Canadian boy, 11, dies of rabies after waking to bat on his face

Canadian boy, 11, dies of rabies after waking to bat on his face

An 11-year-old Canadian boy has died from rabies after waking to find a bat covering his nose and mouth during a family cottage visit in northern Ontario in 2024, according to a report published June 29 in the Canadian Medical Association Journal.

The child awoke to the animal on his face and swatted it away. His father subsequently captured the bat in a cooking pot and released it outside. Because the bat did not appear aggressive or sick and the boy had no visible scratches or bite marks, his parents did not seek medical attention.

Nineteen days after the encounter, the boy began experiencing tingling and numbness on the right side of his face, along with facial swelling and a loss of appetite. Four days after these symptoms began, he visited an urgent care clinic. Doctors there prescribed antiviral medication, suspecting the boy had Bell's palsy caused by the herpes virus.

Three days later, the boy was taken to an emergency department in Ontario after developing vomiting and painful swallowing. Medical staff noted ulcers on his gums and mild impairment of the nerve used for chewing and facial sensation. Despite the family informing doctors of the bat encounter and the notification of public health officials, the child was discharged with a presumed diagnosis of herpes gingivostomatitis.

The boy returned to the hospital the following morning. He exhibited slurred speech, reduced sensation, and weakness on the right side of his face. While waiting for admission, his condition deteriorated rapidly. He developed confusion, visual hallucinations, difficulty swallowing, and a fever of 39C (102F).

He was intubated and moved to a paediatric intensive care unit. Doctors from Canada's Department of Pediatrics and Child Health at the University of Manitoba wrote:

"When we saw the patient in the PICU, we strongly suspected rabies."

Doctors, University of Manitoba, via Canadian Medical Association Journal

A PCR test confirmed rabies on the fourth day of his hospital admission, and the Canadian Food Inspection Agency identified a bat rabies virus variant. After more than two weeks of aggressive treatment and supportive care, the boy died on his 17th day in the hospital.

The case is the first locally acquired human rabies instance recorded in Ontario since 1967. Human rabies is rare in Canada, with only 28 human cases reported since 1924, according to the Canadian Veterinary Medical Association and other reports. In the United States, the CDC reports fewer than 10 people die from the disease annually.

Health experts say the tragedy highlights a dangerous misconception regarding bat encounters. Because bat bites can be extremely small, they often go unnoticed. The virus can be transmitted if infected saliva enters an open wound, the nose, the mouth, or the eyes.

Dr. Brian Hummel, a pediatric infectious disease specialist involved in the case, wrote in the report:

"If you get symptomatic rabies infection, it is near universally fatal. But if you get the prevention before symptoms develop, it is near universally successful."

Dr. Brian Hummel, pediatric infectious disease specialist, via Canadian Medical Association Journal

Medical authorities emphasize that any direct contact with a bat should be treated as high risk, regardless of whether the animal shows classic signs of rabies. Post-exposure prophylaxis, including rabies immune globulin and vaccination, can prevent infection if administered before symptoms appear. Once clinical symptoms develop, there is no established effective treatment.

Similar warnings have emerged in the United States following a recent case in Wisconsin. On June 23, a 6-year-old girl in Tigerton received preventive treatment after a bat latched onto her leg while she climbed a tree. The bat tested positive for rabies, allowing doctors to begin vaccinations quickly.

Nick Mau, a health officer with the Shawano-Menominee Counties Health Department, advised the public to maintain distance from wild animals.

"Educate children. We think a lot of animals are really cute, and they are, but just be mindful of approaching any wild animal," Mau said. "Safety first. Just assume that any animal is going to carry disease, and rabies is one of them."

Nick Mau, health officer, via USA Today

The Canadian Veterinary Medical Association attributed the country's historically low rabies rates to widespread vaccination programs, warning that a failure to continue these programs could lead to a return of the disease.