Randy Hertwig of Monticello swatted at the bat that flew around the cabin porch, and he felt only a pinprick on his hand that day in mid-August. There was no blood, no puncture marks, and he didn't realize that he had been bitten.
Only as Hertwig lay dying last week did his family and physicians realize he had contracted rabies, a neurological virus that's almost always fatal once symptoms begin. Hertwig, a 46-year-old father who loved the outdoors, died Saturday at St. Marys Hospital in Rochester.
He is the fifth person to die of rabies in Minnesota in the past century. Other victims died in 1917, 1964, 1975 and 2000.
"What is most saddening about these deaths is that they could have been prevented with prompt medical attention following exposure," said Ruth Lynfield, state epidemiologist and medical director for infectious diseases at the Minnesota Department of Health.
Each year, two to three people contract rabies in the United States, down from more than 100 each year in the early 1900s, according to the state Health Department.
Bats cause nearly all of the human rabies cases in this country.
Entries by Hertwig's wife, Michele, and son and daughter on the CaringBridge.org website chronicle the way Hertwig's symptoms began a month after the bite went unnoticed as he stacked firewood on a porch.
Four weeks later, in mid-September, a tingling began in his hand where he had been bitten. Soon Hertwig lost his ability to talk or even move, and by mid-October, the longtime machinist lay in a deep coma, beyond reach of even the best medicine.
It's a heartbreaking case, but also, Minnesota health officials said Tuesday, an opportunity to educate the public on how easily a person can contract rabies from a bat or wild animal. The tiny teeth of a bat can scratch or bite without a person even noticing.
"That is one of the big problems with bats, that you can be bitten and not know it," said Joni Sheftel, a state veterinarian for the Minnesota Department of Health. "You can be bitten in your sleep. You can actually have a bat brush up against you and be bitten and not realize that you are bitten."
Experts at the Minnesota Department of Health test brain samples of bats and other animals for rabies. If rabies are detected, anyone who has had contact should have vaccinations immediately. The disease can incubate in a matter of days, or even years.
Sheftel declined to provide any specifics of Hertwig's death because of medical privacy statutes but she did talk in general terms about the frequency of rabies, how to avoid being bitten, and what to do if you may have had a scratch or bite.
"We have some special rules for bats," said Sheftel, who specializes in zoonotic diseases. "The biggest one is that if you wake up and there's a bat in your room, we want you to catch the bat and we will test it for rabies. There's no charge for testing at the state."
The person trying to catch the bat should use thick gloves and a hard container. Bats can bite through sacks and pillowclothes.
"If the bat escapes, or you inadvertently let it out," she said, "then we consider that an exposure and we would recommend rabies [treatment] post-exposure."
People who may have been exposed to the rabies virus can get an injection of rabies immune globulin and five doses of rabies vaccine over a one-month period.
Sheftel said it's important not only to avoid bats or wild animals that might have rabies, but also to immunize pets.
Victim loved the outdoors