Post-exposure prophylaxis or testing of a bat is generally recommended after direct contact with the bat (refer to Bat Exposure) because it is very difficult to ensure that a bite did not take place
Bat exposure: Post-exposure rabies prophylaxis following bat contact is recommended when both of the following conditions apply:
There has been direct contact with a bat, AND
A bite, scratch, or saliva exposure into a wound or mucous membrane cannot be ruled out.
Direct contact with a bat is defined as a bat touching or landing on a person.
In a child, a bat landing on clothing could be considered a reason for intervention, as a history to rule out a bite, scratch or mucous membrane exposure may not be reliable.
From 1998 to 2009, NACI recommended that people who may not be aware of or able to report a bat bite (e.g., sleeping person, young child, cognitively impaired) be offered intervention if a bat was found in the room with them. This recommendation was revised (as described above) in 2009 based on the rarity of human rabies related to bats (one case in Canada reported approximately every 5 years). Analysis conducted in Canada estimated that a case of human rabies related to bedroom exposure to a bat (i.e., finding a bat in the room of a sleeping person with no recognized physical contact with the bat) is expected to occur in Canada once every 84 years. In addition, it has been determined that, to prevent one case of rabies from bedroom exposure to a bat, using a conservative estimate, 314,000 people would need to be treated.
Health Canada guidance is a bit more nuanced