MMWR recently published a report of two Florida resident’s who got a generous extra portion of protein in their salad back in April 2017¹. The two Florida residents were consuming a bag of Fresh Express’ Organic Marketside Spring Mix when they happened to come across a dead bat carcass. They promptly contacted the Florida Department of Health (FLDOH), which in turn notified CDC’s Poxvirus and Rabies Branch

The bat carcass was submitted to the CDC for rabies virus testing, however test where inconclusive and the CDC recommended treatment with post exposure prophylaxis (PEP).

The routine PEP includes human rabies immunoglobulin and 4 doses of inactivated rabies vaccine administered over 14 days with the first dose being should be administered as soon as possible after exposure (day 0 and all additional administered on days 3, 7, and 14 after the first vaccination.) ²

To identify where the bat might have been introduced into the prepackaged salad the CDC performed genetic testing on the carcass and the bat was identified as a Mexican free-tailed bat (Tadarida brasiliensis mexicana)

Tadarida brasiliensis mexicana Source: http://www.nps.gov/sagu/naturescience/insectivorous-bats.htm

The Mexican free tailed bat also known as the Brazilian free-tailed bat is the most common bat in the Southwest US with a U.S. population of over 100 million. ³ They concluded that the culprit bat must have found its way into the salad during the fields harvesting and cutting of the greens as the greens are cultivated in originated from the same geographic location as the Mexican free-tailed bat.

Source: MMWR

The report prompted a limited recall of the Organic Marketside’s Spring Mix product. The salads in question were sold in Walmart stores in the southeastern U.S.⁴   Since April there have been no other reports of bats or other surprise proteins in the company’s salad products. Much to the dismay of the growing number of Paleo (Paleolithic) diet enthusiasts.

 No bats No subsequent bats were harmed in the writing of this blog post.

-Ahmed Babiker, MBBS, 1st year ID Fellow

References:

1. Krishnasamy V et al. Notes from the Field: Postexposure Prophylaxis for Rabies After Consumption of a Prepackaged Salad Containg a Bat Carcass- Florida, 2017. MMWR Morb Mortal Wkly Rep 2017;66:1154-1155
2. Rupprecht CE, Briggs D, Brown CM, et al. Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2010;59(No. RR-2)
3. http://www.nps.gov/sagu/naturescience/insectivorous-bats.htm
4. http://www.independent.co.uk/news/world/americas/dead-bat-bagged-salad-walmart-florida-rabies-investigation-a7676876.html