Craig was treated for a bat bite. He died eight months later

Health authorities are investigating how a tradie from the NSW North Coast died from a rare bat lyssavirus despite being treated for a bite he received more than eight months ago.

Craig “Zebbo” Nolte, a carpenter in his 50s from Ballina in the Northern Rivers region of NSW, died on July 3 after suffering a “very quick case of lyssavirus”, a rare disease closely related to rabies, his wife, Robyn, confirmed in a social media post on Wednesday.

Nolte said her husband had received a prophylaxis immunoglobulin injection, the only effective post-exposure treatment for both rabies and lyssavirus, after he was bitten by the bat around October.

In a social media post on Wednesday, Robyn Nolte (right) confirmed her husband, Craig, was treated for a bat bite last year.

“NSW Health [is] still grappling in their words to how this happened that the injection didn’t work,” Nolte wrote. “RIP my love my best friend.”

Nolte is the first person in NSW to contract and die from lyssavirus. The disease is transmitted from infected bats to humans when bat saliva containing the virus enters the body through a bite or scratch.

A NSW Health spokesperson confirmed Nolte had received treatment following the injury.

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“An investigation is under way to understand factors which may have played a role in his illness,” they said.

Because the two diseases are closely related, the standard treatment for rabies – one shot of immunoglobulin and at least four doses of vaccines given over several weeks – is also highly effective for treating lyssavirus when symptoms are detected early.

The NSW Health spokesperson said the treatment was safe and has been proven to be highly effective, although there have been rare international cases of rabies fatalities in people who have started pre-exposure prophylaxis treatment.

“These are thoroughly investigated to determine the contributing factors,” they said. “This recent case in NSW is also being looked at by experts.”

In a systematic review of more than 120 fatal breakthrough rabies infections since 1980, published in The Lancet journal in 2023, researchers found treatment that deviated from normal practices in more than half of the deaths.

These included errors in the administration of rabies immunoglobulin, delays in seeking health care and comorbidities or immunosuppression.

The median time from exposure (such as a bite or a scratch) to the onset of symptoms was 20 days. Most of the studied fatalities received treatment within two days of exposure.

Lyssavirus can be found in some Australian bats, including flying foxes, but its prevalence in the total population is very low – less than 0.5 per cent, according to a 2018 study.

Cases in humans are even rarer. There have been three previous cases of bat lyssavirus in humans in Australia since 1996 – all leading to death.

More than 100 people required medical assessment after being bitten or scratched by bats last year.

If you see a bat in distress, injured or trapped on the ground, do not try to rescue it. Instead, contact WIRES on 1300 094 737 or a local wildlife rescue group.

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