An 11-year-old Canadian boy has died from rabies after being awoken by a bat on his nose and mouth.

The incident took place while the child was on a visit to a cottage in Ontario with his family in 2024, according to a report in the Canadian Medical Association Journal published on Monday.

The boy, who was not named in the report, swatted the bat off his face, after which his father caught the winged mammal in a pot and released it outside.

The boy's parents did not immediately seek medical attention due to their son not having any visible injuries and not thinking the bat behaved erratically, the journal states. But 19 days later, the boy began experiencing numbness and swelling on his face.

The Canadian Medical Association Journal chronicled his family taking him to get emergency care over the following days and both clinics and hospital doctors trying to diagnose his symptoms.

At first, an emergency clinic prescribed the boy antiviral medication used to treat infections caused by herpes viruses as they presumed he might have Bell's palsy, the temporary paralysis of facial muscles on one side of the face.

Then he went to hospital on back-to-back visits, first getting a presumed diagnosis of herpes gingivostomatitis, a viral infection of the mouth and gums, then returning the following day after the right side of his face went weak, the journal states.

While awaiting to be admitted, he developed a fever of 39C (102F), along with difficulty swallowing, confusion and visual hallucinations. His condition rapidly worsened that day. He was intubated and admitted to the paediatric intensive care unit, the journal notes.

Doctors at the University of Manitoba, Canada's Department of Pediatrics and Child Health said they strongly suspected rabies.

Days later, a test confirmed that was the case. The Canadian Food Inspection Agency also identified a bat rabies virus variant.

The boy died 17 days after being admitted to hospital.

He had no history of allergies, sick contacts, tick bites, or recent travel outside the country.

Rabies infections are rare in Canada. There have been 28 human deaths due to rabies in the country since 1924, according to the Canadian Veterinary Medical Association.

"This low rate of rabies is due to widespread, ongoing vaccination programs, and failure to continue these programs can and will result in a return of disease," the association states on its website.

Any direct human contact with a bat is an indication for rabies postexposure prophylaxi - medical treatment given immediately after potential exposure to a rabid animal.

Infection is almost always fatal once symptoms develop, the report states. (BBC)

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