microchipped, microchip and register it to comply with the APVMA permit.

Day 7_PV

Administer the second vaccination with Nobivac® rabies vaccine

Day 35_PV

If the animal is clinically well and isn't showing signs suggestive of ABLV you can consider the protocol complete.

The animal can return to normal management.

Advise the owner to take all reasonable steps to avoid future contact with bats.

Supplementary option to confirm seroconversion

Further information about the option to confirm seroconversion in an individual animal is available in the complete document, ABLV—Information for veterinarians. Post-vaccination confirmation of seroconversion may be indicated if:

• you suspect an individual may not respond to the vaccine as intended (for example, due to immunosuppressive therapy or disease)
• the owner seeks laboratory confirmation of a response to the vaccine.

Permit for supply and use of the rabies vaccine

Supply and use of the Nobivac® inactivated rabies vaccine is permitted in Australia under Australian Pesticides and Veterinary Medicines Authority (APVMA) permit number PER14236. This vaccine contains ≥2 IU/mL inactivated rabies virus (Pasteur strain) as the only active constituent.

Search 'PER14236' on the APVMA website to see the permit.

No animal rabies vaccine is fully registered for use in Australia.

Who may use the rabies vaccine

The reason for using the vaccine determines who may use it:

• A registered veterinarian with case-specific authorisation from the Queensland Chief Veterinary Officer (CVO), can use the vaccine in Queensland to manage Australian-bat-lyssavirus (ABLV) risk following potential exposure to ABLV.
• All veterinarians who are fully registered by a state or territory veterinary board, can order and use the rabies vaccine to prepare cats and dogs for export from Australia.

Minimising the delay between ABLV-exposure and vaccination

Minimise the interval between potential exposure and the first vaccine (Day 0_PV) as far as reasonable.

Apply as soon as possible to the CVO to use the vaccine for ABLV-prophylaxis. This may include applying:

• before finalising a decision with the owner
• while awaiting the outcome of a laboratory test or observation period.

An authorisation allows you to use the vaccine to prevent ABLV, but does not mean you have to use it. Whether or not to use the vaccine remains your decision.

Once you've received approval to use the vaccine for ABLV-prophylaxis, you can order the vaccine from veterinary suppliers; however this may take some days. To minimise delays, consider

• using rabies vaccine held in stock at your practice (e.g. to prepare cats and dogs for export) for ABLV prophylaxis
• using the approved application to source the vaccine from another practice
• referring the case to a practice with the rabies vaccine in stock.

Applying to use the rabies vaccine

To use the vaccine for ABLV risk management, complete the application form to use inactivated rabies vaccine and submit it to the Queensland CVO by emailing ChiefVetOffice@daf.qld.gov.au.

We'll make all reasonable efforts to respond on the same working day.

We'll respond on the next working day to applications received on weekends and public holidays.

If you submit an application in the afternoon, phone 13 25 23 to alert the Office of the CVO to help ensure a same day response.

Veterinarians in other jurisdictions should apply to the relevant state or territory CVO.

Ordering the rabies vaccine from veterinary suppliers

You can order the rabies vaccine from veterinary suppliers. You'll need to provide a CVO-authorisation when you request the vaccine for ABLV‑prophylaxis.

As cold chain is important to the integrity of the vaccine, vaccine is not usually shipped over the weekend, and supply may be delayed until early the next week.

Use the ABLV information checklist for owners as a basis for advising owners about managing the ABLV risk to a potentially exposed, clinically well animal, and document their informed consent.

Obligations of veterinarians to advise owners

No single option for ABLV risk mitigation is preferable in all circumstances. The higher the risk, the less appropriate it is to try to minimise risk by monitoring and reporting. The lower the risk, a decision to euthanase becomes increasingly unnecessary and disproportionate.

As a veterinarian, you should:

• provide the owner with advice to make an informed decision about what the most appropriate option would be
• document the basis on which the owner makes an informed decision in the patient's clinical record, given the likelihood of infection, the potential consequences, and the pros and cons specific to the circumstances. In particular, document that the owner's decision to vaccinate post‑exposure, or to monitor and report, is made knowing that neither option reduces the risk to zero.

Also consider...

• Read the Australian bat lyssavirus disease overview.
• Find out more about Australian bat lyssavirus and your general biosecurity obligation.
• Find information on ABLV and handling bats from Workplace Health and Safety Queensland.