Boy, 11, dies of rabies 19 days after waking with bat lying on his mouth

An 11-year-old boy died from rabies less than three weeks after he woke up with a bat lying over his nose and mouth.

The child contracted the lethal virus despite not having any apparent bite or scratch marks from the interaction, a report has shown.

Nineteen days after the incident, the boy started presenting with symptoms consistent with the disease, including vomiting, facial ‘pins and needles’, and numbness.

He visited the emergency department where he was given supportive care, as there is no cure once the symptoms of the virus develop.

The parents of the boy – who has not been named – agreed to share their son’s story in a bid to raise awareness of the disease.

It was the first fatal case of rabies in Ontario, Canada, in more than 50 years.

Experts hope that a new report on the boy’s death, published in the Canadian Medical Association Journal (CMAJ), will provide critical guidance to help prevent future rabies deaths.

Rabies in humans is almost always fatal, but post-exposure prophylaxis (PEP) with a series of rabies vaccines and human rabies immune globulin injections can prevent death if administered promptly, before symptoms develop.

Bats are the most common carriers of rabies in North America, but the disease can also be passed from raccoons, skunks, and foxes.

Bats pose a particularly heightened risk as scratches or bites can be small and difficult to see.

Report co-author Dr Brian Hummel said: ‘Any direct human contact with a bat – even in the absence of a visible bite or scratch – is an indication for PEP and should be discussed with public health authorities.

‘This is especially important to consider as we approach the summer months, when human–bat encounters are at their peak.’

He says people who may have been in contact with a wild animal that could potentially have rabies should seek medical attention promptly.

‘Bats may or may not show classic signs of rabies; hence, any direct human contact with a bat is considered high risk,’ he added.

In the case of possible rabies virus exposure, public health authorities should be notified and PEP should be started in consultation.

Dr Hummel, a paediatric infectious disease specialist at the McMaster Children’s Hospital and McMaster University, Ontario, continued: ‘Rabies is almost always fatal, with no established efficacious therapies, making prevention crucial.

‘Rabies PEP is highly effective if administered promptly, in consultation with public health authorities, after any direct human contact with a bat, even in the absence of visible lesions.

‘In people with neurological symptoms that may be compatible with rabies, clinicians should ask about exposure to potentially rabid animals.’

There have been 27 confirmed cases of human rabies in the UK since 1924.

All but one were contracted abroad, primarily from dog bites in South Asia or Africa, before the patient returned to Britain.

The only recent case where rabies was contracted in the UK was in 2002, when a licensed bat handler in Scotland died from a rabies-like virus.

The UK has been completely free of terrestrial rabies – the kind spread between dogs and foxes – since 1922.