A South Carolina woman has been identified as the first case of human rabies in the state in the past 50 years. Very little information has been released, including whether or not she is still alive. Unfortunately, the odds are quite low that she survived. Successful treatment of a Wisconsin girl in 2004 using a radical new protocol was accompanied by much optimism for treatment of this disease, which at the time was described as invariably fatal. While a few other survivors have been reported, rabies is now often referred to as almost invariably fatal, since the protocol has not been the panacea that it was hoped to be, and death is still the typical outcome.

In the latest case, exposure to a bat in the home a few months earlier was the suspected source of infection. This is a common source of exposure and a typical time frame. Few details are presented, so it’s not clear whether the woman was known to have been bitten by the bat or whether that’s suspected for some other reason (such as lack of other possible sources).

This is another indication of the care that needs to be taken around bats. While human rabies is fortunately very rare in Canada and the US (it causes tens of thousands of deaths each year worldwide, mainly from dogs in a few developing countries), bats are an important source of exposure. Any encounter with a bat needs to be accompanied by a determination of whether there is a risk of rabies exposure. Anyone bitten by a bat should try to make sure the bat is caught and tested for rabies, because otherwise there’s no way to prove it wasn’t rabid, and post-exposure treatment would be indicated.

Image: Bat bites can be very dangerous, because they carry the risk of rabies transmission, but they can be so small that they may not even be detected. (Image source: http://agrilife.org/batsinschools/responding-to-a-bat-bite/)