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Published Date: 2012-10-02 12:26:30
Subject: PRO/AH/EDR> Rabies - Peru (07): (PU) human, dog bite
Archive Number: 20121002.1319488

RABIES - PERU (07): (PUNO) HUMAN, DOG BITE
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Date: Fri 26 Sep 2012
Source: Diario Correo (Peru) [in Spanish, trans. Mod.PMB, edited]
http://diariocorreo.pe/ultimas/noticias/1557396/edicion+puno/poblador-de-macusani-fallece-con-mal-de-rabia

Officials of the Pan American Health Organization (PAHO) and the Ministry of Health of Lima arrived in Juliaca to assess and investigate a human death due to rabies.

The victim, a resident of Macusani, was bitten on the face by a dog on the 3rd floor of a hospital while he was visiting a relative on 31 Jul 2012.

The head of the Institutional Development Office of the San Roman Health Network (Juliaca), Percy Casaperalta Calcina, said that the bitten patient, a 34-year-old man, was immunized the same day he was attacked, but he did not continue the [post-exposure] treatment.

Casaperalta Calcina pointed out that the patient returned to the hospital when his health condition worsened, but his relatives requested that he be discharged so that he could be taken to a private clinic. However, he did not receive further medical attention and died in Macusani on 18 Sep 2012.

"He was vaccinated, but he travelled back to Macusani and quit the vaccination scheme. In September he came back to the hospital but his relatives requested a discharge to take him to a private clinic. Instead, they took him back to Macusani where he died. The local medical doctors were asked to conduct an autopsy and take the relevant samples. The tests for rabies were positive," explained Casaperalta Calcina.

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Communicated by:
ProMED-ESP
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[A very sad episode, rabies being a preventable disease. Even though ceasing the vaccination was extremely imprudent, one wonders how persuasive health officials were to convince the patient to complete the treatment.

On the other hand, what is unexplainable is that the dog attack happened inside a hospital, on a 3rd floor, in a hospitalization area. This is particularly serious and it is the responsibility of the hospital authorities. Such an accident is out of any logic and common sense. - Mod.JG]

[In Latin America, the ecology of cats and dogs is substantially different than in the developed world, mainly due to socio-economical constraints, cultural perceptions, and poor infrastructure. This has resulted in serious limitations for the implementation of rabies control programs (Chomel, 1993). The proportion of unowned dogs and cats, or owned ones that are allowed to roam freely, is very high. Moreover, a large percentage of the latter never receive vaccinations or medical treatment.

A HealthMap/ProMED-mail map of Peru can be seen at http://healthmap.org/r/3Bwo. - Mod.PMB]

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