Federal health officials are warning the public to avoid contact with bats after three people died of rabies late last year.
The three deaths – one of which involved a child – occurred between late September and early November of last year in Idaho, Illinois and Texas, according to a report published Thursday in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. Each case was associated with a person having direct contact with bats – such as through a bite or a collision, according to the report – and the spate of fatalities followed a period in which a total of just three bat–associated rabies deaths had occurred over the previous 48 months.
None of the three individuals who died from rabies received post-exposure prophylaxis, a series of shots that can prevent rabies from developing if administered before the start of symptoms. Once symptoms start, rabies is nearly always fatal.
“One patient submitted the bat responsible for exposure for testing but refused post-exposure prophylaxis, despite the bat testing positive for rabies virus, due to a long-standing fear of vaccines,” the report says. “The other two patients did not realize the risk for rabies from their exposures, either because they did not notice a bite or scratch or did not recognize bats as a potential source of rabies.”
The three deaths that occurred last fall were tied to exposure to three species of bats common in the U.S.: the silver-haired bat, Mexican free-tailed bat and big brown bat. All have been implicated in previous rabies cases.
Bat exposure is the leading cause of human rabies cases in the U.S., the CDC report says, accounting for approximately 70% of 89 reported cases acquired in the U.S. from 1960 to 2018. The report says two of the recent bat-associated rabies cases were considered avoidable exposures, with one attributed to a bat roost found in a patient’s home while another occurred after a patient picked up a bat with their hands.
Despite deaths from rabies being rare, “rabid animals and rabies exposures are relatively common,” the report says: In 2020, nearly 6% of approximately 24,000 bats tested for rabies were confirmed as positive.
In a press release, the CDC said data suggests that the uptick in recent rabies cases may spring from a lack of awareness about rabies risks and the importance of receiving appropriate treatment. The CDC recommends avoiding direct contact with bats or calling animal control or a state or local health department to help in trapping a bat for testing if contact does occur, as testing the animal can help determine whether a person needs treatment.
The CDC said there were five rabies deaths in the U.S. in 2021 – four total from bat exposures, and one due to exposure to a rabid dog in the Philippines – compared with no human rabies cases in 2019 and 2020.
The Associated Press reports that 2011 was the last time five U.S. rabies deaths were reported in a single year.
“We have come a long way in the United States towards reducing the number of people who become infected each year with rabies, but this recent spate of cases is a sobering reminder that contact with bats poses a real health risk,” Ryan Wallace, a veterinarian and rabies expert in the CDC’s Division of High-Consequence Pathogens and Pathology, said in the release.