- From ProMED-mail
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- Wisconsin - Teenager Diagnosed With Rabies
- 10-21-4
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- (AP) - A teenager has been diagnosed as having a rare
case of human rabies, only the 2nd case in Wisconsin in nearly 50 years,
health officials said on Wed 20 Oct 2004. Only 3 people in the world are
known to have survived after the onset of rabies symptoms, said Jim Kazmierczak,
Wisconsin's state public health veterinarian. Nearly all patients die within
a few weeks of developing symptoms. Kazmierczak said the Fond du Lac County
teen was bitten by a bat in September 2004 but did not seek treatment.
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- Rabies can be prevented with a vaccine after initial
exposure, but health officials can do little for victims once symptoms
set in. The bat bite was "a minor exposure that was deemed as insignificant,"
Kazmierczak said. "It's tragic."
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- Health officials refused to provide the teen's identity
or condition. Kazmierczak said the patient started having symptoms 13 Oct
2004 and was hospitalized 15 Oct 2004. A lab test performed by the Centers
for Disease Control and Prevention in Atlanta confirmed Tuesday the boy
has rabies.
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- Kazmierczak said the earliest symptoms often are tingling
or numbness in the limb or area where there was a bite, followed by a lack
of coordination, agitation, headache, hallucinations and seizures. Eventually,
the patient goes into a coma and dies. The CDC said most people do not
show symptoms of the disease until one to 3 months after being infected
with the virus. The last 2 human rabies cases in Wisconsin were in 2000
and 1959, Kazmierczak said.
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- In Wisconsin, skunks and bats are the most likely animal
species to carry the rabies virus, although dogs, cats, raccoons, foxes
and livestock also have been infected in the past several years, according
to the Department of Health and Family Services.
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- Although human-to-human transmission is rare, state health
officials were working with the Fond du Lac County Health Department and
local health care providers to assess the any possible risks to people
who came in contact with the teenager.
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- The preventive treatment for rabies is a one-time injection
of rabies immune globulin that contains antibodies against the virus, followed
by 5 doses of rabies vaccines injected into the arm in the next 28 days.
[Postexposure prophylaxis is only effective prior to development of symptoms
of infection. - Mod.CP]
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- ProMED-mail
- promed@promedmail.org
-
- [This is indeed a tragic case. This incident indicates
a continuing need to make the general public aware that the majority of
human cases of rabies in the United States are contracted from rabies-infected
bats. These animals only rarely exhibit overt symptoms of infection.
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- The following is an extract from a previous ProMED-mail
post (Rabies, human - USA: MMWR reports 20001218.2215).
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- "In the United States since 1990, 24 (74 percent)
of the 32 cases since 1990 have been attributed to bat-associated variants
of rabies virus, although a history of a bite was established in only 2
cases. Contact with bats occurred in approximately half of the other cases.
These cases represent various bat-contact histories: a bat bite, direct
contact with bats with multiple opportunities to be bitten, and possible
direct contact with a bat. Canine rabies is prevalent in Africa, Asia,
and Latin America. Worldwide estimates of human rabies deaths exceed 50
000 cases each year, and >95 percent of reported cases occur in regions
where canine rabies is endemic.
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- Although rabies is usually transmitted by a bite, persons
may minimize the medical implications of a bat bite. Unlike bites from
larger animals, the trauma of a bat bite is unlikely to warrant seeking
medical care. Unless the potential for rabies exposure is known to the
patient, rabies post-exposure prophylaxis (PEP) will not be received.
Although bat rabies virus variants can be transmitted secondarily from
terrestrial mammals, the lack of other animal-bite histories and the rarity
of bat rabies virus variants found in terrestrial mammals suggest that
this means of transmission is rare.
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- Persons who are bitten or scratched by any animal should
wash wounds thoroughly and seek immediate medical attention to evaluate
the need for PEP. In all cases where bat-human contact has occurred or
is suspected, the bat should be collected and tested for rabies. If the
bat is unavailable, the need for PEP should be assessed by public health
officials. PEP should be considered after direct contact between a human
and a bat, unless the exposed person can be certain a bite, scratch, or
mucous membrane exposure did not occur. PEP may be considered for persons
who were in the same room as a bat and who might be unaware that a bite
or direct contact had occurred (e.g., when a sleeping person wakes to find
a bat in the room or an adult witnesses a bat in the room with an unattended
child, mentally disabled person, or intoxicated person). PEP is not warranted
when direct contact between a human and a bat did not occur. Seeing a
bat or being in the vicinity of bats does not constitute an exposure."
- Mod.CP]
-
-
- Patricia A. Doyle, PhD
- Please visit my "Emerging Diseases" message
board at: http://www.clickitnews.com/ubbthreads/postlist.php?
Cat=&Board=emergingdiseases
- Zhan le Devlesa tai sastimasa
- Go with God and in Good Health
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