Abstract
Most human rabies deaths in the United States can be attributed to unrecognized exposures to rabies viruses associated with bats, particularly those associated with two infrequently encountered bat species (Lasionycteris noctivagans and Pipistrellus subflavus). These human rabies cases tend to cluster in the southeastern and northwestern United States. In these regions, most rabies deaths associated with bats in nonhuman terrestrial mammals are also associated with virus variants specific to these two bat species rather than more common bat species; outside of these regions, more common bat rabies viruses contribute to most transmissions. The preponderance of rabies deaths connected with the two uncommon L. noctivagans and P. subflavus bat rabies viruses is best explained by their evolution of increased viral infectivity.
Highlights
Most human rabies deaths in the United States can be attributed to unrecognized exposures to rabies viruses associated with bats, those associated with two infrequently encountered bat species (Lasionycteris noctivagans and Pipistrellus subflavus)
In contrast to the patterns seen in humans (Figures 1 and 2A), a wide variety of bat rabies variants are implicated in the terrestrial mammal cases across a broad geographic area and largely correspond to the most common bat rabies virus variants in that geographic region (Figures 1 and 2B)
L. noctivagans and P. subflavus variants account for a substantially larger percentage of transmission events to terrestrial mammals than expected, given the rarity of the host bat species and L. noctivagans and P. subflavus variants in those geographic areas (Figure 2C)
Summary
Most human rabies deaths in the United States can be attributed to unrecognized exposures to rabies viruses associated with bats, those associated with two infrequently encountered bat species (Lasionycteris noctivagans and Pipistrellus subflavus). Particular attention has focused upon two relatively rare bat species (Lasionycteris noctivagans and Pipistrellus subflavus) because rabies variants associated with these species account for approximately 70% of human cases and 75% of cryptic rabies deaths [2,3,4,5,6].
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