Human rabies - Oregon, 1989
Article Abstract:
Rabies was identified as the cause of death of an 18-year-old Mexican man who died on February 3, 1989. This was the first death from human rabies in Oregon since 1978, and in the United States since 1987. The patient died without the diagnosis of rabies having been made. The patient was well until January 17, 1989. He developed fever, nausea, vomiting, shortness of breath and a cough. He was seen in a local emergency room and diagnosed as having bronchitis. On January 24, he went to a second clinic with additional complaints of chills, muscle pain and sore throat. This time he was diagnosed as having an infection of his upper respiratory system. On January 26 he was admitted to a Portland, Oregon hospital with abdominal pain suggestive of appendicitis, although his white blood cell count did not elevate (a usual finding in appendicitis). Images of his abdominal organs produced by ultrasound and CAT scanners were normal. Samples of cerebrospinal fluid contained some abnormal cells, but bacteriologic examination of this fluid and his stools showed no infection. On January 30, 1989 he lost deep tendon reflexes and developed a paralysis in the nerves leading to the muscles of the face and to the muscles of the tongue. He died following a cardiopulmonary arrest (stopped breathing and heart stopped) on February 3. The hospital staff had considered rabies before his admission, but specific diagnostic tests were not obtained until after his death. Following his death, extensive interviews were unable to establish a cause of the patient's rabies. Between 1960 and 1979, 16 percent of all rabies cases could not have their source of infection identified. Since 1980 this rate has increased to 60 percent. Often rabies is not included in the list of differential diagnoses that is so important in the diagnostic process. Since there is evidence of human-to-human transmission by saliva, preventive actions were taken with nine individuals exposed to this patient. Health workers should also consider postexposure rabies prophylaxis for themselves whenever there is exposure to rabies.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
User Contributions:
Comment about this article or add new information about this topic:
Human rabies - Texas, Arkansas, Georgia, 1991
Article Abstract:
Three people died of rabies between Aug and Oct 1991 in Texas, Arkansas and Georgia. Each of these individuals initially had symptoms that were not specific to rabies, and were not diagnosed with rabies until it had progressed to a later stage or after death. None had a recent animal bite or scratch. But one man had come in contact with a silver-haired bat, and a strain of rabies virus commonly found in these bats was isolated from his brain at autopsy. The same strain was found in autopsy tissue from another patient. Bats can carry rabies, and bats have been implicated in five out of seven cases reported in the US since 1980. Sixteen cases of rabies have been reported worldwide between 1980 and 1991; seven of these were in the US. None of the rabies patients reported since 1977 have survived.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
First human death associated with raccoon rabies -- Virginia, 2003
Article Abstract:
A 25-year-old Virginia man died from rabies that he may have got from a rabid raccoon. Although his family could not remember any raccoon exposure, PCR tests on brain tissue revealed the presence of the raccoon rabies virus. About 50,000 rabid raccoons have been identified in Virginia since the late 1970s.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2003
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Enhanced Surveillance for Pregnancy-Associated Mortality--Maryland, 1993-1998. Examining Homicide's Contribution to Pregnancy-Associated Deaths
- Abstracts: Antiretroviral therapy for pregnant women. Pregnant adolescents at risk: sexual behaviors and sexually transmitted disease prevalence
- Abstracts: Bedside manner misses the point. Nurses are sick of being abused. Different from the average student
- Abstracts: What's fun for kids in Washington, DC. How does your child's school measure up? Best-loved books ... online
- Abstracts: Breast cancer therapy: exercising all our options. Hodgkin's disease. Hodgkin's disease -- clinical trials and travails