Woman's Death from Rabies Highlights 'Missed Opportunity' in Public Health

A black bat flying against moonlit clouds
(Image credit: javarman | shutterstock)

A South Carolina woman who died from rabies she contracted from bats in her home might have been saved if she had been told of rabies risks associated with bats, according to a new report of her case.

The 46-year-old woman, who died in December 2011, was the first person to die from rabies in South Carolina in more than 50 years, according to the report published today (Aug. 15) by the Centers for Disease Control and Prevention (CDC). She had sought information from a local county animal control service on having bats removed from her home, but was not advised of the rabies risks associated with bats.

"Lack of referral to guidance concerning health risks associated with bats living in the home was possibly a missed opportunity to prevent rabies infection," CDC researchers wrote in the report.

Shots of rabies vaccine prevent the infection from taking hold after someone is bitten by an animal carrying the virus. People who have seen bats in their homes are generally advised to seek treatment because bats have small teeth, and bites that occur during sleep can go unnoticed. The vaccine is almost always effective if given before rabies symptoms appear.

The South Carolina woman awoke one summer night to find a bat in her room. She shook the animal out of her curtains, and it flew off through a window, her family later said. [10 Deadly Diseases That Hopped Across Species]

In December, she went to the hospital with shortness of breath, excessive sweating and chills. Her symptoms were similar to those of heart disease, and she had had heart problems in the past, so she was transferred to another hospital to be examined by her cardiologist.

But a few hours after her arrival at the new hospital, she stopped breathing and was transferred to the intensive care unit, where she was put on a ventilator for several days. Her condition worsened, and her organs started to fail.

Five days after she was admitted to the hospital, additional interviews with her family revealed that she had seen bats in her home the previous summer. Her doctors sent samples of her skin and saliva to the CDC to be tested for rabies.

The tests came back positive, but it was too late to administer the vaccine to the woman, who died several days later. The family members, and anyone at the hospital from the ambulance personnel to administrative staff who reported possible contact with the patient were given vaccine shots.

The rabies virus that had infected the woman was a strain found in Mexican free-tailed bats, the CDC investigations showed.

The number of human deaths from rabies in the United States has declined over the past century, to as low as one or two yearly in the 1990s. Bats are responsible for the majority of cases. Since 1995, more than 90 percent of people who got rabies in the United States contracted it from bats. 

The rabies virus infects the central nervous system, and causes inflammation in the brain and, ultimately, death. The early symptoms of rabies in people are fever, headache and general weakness or discomfort, and can be mistakenly attributed to other illnesses.

Therefore, the CDC researchers recommended considering rabies in any progressive encephalitis (inflammation of the brain) that doesn’t have clear cause.

The woman's case "highlights the importance of strong partnerships among public health officials and diverse non–health-care partners," the report said.

People who see bats in or around their homes might reach out to a variety of groups, including animal control, law enforcement or wildlife agencies, and it is important that these entities have strong partnerships and clear communication so that they can appropriately refer people exposed to bats for risk assessment and treatment, the report said. 

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Bahar Gholipour
Staff Writer
Bahar Gholipour is a staff reporter for Live Science covering neuroscience, odd medical cases and all things health. She holds a Master of Science degree in neuroscience from the École Normale Supérieure (ENS) in Paris, and has done graduate-level work in science journalism at the State University of New York at Stony Brook. She has worked as a research assistant at the Laboratoire de Neurosciences Cognitives at ENS.