Treatment of Illnesses Caused by Rat Exposure
The treatment for rat-borne illnesses varies based on the specific disease, with penicillin being the first-line treatment for rat-bite fever, while supportive care is the mainstay for viral infections like hantavirus, with no specific antiviral therapy currently available. 1, 2
Rat-Bite Fever
Rat-bite fever is caused by Streptobacillus moniliformis, which is part of the normal oral flora of rats and other rodents.
Clinical Presentation:
- Fever, headache, nausea, myalgia developing within ten days of rat exposure 1
- Rash and arthritis, particularly in hands and feet 1, 3
- Can present without fever in some cases, making diagnosis challenging 3
Treatment:
- First-line treatment: Intravenous penicillin 1
- Alternative for penicillin-intolerant patients: Tetracycline 1
- Treatment duration typically 2 weeks 1
- Early treatment is essential as complications can be fatal 1, 3
Hantavirus Infections
Hantaviruses cause two major clinical syndromes: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS).
Clinical Presentation:
- General malaise, fever, myalgia, and headache 4, 2
- HPS: Primarily affects the lungs with noncardiogenic pulmonary edema 2
- HFRS: Systemic manifestations with kidney involvement 2
- Laboratory findings: Elevated lactate dehydrogenase (LDH) 4
Treatment:
- Primarily supportive care 2
- No specific antiviral therapy has proven effective 2
- Management focuses on respiratory and hemodynamic support 2
Leptospirosis
Leptospirosis is a bacterial infection also transmitted by rodents.
Clinical Presentation:
- General malaise, fever, myalgia, and headache 4
- Distinctive features: Photo/sonophobia and neck stiffness 4
- Laboratory findings: High C-reactive protein (CRP), leukocytosis with left shift, abnormal liver function with raised total bilirubin 4
Treatment:
- Antibiotics are the mainstay of treatment
- Early antibiotic therapy can prevent progression to severe disease 4
Prevention of Rat-Borne Diseases
Rodent Control:
- Keep food and water covered and stored in rodent-proof containers 5
- Dispose of trash and garbage regularly 5
- Eliminate clutter where rodents might nest 5
- Use spring-loaded traps with peanut butter as bait 5
Cleaning Rodent-Contaminated Areas:
- Wear protective gloves (rubber, latex, vinyl, or nitrile) 5
- Spray rodent urine and droppings with disinfectant or chlorine solution before cleaning 5
- Avoid generating aerosols by not vacuuming or sweeping until disinfection 5
- Use paper towels to pick up urine and droppings 5
- Disinfect all potentially contaminated surfaces 5
Handling Dead Rodents:
- Wear protective gloves 5
- In western United States, use insect repellent containing DEET to prevent fleabites 5
- Spray dead rodents with disinfectant or chlorine solution 5
- Double-bag rodent remains for disposal 5
For Heavy Rodent Infestations:
- Ventilate closed buildings for at least 30 minutes before entering 5
- Wear appropriate protective equipment including coveralls, gloves, goggles, and respiratory protection 5
- Contact local health authorities for guidance 5
Important Considerations
- Diagnosis of rat-borne illnesses can be challenging due to nonspecific symptoms 4, 3
- Serology remains the gold standard for diagnosis of many rat-borne diseases 4
- A high degree of awareness is necessary, especially in cases with atypical presentations 3
- Always consider rat-borne infections in patients with unexplained fever and known rat exposure 6