An 11-year-old boy in Canada has died from rabies after waking during a family holiday to find a bat resting on his nose and mouth — a case that doctors say was almost certainly preventable and highlights dangerous gaps in public awareness about the disease. The incident occurred at a cottage in northern Ontario in 2024, and details have now been published in the Canadian Medical Association Journal.

The boy swatted the bat away and his father caught it in a pot and released it outside. Because their son showed no visible bites or scratches, and because the bat had not appeared to behave unusually, his parents did not seek medical attention. Nineteen days later, the boy developed tingling, numbness and swelling on the right side of his face. He was initially seen at an urgent care clinic, where Bell's palsy — a temporary paralysis of facial muscles — was suspected, and antiviral medication was prescribed. On subsequent hospital visits, he was diagnosed with herpes gingivostomatitis, a viral mouth infection, before his condition deteriorated sharply. He developed a fever of 39°C, difficulty swallowing, confusion, visual hallucinations and hypersalivation, and was intubated and admitted to a paediatric intensive care unit. Doctors strongly suspected rabies given the bat exposure and his neurological symptoms; tests confirmed the diagnosis on his fourth day in hospital. He died 17 days after admission, with his family at his bedside.

Rabies is exceedingly rare in Canada — only 28 human deaths have been recorded since 1924, and the last confirmed case in Ontario dated to 1967. The virus is spread through the saliva of infected animals, typically entering the body via bites, scratches, or contact with mucous membranes such as the eyes, nose or mouth. Bats are the primary reservoir of rabies in North America, though skunks, raccoons and foxes also carry the disease. The authors of the journal report stressed that bat bites and scratches are often so small they go unnoticed, and that the absence of erratic behaviour in a bat does not rule out infection.

Once rabies symptoms appear, the disease is almost always fatal and there is no effective treatment. However, rabies post-exposure prophylaxis (PEP) — a series of preventive treatments administered after a potential exposure — is nearly always effective if given promptly, with documented success across an estimated 29 million cases worldwide. Medical guidelines recommend that any direct contact between a human and a bat be treated as an indication for PEP, regardless of whether a bite or scratch is visible. "Early recognition of exposure and timely PEP remain the only effective means of rabies prevention," the journal's authors wrote. The case has prompted renewed calls for public education campaigns so that families understand the risk posed even by brief, seemingly harmless encounters with bats.