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In the first half of 2011, 21 school-age children and two adults died of rabies transmitted by the common vampire bat (Desmodus rotundus) in and around the small rural village of Yupicusa in the Peruvian Amazon (Figure 1) [1]. This is only one of many such outbreaks occurring throughout the greater Amazon Basin (Figure 2), which, despite efforts at increasing education, vaccination, and bat population control, seem to have escalated over the last three decades—a timeline concurrent with major social and ecological changes in the area [2]. The remote and impoverished nature of communities affected by these outbreaks and the unique niche of vampire bats in a changing socioecological landscape create challenges beyond those faced in previous rabies control efforts and require new strategies to address this public health menace through ecosystemlevel intervention. Here we examine this complex system and offer perspectives from a field expedition to Imaza following the 2011 outbreak. Although the distribution of D. rotundus covers most of Latin America (Figure 2), the 2013 World Health Organization (WHO) Expert Consultation on Rabies gives only passing mention to vampire bats, primarily emphasizing the likelihood that infection from this reservoir is underreported. The knowledge gaps highlighted by this comprehensive report allow the perpetuation of untested control strategies and limit effective responses to the reemergence of rabies in countries that have largely eliminated the virus from domestic dog populations [3]. Vampire bats remain a holdout on the global stage of rabies control, the neglected host of an already neglected disease.

Vampire Bats and Rabies: Toward an Ecological Solution to a Public Health Problem