ONTARIO — An 11-year-old Canadian boy has died from rabies weeks after he woke up to find a bat resting on his face, according to a newly published medical case report.The unidentified boy was staying with family at a cottage in northern Ontario during the summer of 2024 when he awoke to discover a bat lying across his nose and mouth, according to the report published on Monday in the Canadian Medical Association Journal. He swatted the bat away, and his father captured it before releasing it outside.Because the child had no visible bite marks or scratches and appeared to be unharmed, his family did not seek medical care. About 19 days later, however, he developed facial numbness and persistent vomiting before his condition rapidly worsened.Doctors ultimately diagnosed rabies, the first locally acquired human case reported in Ontario since 1967, according to the report. Despite aggressive treatment, the boy died after more than two weeks in the hospital.The incident took place while the child was on a visit to Ontario with his family in 2024, according to the report.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.The report's authors said the case highlights the importance of seeking immediate medical evaluation after any direct contact with a bat, even if there is no visible bite or scratch. Once rabies symptoms appear, the disease is almost always fatal. However, treatment given soon after exposure can prevent the infection from developing.