CDC raises awareness of the risks of rabies from bats in the U.S.

Reviewed by Emily Henderson, B.Sc.Jan 6 2022

The Centers for Disease Control and Prevention (CDC) is raising awareness of the risks of rabies from bats in the U.S. after three people, including one child, died from rabies between late September and early November 2021. The three cases, described in the January 6, 2022, Morbidity and Mortality Weekly Report, bring the total number of cases in 2021 to five, compared to no reported rabies cases in people during 2019 and 2020.

Over a five-week period between September 28, and November 3, 2021, three people-; one each in Idaho, Illinois, and Texas-; were confirmed to have rabies after direct contact with bats in or around their homes and died. Two of the bat-associated cases were considered avoidable exposures: one was attributed to a bat roost in the patient's home, the other to the patient picking up the bat with bare hands. Two patients released the bat, rather than capturing it for testing. None of the three individuals received post-exposure prophylaxis (PEP), shots that can prevent rabies from developing if received before symptoms start.

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."

Ryan Wallace, DVM, MPH, veterinarian and rabies expert, CDC's Division of High-Consequence Pathogens and Pathology

Exposure to rabid bats is the leading cause of rabies in humans in the U.S., accounting for 70% of people who become infected. The number of rabid bats reported to the National Rabies Surveillance System has been stable since 2007, which suggests that this uptick in cases of rabies in people may be due to a lack of awareness about of the risks of rabies – and that getting PEP is a life-or-death matter.

Bat bites do not always cause a visible mark yet can still spread rabies virus through infected saliva – so any direct contact with a bat should be assessed by a clinical or public health provider. It typically takes anywhere between three weeks to three months, though sometimes more or less time, for people to develop symptoms if infected. PEP is effective in preventing rabies until symptoms develop. Once symptoms begin, rabies is nearly always fatal.

CDC is urging people to take the following measures to prevent or lessen the risk of infection with rabies:

1. Avoid direct contact with bats.
2. If you do come into contact with a bat OR if someone possibly had contact with a bat, do the following:
   1. Call your state or local health department or animal control to help trap the bat for testing or safely trap the bat yourself. Testing a bat to determine if it is rabid can help to determine whether you need PEP.
   2. 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. 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.

If potentially exposed to a rabid animal, receiving PEP soon after exposure and before symptoms begin is critical. While rabies deaths in people in the United States are not common, CDC estimates that approximately 60,000 people receive PEP each year to prevent becoming ill with rabies. PEP is nearly 100% effective at preventing rabies if received before symptoms start.