Rabid bat in salad: LGMA said anything?

On April 3, 2017, two Florida residents consumed part of the same prepackaged salad before reportedly discovering the partial remains of a bat carcass in the salad. Bats are known reservoirs for rabies virus, which causes rabies disease in both animals and humans (1). The persons who ate the salad contacted the Florida Department of Health (FLDOH), which notified CDC’s Poxvirus and Rabies Branch. CDC and FLDOH determined that the immediate concern was for potential rabies virus exposure, because approximately 6% of bats submitted to U.S. public health departments annually test positive for rabies virus (2,3).

Grey Headed Flying Fox (Pteropus poliocephalus)

(This is an Australian flying fox, left; everything is bigger here.)

Although percutaneous exposures are more likely to result in successful transmission of rabies virus to humans (1), transmission can occur when infectious material, such as saliva or nervous tissue from an infected animal, comes into direct contact with human mucosa (2). Infection with rabies virus causes an acute, progressive encephalitis that is nearly always fatal once clinical signs have begun. The disease is preventable if exposed persons receive timely postexposure prophylaxis (PEP), which includes human rabies immunoglobulin and 4 doses of inactivated rabies vaccine administered over 14 days (4).

FLDOH submitted the bat carcass to CDC for rabies virus testing on April 4. Polymerase chain reaction and direct fluorescent antibody tests were inconclusive because of the deteriorated condition of the carcass. However, because the cranium of the bat was intact, exposure to brain material by the persons who consumed the salad was unlikely, although exposure to the bat’s organs or peripheral nervous tissue was possible. PEP was recommended because laboratory test results were inconclusive and exposure to nervous tissue could not be ruled out.

The salad was purchased from a company A store location. After being notified of the investigation, company A removed the lot of prepackaged salad from all store locations on April 5. Company B (the prepackaged salad supplier) recalled the affected lot of salads on April 8. CDC advised consumers to contact their local health department for PEP evaluation only if the consumer had eaten a recalled prepackaged salad and had found animal material in the salad. CDC was not notified of any other reports of dead bats in prepackaged salads.

To identify where the bat might have been introduced into the prepackaged salad, CDC performed genetic analyses on the bat to determine its subspecies. Based on morphology and phylogenetic analyses (Bayesian inference and haplotype network analyses) of mitochondrial DNA sequence data (Cytb and D-loop), the bat was identified as a Mexican free-tailed bat (Tadarida brasiliensis mexicana), which is found throughout the southwestern United States. It is genetically distinct from T. brasiliensis cynocephala, which occurs in the southeastern United States (Figure) (5).

The investigation determined that cutting and harvesting of greens for the recalled salad occurred in fields in the west and southwest United States before they were transported to a processing plant in Georgia. At the processing plant, the greens were washed with chlorinated water and packaged. Given the physical condition of the bat (e.g., decomposed, bisected) and the geographic location of the fields and the processing plant, along with the genetic identification of the bat, investigators concluded the bat most likely came into contact with the salad material in the field during harvesting and cutting and was then transported to the processing facility.

Several factors likely reduced the risk for rabies virus transmission to the two Florida consumers. No rabies virus was detected in the specimen, the bat’s cranium was intact, and the salad was rinsed before packaging, thereby diluting any potential virus. In addition, mucosal membrane exposures have rarely been proven to result in rabies disease, and rabies virus does not survive more than a few days outside a host (2). Although this exposure was likely of low risk, this investigation was an example of effective industry and government collaboration to remove a product of concern from the marketplace rapidly to protect consumers.

‘Notes from the Field: Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containing a Bat Carcass — Florida, 2017

Weekly / October 27, 2017 / 66(42);1154–1155, Vikram Krishnasamy, MD1,2; Matthew R. Mauldin, PhD3; Matthew E. Wise, PhD2; Ryan Wallace, DVM3; Laura Whitlock, MPH2; Colin Basler, DVM2; Clint Morgan, MS3; Dana Grissom4; Sherry Worley4; Danielle Stanek, DVM5; Jamie DeMent, MNS5; Pamela Yager3; William Carson3; Rene E. Condori, MS3; Yoshinori Nakazawa, PhD3; Claire Walker3; Yu Li, PhD3; Christopher Wynens, DVM6; Allison Wellman, MPH6; James Ellison, PhD3; Emily Pieracci, DVM


‘We meet all standards’ Fresh Express uses Pinto defense after dead bat found in salad

The U.S. Centers for Disease Control and Prevention (CDC) are working with the Florida Department of Health and the U.S. Food and Drug Administration (FDA) to support an investigation of a dead bat that was found in a packaged salad purchased from a grocery store in Florida. Two people in Florida reported eating some of the salad before the bat was found. The bat was sent to the CDC rabies lab for laboratory testing because bats in the United States sometimes have been found to have this disease. The deteriorated condition of the bat did not allow for CDC to definitively rule out whether this bat had rabies.

Transmission of rabies by eating a rabid animal is extremely uncommon, and the virus does not survive very long outside of the infected animal. CDC is supporting Florida local and state health officials in evaluating the people who found the bat in the salad. In this circumstance, the risk of rabies transmission is considered to be very low, but because it isn’t zero, the two people who ate salad from the package that contained the bat were recommended to begin post-exposure rabies treatment. Both people report being in good health and neither has any signs of rabies. CDC is not aware of any other reports of bat material found in packaged salads.

On April 8, 2017, Fresh Express issued a recall of a limited number of cases of Organic Marketside Spring Mix. The salads were sold in a clear container with production code G089B19 and best-if-used-by date of APR 14, 2017 located on the front label. The recalled salads were distributed only to Walmart stores located in the Southeastern region of the United States. All remaining packages of salad from the same lot have been removed from all store locations where the salad was sold.

The company said in a statement it worked quickly with officials to remove the entire batch of salads from store shelves, and only one line of its products had been affected.

“Fresh Express takes matters of food safety very seriously and rigorously complies with all food safety regulations including the proscribed Good Agricultural Practices.”

Maybe install bat filters as the lettuce goes through a wash?

Bangladesh bans sale of palm sap after bat poop with Nipha virus kills 35

The N.Y. Times reports that Bangladesh is suffering an outbreak of deadly Nipah virus, causing the government to adopt an unusual prevention tactic: a ban on the sale of fresh palm sap.

The virus, carried by bats, was identified only in 1999. It causes dangerous brain inflammation in humans and is infectious. The Bangladeshi outbreak is unusually lethal, killing 35 of the 40 people known to have been infected.

The first known outbreak of Nipah virus was in Malaysia, where most victims raised or butchered pigs that were the source of infection. The pigs are believed to have rooted beneath bat colonies in trees, eating food contaminated by droppings. But the Bangladesh outbreak happened without a swine vector.

Bangladeshis like drinking date palm sap, which is gathered “in a way similar to maple syrup collection,” said Dr. Jonathan H. Epstein, a veterinarian with the EcoHealth Alliance, which is helping Bangladesh track the virus.

Gatherers called gachis climb high into the trees, shave the bark with machetes and hang clay pots on the trunks to collect the sap at night. Large fruit bats called Indian flying foxes are attracted and lap up the running sap, sometimes fouling the pots with their saliva, urine or feces.

Many people in the tropics leave palm sap to ferment into wine — and fermentation might kill the virus. But most Bangladeshis are Muslim, and do not drink alcohol, Dr. Epstein said.

Bat poop sickens ND courthouse workers

Bats in the belfry – or North Dakota’s McLean County Courthouse –and their poop has seriously sickened at least two employees with histoplasmosis, caused by inhalation of spores from bat guano.

The Bismarck Tribune reports the county has battled a bat problem for years, bringing in specialists to try to seal the old building, trap the bats and remove a thick covering of guano in the courthouse attic.