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A man awoke to a bat on his neck and declined a vaccine. Weeks later, he died of rabies.

Bats congregate in a cave in Queen Elizabeth National Park in Uganda in 2018. (Bonnie Jo Mount/The Washington Post)
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An Illinois resident in his 80s woke up to a bat on his neck in mid-August. The bat tested positive for rabies, but the man declined the rabies vaccine, officials say. He died a month later.

This is the first known case of a human contracting rabies in Illinois since 1954, according to the Illinois Department of Public Health. Only one to three human rabies cases are reported in the United States each year, the Centers for Disease Control and Prevention said. Wildlife experts found a colony of bats living in the man’s home. The state’s health department did not release the name of the deceased or say why he declined the vaccine.

“Sadly, this case underscores the importance of raising public awareness about the risk of rabies exposure in the United States,” Mark Pfister, executive director of the Lake County Health Department, said in a news release.

While human rabies cases are preventable and rare, the disease is more than 99 percent fatal once contracted. Anyone who may have been bitten by a rabid animal should seek treatment immediately, officials advise. Rabies is untreatable once symptoms begin to show.

Most bats are not rabid, but experts say it’s crucial to identify whether any animal you’ve come into contact with has the disease. If a bat or other animal cannot be tested for rabies, it’s safest to get the rabies post-exposure vaccine series.

If treated quickly after a potential exposure with the vaccine series — generally four doses administered in the arm over two weeks — humans are highly unlikely to develop symptoms.

“If you do not get the preventive treatment and you have symptoms of rabies, there isn’t a treatment that’s really been successful at helping people come out of that alive,” said Illinois state public health veterinarian Connie Austin.

Rabies can be spread by being bitten or scraped by an infected animal such as a dog, raccoon, skunk or fox. Most recent human rabies cases in the United States have been traced to bats, according to the CDC.

Although few people actually contract the disease, about 60,000 Americans receive the post-exposure vaccine series each year.

There’s a bat in your house! Here’s what NOT to do.

Austin said avoiding rabies is simple: Keep an eye on the animals you’re coming into contact with and contact your local health department if you think you’ve been exposed.

Rabies is commonly spread through saliva, often via bites. While people generally know when they’ve been bitten by a bat, Austin said the animals’ teeth are small enough that the bites might not always be obvious.

Anyone who wakes up with a bat in their house or finds a bat in a room where another animal or a child has been should get the bat tested for rabies if possible, she said.

You should not handle a bat with your bare hands, Austin said, but placing a box or trash can over the animal is okay.

Once the bat is trapped, call your local animal control department. If it cannot be trapped, Austin said, anyone who could have been bitten or otherwise exposed to rabies should get the vaccine series.

“If it’s either untested or it’s positive, then those are the situations where you’ve got to get that preventive treatment,” she said.

If you do have a bite from a bat or other possibly rabid animal, wash the bite with soap and water and seek immediate medical attention. The same goes if you believe your pet may have been exposed to rabies and isn’t vaccinated against it.

Animals that have rabies tend to be aggressive, Austin said, and could also show symptoms such as fever, excessive drooling, seizures and more. Not all animals with rabies will foam at the mouth, though some will if the disease is in a more advanced stage. Bats infected with rabies might exhibit odd behavior, such as staying awake during the day or being unable to fly.

Foxes keep attacking this 88-year-old, leading him to strangle one with his bare hands

Humans might not experience rabies symptoms for weeks or months after being exposed, and early symptoms may mimic the flu. Rabies attacks the brain and spinal cord and can cause confusion, hallucinations, cerebral dysfunction and other symptoms.

This year, 30 bats have tested positive for rabies in Illinois, according to the state’s public heath department. Illinois tests more than a thousand bats each year after possible exposures, and only about 3 percent have the disease.

Austin said she hopes people who are hesitant about medical treatments such as the rabies vaccine will consider what could happen if they refuse care.

“What people have to remember is the vaccine is going to prevent something worse from happening,” she said. “If you don’t get vaccinated, the outcome can be much worse if you get the disease itself.”

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