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I don't think this is a biting fetish or cannibalism.
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I think it's a virus,
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and the biting is merely a means of transmission.
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What kind of virus?
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There are several possibilities. Creutzfeldt-jakob disease,
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tick-borne encephalitis, but the most likely culprit is rabies,
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and that wouldn't show up in an autopsy except in brain tissue.
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So since Lewis was the only victim not bitten by a human,
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the unsub must have used an animal to infect him first.
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And after that, he somehow facilitated human to human transmission.
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That would explain the random victimology.
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It doesn't matter who he infects.