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Australian bat lyssavirus: implications for public health

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Australian bat lyssavirus (ABLV) is genotype 7 of the 12 known lyssaviruses and is closely phylogenetically related to rabies (genotype 1).1 Although indigenous cases of rabies have never been identified in Australia, low-level ABLV endemicity has been found in Australian bats. Two variants have been identified: pteropid-ABLV, which has been found in all four Australian flying fox species (Megachiroptera), and YBST-ABLV, which has been identified in yellow-bellied sheathtail bats, a species of microbats (Microchiroptera).2 Both variants have been implicated in fatal human infection, albeit rarely.35 The third confirmed human case of ABLV infection, and the first in a child, was recently reported.5 Here, we outline the public health considerations of this emerging infection.

Clinical aspects

All three reported cases of human ABLV infection had clinical courses consistent with what is known of encephalitic (furious) rabies. Encephalitic rabies presents between several weeks and many years after exposure. It is usually characterised by progressive cerebral and autonomic dysfunction, preceded by a short, non-specific prodrome. Hydrophobic and aerophobic spasms are pathognomonic. The patient may initially be calm and cooperative, with interrupting…