An 11-year-old male in Ontario, Canada, has deceased due to a rabies infection following direct contact with a bat.

加拿大安大略省一名 11 歲男孩因與蝙蝠直接接觸，感染狂犬病而死亡。

The clinical progression commenced nineteen days post-exposure, during which the patient had encountered a bat while asleep at a northern Ontario cottage in 2024. Despite the absence of visible cutaneous lesions and the lack of erratic animal behavior, the virus was transmitted. Initial medical consultations resulted in misdiagnoses of Bell's palsy and herpes gingivostomatitis, attributed to the presentation of facial numbness and swelling. Subsequent neurological deterioration—characterized by visual hallucinations, confusion, and the loss of brainstem reflexes—necessitated admission to a Pediatric Intensive Care Unit. Laboratory analysis and the Canadian Food Inspection Agency confirmed a bat rabies virus variant.

臨床進展在接觸 19 天後開始，該患者於 2024 年在安大略省北部的一棟度假小屋睡眠時接觸到蝙蝠。儘管沒有明顯的皮膚病變且動物行為正常，病毒仍完成了傳播。最初的醫療諮詢由於患者出現面部麻痺與腫脹，導致被誤診為貝爾面癱（Bell's palsy）及疱疹性齦口炎。隨後的神經系統惡化——以視覺幻覺、意識混亂及腦幹反射喪失為特徵——使其必須入住兒童加護病房。實驗室分析與加拿大食品檢查局證實，為一種蝙蝠狂犬病毒變異株。

Historically, this incident represents the first locally acquired human rabies case in Ontario since 1967, contributing to a total of 28 documented cases in Canada since 1924. While domestic animal vaccinations have mitigated canine-mediated transmission, chiropteran species remain the primary vector in North America. The medical literature emphasizes that the diminutive nature of bat dentition often renders bite marks imperceptible. Consequently, the administration of post-exposure prophylaxis (PEP), comprising a vaccine and human rabies immune globulin, is indicated for any direct contact. Should symptomatic manifestation occur, the prognosis is near-universally fatal, as evidenced by the withdrawal of life-sustaining therapies on the seventeenth day of the patient's hospitalization.

從歷史上看，此事件是安大略省自 1967 年以來首例本地感染的人類狂犬病病例，使得加拿大自 1924 年以來記錄在案的病例總數達到 28 例。雖然家畜疫苗接種減少了由犬類介導的傳播，但蝙蝠物種仍是北美洲的主要媒介。醫學文獻強調，由於蝙蝠牙齒極小，咬傷痕跡往往难以察覺。因此，對於任何直接接觸，均建議進行暴露後預防（PEP），包括接種疫苗和人類狂犬病免疫球蛋白。一旦出現症狀，預後幾乎均為致命，正如該患者住院第 17 天撤除維持生命治療的情況所示。

The patient died after the onset of clinical symptoms, underscoring the necessity of immediate PEP regardless of visible injury.

患者在臨床症狀出現後死亡，凸顯了無論是否有明顯傷口，立即進行 PEP 的必要性。