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Year’s first US human rabies death announced on World Rabies Day

An Illinois man who woke up to find a bat nestled on his neck in mid-August has died of rabies, the Illinois Department of Health announced Tuesday. Cause of death was confirmed by the US Centers for Disease and Control (CDC).

In a bitterly ironic twist, Tuesday was also World Rabies Day, a global day of action and awareness dedicated to rabies prevention. 

Rabies awareness has proved pretty effective in this county: Only one to three cases of rabies are reported in humans in the US each year, according to the CDC. But once clinical symptoms appear, the disease is almost always fatal. The victim in Illinois—the state’s first case since 1954—began experiencing clinical symptoms such as neck pain, headache, finger numbness, and difficulty speaking, four weeks after the incident. The bat was captured and tested positive for rabies. Although the man was advised that he needed to start post-exposure rabies treatment immediately, he declined.

While actual cases of human rabies in the US are rare, rabies exposures are common and an estimated 60,000 Americans receive the post-exposure vaccination series each year.

The rest of the world is not so lucky.

Every year, nearly 60,000 people die of rabies around the world. Globally, the rabies virus is most commonly transmitted to humans via animal bites, and more than 99% of those deaths are due to bites from domestic dogs.

Today the US is considered free of canine rabies. 

A country is defined as free of dog rabies if no indigenously acquired dog-mediated rabies cases have been confirmed in humans, dogs, or any other animal species for at least two years. Western Europe, Canada, Japan, and some Latin American countries are also considered canine rabies-free.

But all countries are still at risk of canine rabies due to the importation of dogs who carry the virus. Just last summer, the CDC temporarily suspended the importation of dogs from more than 100 countries classified as high risk for canine rabies (the agency estimates that 6% of all dogs imported into the US arrive from countries at high risk for canine rabies).

Fortunately, no one has died as result of those importations.

It’s been more than four decades since the US recorded a human rabies death due to a dog bite—that was a 7-year-old girl who died after she was bitten by a rabid dog in Texas in 1979. And that was a decade after the next most-recent case—a 13-year-old boy who died after getting bitten by a rabid dog in Kansas.

Veterinarians have played a crucial role.

Following a massive campaign to vaccinate dogs starting in 1947, rabies deaths in the US linked to dog bites and scratches plummeted in the US. And since the watershed year of 1960, most rabies deaths have come from exposure to wild animals such as skunks, raccoons, and especially bats, which account for around 70% of US rabies deaths since 1960.

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