Notes From the Field: Three Human Rabies Deaths Attributed to Bat Exposures — U.S. August 2021

Details

• Journal Article:
  MMWR Morb Mortal Wkly Rep
• Personal Author:
  Kunkel, Amber ; Minhaj, Faisal S. ; Whitehill, Florence ; Austin, Connie ; Hahn, Christine ; Kieffer, Amanda J. ; Mendez, Leila ; Miller, Jael ; Tengelsen, Leslie A. ; Gigante, Crystal M. ; Orciari, Lillian A. ; Rao, Agam K. ; Wallace, Ryan M.
• Description:
  During September 28–November 10, 2021, CDC confirmed three human rabies deaths in the U.S. all in persons who did not seek postexposure prophylaxis (PEP) after bat exposures that occurred during August 2021. This increase in bat-associated human rabies deaths in the U.S. followed only three deaths during the previous 48 months. The cases during fall 2021 occurred in two adults and one child, all male, from Idaho, Illinois, and Texas. Initial symptoms included pain and paresthesia near the site of exposure progressing to dysphagia, altered mental status, paralysis, seizure-like activity, and autonomic instability. All three patients had recognized direct contact (e.g., bite or collision) with a bat approximately 3–7 weeks before symptom onset and died approximately 2–3 weeks after symptom onset. The deaths were associated with three bat species: Lasionycteris noctivagans (silver-haired bat), Tadarida brasiliensis (Mexican free-tailed bat), and Eptesicus fuscus (big brown bat) (Figure). All three species are common in the U.S. and have been implicated in previous rabies cases. One patient submitted the bat responsible for exposure for tTesting but refused PEP, despite the bat tTesting positive for rabies Virus, due to a long-standing fear of vaccines. 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. Case and contact investigations were led by the appropriate state and local health departments, and all human laboratory tTesting occurred at CDC. This activity was reviewed by CDC and conducted consistent with applicable federal law and CDC policy.
• Subjects:
  Chiroptera Notes From The Field Rabies/Epidemiology Rabies/Mortality
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2022; v. 71, no. 1
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  http://dx.doi.org/10.15585/MMWRmm7101a5
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Pubmed ID:
  34990442
• Pubmed Central ID:
  PMC8735561
• Document Type:
  Journal Article
• Place as Subject:
  Idaho ; Illinois ; Texas ; U.S.
• Pages in Document:
  p. 31-32
• Volume:
  71
• Issue:
  1
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:71d3d632442e6d3c8413eb09f42b9a54bd01619b4a53aabcbf96bdad02e9a88025d41087f91eb6ab1a8f71614c56e8fe4f96007ac1d9ebfc32b1a6be3bcce108
• Download URL:
  https://stacks.cdc.gov/view/cdc/113675/cdc_113675_DS1.pdf
• File Type:
  [PDF - 229.51 KB ]