An 11-year-old Canadian boy died of rabies after waking up to find a bat resting on his nose and mouth as he slept in a family cottage.
This has prompted doctors to warn that any direct contact with a bat should be treated as a possible exposure to rabies – even if there are no visible signs of a bite or scratch.
The case, which occurred in northern Ontario in the summer of 2024, was detailed in a peer-reviewed report published Monday in Journal of the Canadian Medical Association (CMAJ).
The authors said they published the report to raise awareness and help prevent similar deaths, the BBC reported.
According to the report, the boy woke up to find a bat lying across his nose and mouth.
He brushed it off – and his father caught the animal in a container before letting it out.
No bites, scratch marks
Because the child had no obvious bites or scratches and did not appear to be behaving abnormally, the family did not seek immediate medical attention or post-exposure rabies prophylaxis (PEP).
Nineteen days later, the boy had tingling, numbness and swelling on one side of his face. His symptoms initially resembled more common conditions, leading doctors to suspect diseases such as Bell’s palsy and viral infections of the mouth.
Anyone who wakes up with a bat in the room, has direct contact with a bat, or cannot rule out a bite should immediately consult with public health authorities to determine if rabies post-exposure prophylaxis (PEP) is needed.
US Centers for Disease Control and Prevention warns that bats are the leading source of human rabies deaths in the United States.
Bat bites can be extremely small and can go unnoticed.
A stick is needed not to be released until health officials determine whether to test for rabies.
As the boy’s condition rapidly deteriorated, he developed a high fever, difficulty swallowing, confusion and visual hallucinations before being admitted to intensive care. Laboratory tests later confirmed the rabies was caused by a variant virus associated with bats.
He died 17 days after hospitalization.
Doctors noted that rabies is almost invariably fatal once symptoms begin, but it is also highly preventable if post-exposure treatment begins soon after a potential exposure.
They recommend that any direct human contact with a bat, even without obvious injuries, should be discussed immediately with local public health authorities so that PEP can be considered.
Health experts say the case underscores a simple but potentially life-saving message: If a bat makes direct contact with a person — especially someone who was asleep, unconscious or unable to recognize a bite — seek immediate medical attention.
The rage of man
Human rabies remains extremely rare in Canada.
of Canadian Veterinary Medical Association just says 28 human deaths from rabies have been recorded in the country since 1924, mainly due to vaccination programs and rapid post-exposure treatment.
However, bats remain the primary source of human rabies infections in North America because their bites and scratches can be so small that they go unnoticed.
Early treatment with rabies vaccine and immunoglobulin is very effective before symptoms appear, but once clinical rabies occurs, there is no proven cure.
