11-Year-Old Canadian Boy Dies of Rabies After Bat Encounter in Ontario

An 11-year-old boy from northern Ontario died of rabies after waking up with a bat on his nose and mouth during a cottage visit, according to a report in the Canadian Medical Association Journal. The child’s father captured the bat in a cooking pot and released it outside; no bite marks were observed and the family did not seek medical care at the time.

Nineteen days later the boy developed facial numbness, swelling and loss of appetite. Initial treatment at an urgent-care clinic targeted presumed Bell’s palsy caused by herpes. After his condition worsened, he was admitted to a hospital where doctors noted gum ulcers and facial nerve impairment. The family disclosed the bat incident, prompting a public-health notification.

The patient was discharged with a diagnosis of herpes gingivostomatitis but returned the next day with facial weakness, slurred speech, fever, difficulty swallowing, confusion and visual hallucinations. He was placed on a ventilator in the pediatric intensive-care unit. "When we saw the patient in the PICU, we strongly suspected rabies," the physicians said. A PCR test confirmed rabies on the fourth day of admission, and the Canadian Food Inspection Agency identified a bat rabies virus variant. The boy died on his 17th day in hospital.

Rabies, a virus that attacks the central nervous system, is almost always fatal once symptoms appear. In Canada, animal cases number in the thousands each year, but human infections are rare, with only 28 reported since 1924. This case is the first locally acquired rabies in Ontario since 1967. Health authorities advise immediate wound cleaning, prompt medical evaluation after animal exposure and timely post-exposure prophylaxis to prevent the disease.