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Published Date: 2012-05-12 13:54:10
Subject: PRO/AH/EDR> Rabies - Peru: (CS), vampire bat, human
Archive Number: 20120512.1131075

RABIES - PERU: (CUSCO), VAMPIRE BAT, HUMAN
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Date: Thu 8 May 2012
Source: La Voz [in Spanish, trans. Mod.TY, edited]
http://www.diariolavozdehuamanga.com/noticias/local/2592-nina-muere-con-rabia-humana-tras-ser-mordida-por-murcielago.html

After a week of being interned in the intensive care unit [ICU], a 12 year old girl from the Nuevo Progreso community, in Kimbiri-La Convencion (Cusco), VRAE area, died after being infected with sylvatic rabies [virus] due to a bat bite.

The victim arrived at the Ayacucho Regional [Hospital] around 10:00 at night, referred from this forested area, where she was diagnosed with kidney failure and neurological problems. After a week of being interned in the ICU she died. After her death, samples of brain tissue were sent to the National Institute of Health where human rabies was confirmed.

She developed the disease because she was bitten [by a bat] and the case was not reported in time. Because of this [the delay], health care providers could not initiate vaccination.

According to the head of the Regional Health Office, Dr. David Gordillo Inostroza, he stated preventive actions to control these kinds of cases have been put into action. "The DIRESA [regional health directorate] has taken this theme to initiate promotive preventive action. We have instructed the populace that when there is a bat bite they must report it. In this community, there is a high percentage of similar cases, but due to unawareness or fear, they do not go to health units, because before a case begins to develop symptoms a vaccination regimen must be initiated; if the disease develops, nobody is saved," he stated.

Also, he stated that barriers, such as bed nets, should be used to avoid bat bites. In suspected cases [of exposure], one must begin vaccination with an 8 day regimen.

Gordillo Inostroza stated that as part of control to avoid human infections, followup of suspected cases in livestock be carried out. Chungui, Anco, Santa Rosa and Chilcas are basically the places where positive cases have occurred.

"Followup is being done in case she [the girl] has infected other people with her saliva, [and] because 26 people in this community were also found to have had this type of bite [from a bat]," he said.

[Byline: Jesus Fernando Cruz Chumbe]

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[The risk of rabies virus transmission from the girls to other people in contact with the patient is extremely low to non-existent. The USA CDC states, "In addition to transmission from cornea and organ transplants, bite and non-bite exposures inflicted by infected humans could theoretically transmit rabies, but no such cases have been documented. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, feces) does not constitute an exposure and does not require postexposure prophylaxis." (http://www.cdc.gov/rabies/exposure/index.html).

The child was reported to have "sylvatic" rabies, acquired from bats. The bat involved was no doubt the vampire bat, _Desmodus rotundus_. Rabies, transmitted by the bite of infected bats or dogs, caused the deaths of at least 20 people in 2011 in Peru. Within the past 2 years, there have been several reports of vampire bat (_Desmodus rotundus_) transmitted rabies to people and livestock living in the Peruvian Amazon.

An image of _Desmodus rotundus_ can be accessed at http://www.animalpicturesarchive.com/WebImg/335/1208760244-t.jpg.

Maps of Peru showing the location of Ayacucho province can be accessed at http://www.lib.utexas.edu/maps/americas/peru_pol91.jpg and at the HealthMap/ProMED-mail interactive map http://healthmap.org/r/2lQ8. - Mod.TY]

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