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September 17, 1997

Human Rabies—Montana and Washington, 1997

JAMA. 1997;278(11):889-890. doi:10.1001/jama.1997.03550110027012

ON JANUARY 5 and January 18, 1997, respectively, a man in Montana and a man in Washington died of neurologic illnesses initially suspected to be Creutzfeldt-Jakob disease (CJD) but diagnosed as rabies encephalitis during subsequent histologic examination on autopsy. The cases were not linked epidemiologically, and no secondary cases occurred. Postexposure prophylaxis (PEP) was administered to 113 potential contacts. This report summarizes the clinical presentations of the cases and the epidemiologic investigations by the Montana Department of Public Health and Human Services and the Washington State Department of Health; nucleic acid sequencing indicated that the silver-haired bat (Lasionycteris noctivagans) and the big brown bat (Eptesicus fuscus), respectively, were the probable sources of exposure.

Case 1  On December 20, 1996, family members of a 65-year-old male resident of Blaine County, Montana, observed him experiencing apparent visual hallucinations. This behavior recurred, and he subsequently had slurred speech and complained of diffuse