After two years with no cases of rabies in the U.S., three people – including one child – in the country died last year from the viral disease, the Centers for Disease Control and Prevention announced Thursday.
Each of the three rabies fatalities were related to direct contact with bats, said the CDC.
Rabies is a potentially fatal but preventable and treatable disease impacting the brain and nervous system that often spreads to people when they are bitten by an infected animal. In the U.S., rabies is mostly found in wild animals like bats, raccoons, skunks, and foxes. Vaccination can prevent the illness in house pets and people.
Exposure to rabid bats is the leading cause of rabies in humans in the U.S., accounting for 70 percent of infections.
If left untreated, rabies symptoms can at first resemble the flu and may progress to: cerebral dysfunction, anxiety, confusion, agitation, delirium, abnormal behavior, hallucinations, fear of water and insomnia. After clinical symptoms disappear, the disease is almost always fatal.
Although rabies deaths in the U.S. are relatively rare, the CDC estimates that approximately 60,000 people received post-exposure prophylaxis (PEP) shots each year to prevent becoming ill with the virus. PEP is close to 100 percent effective at preventing rabies if received before symptoms start.
From Sept. 28 through Nov. 3 of last year, one person each in Idaho, Illinois, and Texas were confirmed to have rabies and later died. All three were males who encountered bats in their homes.
Their deaths were associated with three different bat species common in the U.S.: the silver-haired bat, the Mexican free-tailed bat and the big brown bat.
“Two of the bat-associated cases were considered avoidable exposures,” said the CDC. “One was attributed to a bat roost in the patient’s home, the other to the patient picking up the bat with bare hands.”
None of the three individuals received PEP shots that can prevent rabies from developing if administered before the onset of symptoms, with one actually refusing the shot due to a fear of vaccines. Additionally, two patients released the bats rather than capturing the specimens for testing, which can held determine the need for PEP.
Including these three rabies deaths, there were five overall cases of the virus last year in the U.S. According to CDC data, this is the highest number of annual cases since 2011, when seven cases were reported.
“We have come a long way in the United States towards reducing the number of people who become infected each year with rabies, but this recent spate of cases is a sobering reminder that contact with bats poses a real health risk,” said Ryan Wallace, a veterinarian and rabies expert in CDC’s Division of High-Consequence Pathogens and Pathology.
Since the number of rabid bats reported to the National Rabies Surveillance System has been stable since 2007, the CDC said the uptick in cases may be due to a lack of knowledge about the virus and the life-or-death importance of PEP treatment.
Bat bites do not always leave visible traces and rabies can also spread through saliva, so anyone who has had direct contact with a bat should be assessed by a clinical or public health provider, said the CDC. Other tips for preventing rabies include:
· Avoid direct contact with bats
· If you come in contact with a bat, call your state or local health department or animal control to help trap the bat for testing or safely trap the bat
· If you come in contact with a bat, contact your doctor or a local public health official to assess whether PEP is needed
“These steps are important even if contact with a bat takes place through clothing and bite or scratch marks are not visible,” said the CDC.
“Sometimes it is not clear whether someone may have had contact with a bat, such as when a bat is found in a room with someone who is sleeping or where a child has been left unattended.”
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