A man in Minnesota died of rabies after waking up in the middle of the night to a bat biting his hand.
The unnamed man, who was 84 years old, died in 2021 from rabies, six months after he was bitten by the bat, according to a new study published by the Clinical Infectious Diseases. The medical journal went on to look at the man’s health history, noting that he was first bitten by the bat on 27 July 2020.
There was no visible wound on his hand, so he went on to wash it with soap and water that night. However, the bat was tested on 30 July 2020 by researchers, who discovered that the animal was positive for rabies.
Rabies is “a deadly virus spread to people from the saliva of infected animals,” which is “usually transmitted through a bite,” according to the Mayo Clinic.
According to the study published in the journal, the man was not previously vaccinated for rabies before getting the bite. However, following the bat’s positive test for rabies, the patient received post-exposure prophylaxis (PEP) rabies treatment, which consists of antibody injections. His wife also received PEP treatments for possible exposure to rabies, since she was sleeping next to him when he got bitten.
In addition to the initial PEP treatment, the man also received three additional doses of rabies vaccine, the study reports.
On 7 January 2021, five months after being exposed to rabies and the PEP administration, the man “developed right-sided facial paroxysms of severe pain with excessive right eye lacrimation”.
His symptoms continued to worsen and he was hospitalised on 14 January. Some of his symptoms included “worsening facial pain,” “generalised weakness”, and “night sweats”. He developed a fever on 16 January, which continued until his death, and was intubated due to “inability to protect his airway”.
The patient died on 22 January 2021, 15 days after his symptoms started. That same day, the Centers for Disease Control and Prevention (CDC) confirmed that he had a rabies infection. The death marked the “first reported failure of rabies PEP using modern cell-culture vaccine in the Western Hemisphere in a patient who received PEP promptly after a confirmed exposure,” the study said.
The researchers suggested that the reason why the PEP administration failed after the man received the bite could be due to age and underlying conditions, with the study noting that he had coronary artery disease, Type II diabetes, and chronic kidney disease. They further suggested that the patient’s “immune dysfunction” was most likely the explanation for why he died.
According to the CDC, approximately 5,000 animal rabies cases in the US are reported annually to the medical agency, with more than “90 per cent of those cases occurring in wildlife”.
Along with bats, “the principal rabies reservoir hosts” in the country include raccoons, skunks, and foxes. The agency also noted that the number of deaths due to rabies have declined throughout the last century, “from more than 100 annually in the early 1900s to just one or two per year since 1960”. The CDC said that this decline could be attributed to different medical resources, such as the “availability of post-exposure prophylaxis for rabies”.
However, in 2021, five Americans died of rabies, which was the largest number of deaths due to the virus in a decade. In January 2022, the CDC said that some of the people who died didn’t realise that they’d been infected.
Officials also noted that some of these individuals were not vaccinated, such as an 80-year-old Illinois man, who refused to take the rabies shots because of a longstanding fear of vaccines. An Idaho man and a Texas boy did not get shots because of a belief that no bat bite or scratch broke their skin.
Along with the man who died in Minnesota in 2021, another person was bitten by a rabid dog while travelling in the Philippines and died in New York after returning to the U.S.
