An 11-year-old boy from Ontario, Canada, has died from rabies after a bat landed on his face while he slept, despite having no visible bites or scratches. The case, detailed in the Canadian Medical Association Journal, underscores the importance of seeking immediate medical attention after any direct contact with a bat.
Details of the Incident
During a family visit to a cottage in northern Ontario in 2024, the boy was awakened by a bat sitting on his nose and mouth. He swatted the bat away, and his father caught it in a cooking pot and released it outside. Because the boy had no visible bites and the bat was not behaving erratically, the parents did not seek medical care.
More than two weeks later, the boy developed paresthesia (tingling), numbness, and swelling on the right side of his face. A local urgent care clinic prescribed an antiviral drug. Within days, his condition worsened, leading to hospital admission with symptoms including facial weakness, slurred speech, fever, trouble swallowing, confusion, and visual hallucinations.
Medical Response and Outcome
Doctors confirmed rabies diagnosis after the boy was admitted to the paediatric intensive care unit. By his fifth day in hospital, he had no reflexes in his brain stem, which regulates breathing and heart rate. Life-sustaining therapies were withdrawn on day 17, and he died peacefully with his family at his bedside.
“Any direct human contact with a bat, even in the absence of a visible bite or scratch, is an indication for PEP [post-exposure prophylaxis] and should be discussed with public health authorities,” the doctors wrote in the journal article titled “Fatal Rabies in a Child.”
Rabies Prevention and Treatment
Rabies is a deadly viral disease that attacks the central nervous system and is 100% fatal once clinical symptoms appear. However, it is entirely preventable if post-exposure prophylaxis (PEP) is administered shortly after exposure. PEP is an emergency medication that stops the virus from replicating and must be started as soon as possible, ideally within 24 hours and no later than 72 hours. The treatment requires a 28-day course of antiretroviral drugs.
Despite decades of research, “no proven effective therapy exists after symptom onset,” the doctors noted. A rabies vaccine is readily available in the UK as a private travel vaccine, typically costing between £50 and £120 per dose, with a standard course of two to three injections over 28 days.
Context and Warnings
This case was the first locally acquired rabies in Ontario since 1967. The boy’s family shared details in hopes of increasing awareness. Health authorities urge anyone who has direct contact with a bat to seek PEP immediately, even without visible injuries.
