Rabies risk: What to know about disease after child’s death

An Ontario child died last month after coming into contact with a rabid bat in their bedroom, which was the first known human rabies case in Canada since 2019.

Officials warn that bats across the country pose a risk, while the deadly disease is also present in certain populations of skunks, raccoons and foxes.

“Rabies has been around for a long time and it’s going to be around for a long time,” infectious animal disease expert J. Scott Weesetold CTVNews.ca. “It’s present in various wildlife species in Canada, and we’re not going to eliminate that. So it’s just a matter of being aware of the risk and what to do.”

Weese is a professor and chief of infection control at the University of Guelph’s Ontario Veterinary College. He says although human rabies cases remain very rare in Canada, without quick medical intervention the disease is “invariably fatal.”

“We’ve got good ways to control rabies, we have excellent ways to prevent it after exposure,” he said. “It’s usually just a lack of recognition: someone has an encounter with a wild animal, doesn’t realize it might be rabies, so they don’t seek out the help that would prevent disease.”

Here’s what you need to know about rabies:

How is rabies spread?

Infected animals spread the rabies virus through their saliva, most often with a bite. In the case of the Ontario child, the parents didn’t see any signs of bites or scratches after finding the bat and so they didn’t seek immediate medical help.

“If it’s a larger animal and a larger bite, people pay attention to the bite because it’s big and it hurts and you can tell there’s something there,” Weese explained. “With a bat bite they’re really small or you don’t even notice them … and you can’t always find a bat bite very easily too, because their teeth are really small.”

How dangerous is rabies?

The recent death in Ontario was the province’s first domestic human rabies case since 1967 and only the 28th case recorded in Canada in the past century. All were fatal. The five most recent cases since 2000 have occurred in Ontario, British Columbia, Alberta and Quebec.

“Odds of recovery once you develop signs of rabies are really low,” Weese said. “Rabies is one of the worst diseases you can get of any sort, because you’re almost always going to die.”

An estimated 59,000 people die from rabies worldwide every year, with 95 per cent of cases occurring in Africa and Asia. Approximately 99 per cent of all human cases start with a bite from an infected dog. Dog rabies is not present in Canada.

What animals carry rabies?

Every Canadian case since 1967 has involved bats, which are the most widely distributed species with rabies in Canada.

The disease has also been found in skunks in Saskatchewan, Manitoba and Ontario; raccoons in Ontario, Quebec and New Brunswick; and foxes in Nunavut, Northwest Territories and the northern parts of Quebec, Manitobaand Labrador.

Weese says the disease has been detected in Ontario foxes too, while raccoon rabies in Canada is mostly confined to the province’s St. Catharines area. Because of bats, however, risks remain throughout the country.

“A raccoon can still get rabies from a bat,” Weese added. “The other thing with raccoons is there’s a lot of raccoon rabies in the U.S. and it can always sneak back in.”

Weese’s overall message to Canadians is simple: don’t touch wildlife.

“Wildlife is fun to watch,” he said. “And there’s a lot of temptation to try to feed them or help them or touch them, and it’s just bad for them and it’s bad for us.”

How is rabies exposure treated?

Acting fast is key to survival, Weese says, and that involves contacting your local public health officials as soon as you’ve been bitten, scratched or exposed to a potentially infected animal.

Treatment typically starts with antibodies to neutralize potential virus, followed by a series of four vaccines over two weeks delivered in the arm. This must be done before symptoms appear, which can range from days to months. Early symptoms like fever and headaches can lead to others like seizures and hallucinations before death.

“The treatment is very effective and it’s very straightforward, and I’ve been there with my family,” Weese said. “We had a rabies exposure in our house years ago. So all of us, kids, we went through post-exposure prophylaxis and it’s straightforward.”

Are pets also at risk?

Rabies vaccines are required for dogs and cats in Ontario, and largely part of routine vaccinations for pets in other parts of Canada. If your pet has come into close contact with a potentially infected animal, you should contact a veterinarian for a rabies vaccine booster.

“We try to boost their immunity and then they might get an observation or a quarantine period, depending on their vaccination status,” Weese said. “That’s another reason we want dogs and cats vaccinated, because if they do have an exposure, if they’re properly vaccinated and they get a booster, their quarantine period is pretty minimal and pretty easy. If they’re unvaccinated then they can have a long quarantine.”