Exposure to rabies comes from contact with saliva

Doctor typing on computer

Hello again, dear readers, and welcome back to the monthly letters column. You’ve filled our mailboxes to the brim, so we’ll dive right in.

-- We recently discussed the series of shots required when someone is exposed to rabies. This prompted a letter from a reader in Virginia whose husband found a baby bat. ”He touched the bat with his foot (while wearing socks and shoes), and it flew off,” she wrote. “Then he got worried about rabies. Is there a test that can reassure someone they don’t have rabies?”

There is no single test for rabies in humans. Instead, several tests on samples of saliva, blood serum and spinal fluid are performed. The results show if infection has occurred. Rabies is nearly always transmitted through a bite. It is possible to get infected through surface contact with infected saliva, but it’s rare. In the scenario you describe, your husband did not come into direct contact with the bat.

-- In response to a column about gastroesophageal reflux disease, or GERD, a reader from Louisiana shared their approach to managing the condition. “A behavioral change that works for me to prevent GERD is the elimination of sugar from one’s diet,” they wrote. “Give it a try, and if it works, you have a solution. If not, no harm done.” The reader’s experience is backed by recent research. A study published last year in the American Journal of Gastroenterology found that people with GERD who reduced sugar improved the pH level in their esophagus and experienced fewer reflux episodes.

-- We’ve had several letters in reference to a column that included a discussion about hydration. One reader asked about distilled water. “I prefer the non-taste of distilled water, so that is what I normally drink,” she wrote. “But someone told me it’s bad for my body. Is that true?” It is safe to drink distilled water when accompanied by a balanced diet. That’s important because distilled water has been stripped of electrolytes and minerals, including calcium and magnesium. Although the primary source of minerals essential to human health is the foods we eat, water also plays a role. Some studies have found that relying solely on distilled water may contribute to lower levels of these important minerals.

This brings us to a letter from a reader from Nebraska who regularly drinks spring water and wonders if it contains minerals. The answer is yes. For people who dislike the taste of tap water, spring water can be a good alternative.

Elizabeth Ko, MD and Eve Glazier, MD

-- A column about balance that suggested standing on one foot as a useful strengthening exercise prompted a question from a reader. “Should I balance on one foot with bare feet or with shoes on?” they wrote. “I think there will be a significantly different result.” You’re correct that each scenario elicits a slightly different kinetic response. But since both involve the mechanics of balance, we think both would be useful.

Thank you, as always, for taking the time to write. We love hearing from you. We have had an unusual amount of mail recently and will add several bonus letter columns in the coming weeks.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)