11-year-old boy dies of rabies after waking with bat on his face in Ontario
A medical journal has detailed the case of an 11-year-old boy who died from rabies in Ontario, Canada, after a bat landed on his face while he slept. The incident, the first locally acquired human rabies case in the province since 1967, occurred in 2024 but was reported this week.
The incident
During a family holiday in northern Ontario in 2024, an 11-year-old boy woke to find a bat on his face, near his mouth and nose. He brushed it off, and his father caught the animal in a flowerpot and released it outside. The boy had no visible bites or scratches, and the bat did not appear aggressive, so the parents did not seek medical attention.
Delayed symptoms and misdiagnosis
Nineteen days later, the boy developed numbness and swelling on the right side of his face, along with loss of appetite. He was taken to a local emergency clinic, where doctors suspected Bell's palsy and prescribed antiviral medication for herpes viruses. Over the following days, his condition worsened: painful facial swelling, vomiting, gum ulcers, and nerve damage. Despite multiple hospital visits, rabies was not initially considered. At one point, he was diagnosed with herpetic gingivostomatitis, a viral infection of the mouth and gums.
Rapid decline and death
On the fourth day after symptoms began, the boy returned to the emergency department with speech difficulties, a fever of 39°C, trouble swallowing, confusion, and visual hallucinations. He was intubated and admitted to the pediatric intensive care unit the same day. Doctors at the University of Manitoba then suspected rabies, and tests confirmed a bat-variant rabies virus. The boy died 17 days after hospitalization. He had no history of allergies, contact with sick individuals, tick bites, or recent travel abroad.
Rarity and warning
This case is the first locally acquired human rabies in Ontario since 1967. Canada has recorded only 28 rabies deaths since 1924, a low rate attributed to widespread vaccination programs.Rabies is almost invariably fatal once symptoms appear.
Health authorities stress that any direct contact with a bat, even without visible injury, warrants immediate post-exposure prophylaxis.The low incidence of rabies is the result of extensive and ongoing vaccination programs; if vaccination were discontinued, rabies would re-emerge and indeed would re-emerge.
