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Human Rabies Deaths - Minnesota and California, 2024
Abstract:
Rabies is an enzootic viral disease in the continental United States and is typically transmitted through the bite of an infected mammal. Infection is almost always fatal if rabies postexposure prophylaxis (PEP) is not received before the onset of symptoms. Bats are the leading source of U.S. human rabies cases. In 2024, CDC identified two U.S. human rabies deaths in September (Minnesota) and November (California) in persons who had a recognized bat encounter but might not have been aware of the potential rabies risk. Neither patient reported the bat encounter to public health officials nor sought medical attention, including PEP, before symptom onset. Health officials conducted risk assessments among 384 persons in Minnesota, North Dakota, and California who had possible contact with either the bats that were presumed to have rabies or the patients while they were infectious; 45 (12%) of these persons were recommended to receive PEP. Bat bites often result in trivialized or inapparent wounds. Anyone with a possible bat exposure, even in the absence of a recognized bite, should immediately report the encounter to a health care provider or to public health officials for risk assessment, consideration of options for bat testing, and PEP administration, if indicated. Increased awareness of the potential risk for rabies after any bat interaction, even without a visible bite wound, might help prevent deaths.
Insights
Rabies is a fatal viral disease transmitted by mammals, with bats being the leading source in the U.S. Increased awareness of bat interactions, even without bites, is crucial for preventing rabies deaths.
Area of Science:
- Veterinary Medicine
- Infectious Diseases
- Public Health
Background:
- Rabies is a fatal zoonotic viral disease endemic in the continental U.S.
- Transmission typically occurs via infected mammal bites, with bats being the primary source of U.S. human cases.
- Postexposure prophylaxis (PEP) is nearly always effective if administered before symptom onset.
Purpose of the Study:
- To highlight the critical need for increased awareness of rabies risk following bat encounters.
- To emphasize prompt reporting of all potential bat exposures for risk assessment and PEP administration.
- To prevent rabies-related fatalities by addressing underreported bat exposures.
Main Methods:
- Review of recent U.S. human rabies cases linked to bat encounters.
- Analysis of public health risk assessments and PEP recommendations for individuals with potential bat exposure.
- Evaluation of awareness regarding rabies transmission from bats, even without apparent bites.
Main Results:
- Two fatal U.S. human rabies cases in 2024 were linked to unrecognized bat exposures.
- Of 384 individuals assessed after potential contact with rabid bats or infectious patients, 45 (12%) were recommended PEP.
- Bat bites can be minor or unnoticed, leading to underreporting of exposures.
Conclusions:
- Any potential bat exposure warrants immediate reporting for risk assessment and potential PEP.
- Public health messaging must emphasize rabies risk from all bat interactions, not just bites.
- Enhanced awareness and prompt medical attention are vital to prevent rabies deaths in the U.S.
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