Top 5 Takeaways

1. Increase in Rabies Deaths: Three human rabies deaths occurred in the U.S. in fall 2021, all linked to bat exposures and lack of postexposure prophylaxis (PEP).
2. Symptoms and Progression: Initial symptoms included pain and paresthesia near the exposure site, progressing to severe neurological symptoms and death within weeks.
3. Species Involved: The deaths were associated with three bat species: silver-haired bat, Mexican free-tailed bat, and big brown bat.
4. Preventive Measures: Avoiding contact with bats, capturing and testing bats involved in human exposures, and seeking PEP can prevent rabies transmission.
5. Importance of Testing: Timely testing of bats for rabies can save lives by ensuring those at risk receive PEP and reducing unnecessary PEP administration.

Original Article Author and Citation

Corresponding Author

Amber Kunkel, akunkel@cdc.gov

Suggested Citation

Kunkel A, Minhaj FS, Whitehill F, et al. Notes from the Field: Three Human Rabies Deaths Attributed to Bat Exposures — United States, August 2021. MMWR Morb Mortal Wkly Rep 2022;71:31–32. DOI: http://dx.doi.org/10.15585/mmwr.mm7101a5

Summary

During September 28–November 10, 2021, CDC confirmed three human rabies deaths in the United States, all linked to bat exposures in August 2021. The victims, two adults and one child, did not seek PEP after their exposures. Initial symptoms included pain and paresthesia near the exposure site, progressing to severe neurological symptoms and death within weeks. The deaths were associated with three bat species common in the U.S. Preventive measures include avoiding contact with bats, capturing and testing bats involved in human exposures, and seeking PEP when necessary.

Methods

Case and contact investigations were led by state and local health departments, with all human laboratory testing conducted at CDC. The investigations included identifying the bat species involved and confirming rabies through laboratory testing.

Discussion

The increase in bat-associated human rabies deaths highlights the importance of public awareness and preventive measures. Rabies is nearly always fatal once symptoms develop but can be prevented with timely PEP. The cases underscore the need for rapid evaluation and testing of bats involved in human exposures and the importance of public education on the risks associated with bat contact.

Conclusion

Rabies transmission from bats to humans can be prevented through public awareness, avoiding bat contact, and timely PEP administration. Testing bats involved in human exposures is crucial for determining the need for PEP and preventing unnecessary treatments. Public health efforts should focus on educating the public about the risks and preventive measures associated with bat exposures.

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