CDC warns about bat-linked rabies after three deaths in recent months

The Centers for Disease Control and Prevention (CDC) has issued a warning over bat-linked rabies cases among humans after three people died in a five-week period in the fall.

Three people, including one child, died from rabies between Sept. 28 and Nov. 10 after direct contact with bats in and around their homes in Idaho, Illinois and Texas in August.

None of the three patients, who were all male, received post-exposure prophylaxis (PEP) shots designed to prevent rabies before symptoms start — at which point the disease is almost always fatal.

The patients had contact with a bat three to seven weeks before developing symptoms and died about two to three weeks after these symptoms surfaced. Two of the cases were considered “avoidable,” with one involving a bat roost in the patient’s home and another involving a patient picking up the bat with bare hands.

Two of the patients released the bat instead of capturing it for testing. One exposed patient did have the bat tested, but after a positive test result they did not get PEP “due to a long-standing fear of vaccines.”

These three incidents brought 2021’s total rabies cases to five after no cases reported in 2019 and 2020, the CDC noted.

“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,” said Ryan Wallace, an expert in the CDC’s Division of High-Consequence Pathogens and Pathology.

The bats involved were the silver-haired bat, Mexican free-tailed bat and big brown bat, which are all considered “common” in the U.S. Bats are the leading cause of rabies in humans in the country.

The CDC recommends that any person with direct contact with bats should call their state or local health department or animal control to help capture the animal for testing. 

The agency then suggests exposed people discuss whether PEP is necessary with a doctor or local public health official. Bat bites or scratches are not always visible, and the disease can spread through its saliva, so receiving PEP can be a “life-or-death matter.”