Published Date: 2012-09-21 17:15:57
Subject: PRO/AH/EDR> Rabies - China (03): (ex India) human, exposure unknown
Archive Number: 20120921.1304335
RABIES - CHINA (03): (EX INDIA) HUMAN, EXPOSURE UNKNOWN
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 21 Sep 2012
Source: Ynetnews.com Israel News [edited]
Israeli dies of rabies in China
A 34-year-old Israeli died at a hospital this week, apparently of rabies, Yedioth Ahronoth [The Times of Israel] reported on Friday [21 Sep 2012]. According to this report, the Israeli, who recently arrived in China after travelling [in] India, contacted an Israeli businessman a few days ago and told him he was feeling ill, was suffering from severe back pain, had difficulty drinking and was vomiting constantly.
The businessman rushed the Israeli to a local hospital where he underwent a cardiac catheterization procedure. While at the hospital the Israeli suffered from hallucinations during which he claimed the Chinese doctors were trying to harvest his organs.
The physicians initially thought the man was suffering from some sort of mental illness and tried to determine whether he used drugs. Some doctors suggested transferring the Israeli to a psychiatric hospital after he recuperated, but his condition quickly deteriorated. He slipped in and out of consciousness, and the doctors hooked him up to a ventilator.
The mystery was solved when an infectious disease specialist was rushed to the Israeli's room and determined that he had contracted rabies. It remains unclear whether the Israeli, who died on Wed 19 Sep 2012, [had been] bitten by a dog and if so when [and where].
More than 55 000 people dies of rabies each year, [many] in India.
ProMED-mail from HealthMap alerts
[People contract rabies predominantly following a deep bite or scratch by an infected animal. Dogs are the main host and transmitter of rabies in Asia. The initial symptoms of rabies are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation (paraesthesia) at the wound site. As the virus spreads through the central nervous system, progressive, fatal inflammation of the brain and spinal cord develops. 2 forms of the disease can follow. People with furious rabies exhibit signs of hyperactivity, excited behaviour, hydrophobia and sometimes aerophobia. After a few days, death occurs by cardio-respiratory arrest. Paralytic rabies accounts for about 30 percent of the total number of human cases.
No tests are available to diagnose rabies infection in humans before the onset of clinical disease, and unless the rabies-specific signs of hydrophobia or aerophobia are present, the clinical diagnosis may be difficult. Human rabies can be confirmed intra-vitam and post mortem by various diagnostic techniques aimed at detecting whole virus, viral antigens or nucleic acids in infected tissues (brain, skin, urine or saliva). [See: http://www.who.int/mediacentre/factsheets/fs099/en/index.html].
The preceding press report does not identify the type of test used to establish the diagnosis. The incubation period for rabies virus infection in humans is typically 1-3 months, but may range from less than one week to more than one year, depending among other things on on the site and size of the initial wound. The report lacks information on the date of arrival of the patient in Beijing or the length of his stay India [or elsewhere]. Hence it cannot be determined whether he contracted infection prior to or after his arrival in Beijing. It is also possible that he may have been infected elsewhere (possibly even in Israel) prior to his arrival in India. The victim did not report contact with any potentially infected animal.
The interactive HealthMap of Beijing can be accessed at: http://healthmap.org/r/2JT4. - Mod.CP]