Western First: Man Was Bit by Rabid Bat, Treated, Died Anyway

Experts describe 'extremely rare' case in man with 'unrecognized immune deficiency'
By Arden Dier,  Newser Staff
Posted Apr 4, 2023 10:38 AM CDT
In a First, Man Received Rabies Treatment, Died Anyway
A man receives a vaccination.   (Getty Images/Drazen Zigic)

A Minnesota man has the awful distinction of becoming the first person given post-exposure treatment for rabies to die regardless, at least in the Western Hemisphere. An article published Wednesday in Clinical Infectious Diseases describes "the first reported infection of rabies virus in a person who received timely and appropriate treatment to prevent rabies infection following exposure since the development of modern rabies vaccines," lead author and CDC epidemiology field officer Stacy Holzbauer tells Fox News. The Daily Mail notes the case represents the first failure of treatment in the Western Hemisphere. It centers on a 84-year-old man who awoke one morning in January 2021 to find a bat biting his right hand.

He washed his hand, then captured the bat, which tested positive for rabies. "The patient immediately sought and was administered appropriate care, which included rabies post-exposure prophylaxis" or PEP, involving a series of vaccinations and human rabies immunoglobulin injections, according to the report. About five months later, he experienced severe pain on the right side of his face. That progressed to numbness in his face and right hand, accompanied by nausea, vomiting, and difficulty swallowing. He was hospitalized but ultimately died within 15 days of the first symptoms.

The 84-year-old had coronary heart disease, controlled type 2 diabetes, hypertension, hyperlipidemia, chronic kidney disease, and an enlarged prostate. But he also had monoclonal gammopathy of undetermined significance (MGUS)—"an unrecognized immune deficiency that probably contributed to the failure," Dr. Aaron Glatt, chief of infectious diseases at Long Island's Mount Sinai South Nassau Hospital, tells Fox. Holzbauer hopes to calm fears, noting the death "represents an extremely rare event and does not challenge the high efficacy or safety profile of rabies [PEP]." According to Fox, an average of 2.5 people died from rabies in the US each year from 2000 to 2021, but none received PEP before symptoms appeared. (More rabies stories.)

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