Bat-borne zoonoses: transmission, impact, prevention, and management

Climate change and biodiversity loss are global environmental crises driving emerging infectious diseases, including bat-borne pathogens of public health significance: Ebola, Marburg, Nipah, Hendra, classic rabies virus, and Australian bat lyssavirus, as well as the fungus Histoplasma This review presents the evidence on the mechanisms of transmission, impact, and prevention and management strategies relevant to each of these pathogens. Transmission pathways vary between pathogens but often involve exposure to body fluids or excreta of a bat or other infected animal or human. The diseases associated with these infections have high mortality rates, and survivors may continue to experience a range of long term effects, including neurological and neuropsychiatric signs and symptoms. Prevention strategies may be implemented to reduce the risk of zoonotic spillover and human-to-human transmission of these pathogens, including better ecological stewardship, reducing exposure of domestic animals and humans to bats, isolation of infected people, and, where possible, vaccination of humans and animals. The mainstay of treatment for these conditions is supportive care; however, specific drugs are now available for histoplasmosis and Ebolavirus infection. In the face of climate change and further loss of biodiversity, developing more effective strategies to prevent and manage these conditions will be critical.