The World Health Organisation (WHO) has updated its travel advice for travellers planning to visit India following the death of a British woman due to rabies last month. The organisation now says that there’s a high risk of rabies. It recommends that anyone who comes in contact with domestic animals – especially dogs – gets a pre-exposure immunisation.
In last month’s incident, the woman, who was believed to have been a grandmother in her 50s, was treated for rabies after a dog bit her on a trip in south Asia. She was reportedly turned away by doctors at Darent Valley Hospital twice before being diagnosed. She then got treatment at London’s Hospital for Tropical Diseases before her death.
University College London Hospital’s NHS Foundation Trust said last month that they regret to say that a patient being treated for rabies died. The family of the patient requested that media respect their privacy during the difficult time. They wouldn’t be releasing any more details, while the family didn’t want to make any statement. They give the family their sincerest condolences, it added. The hospital had reassured that staff, patients and visitors that there was no risk to them.
An investigation was launched into how the woman was turned away from the hospital’s emergency department. A Darent Valley Hospital spokesman said that there’s no rabies in the UK. If a patient shows up with vague symptoms, a doctor probably won’t consider rabies as a diagnosis unless the patient highlights coming in contact with a wild animal in a country where the disease has a known presence. The hospital responded to the information the patient gave them at the time.
The hospital spokesman added that, although there aren’t any cases of rabies passing through human-to-human contact, five members of staff that came into close contact with the patient were being vaccinated as a precaution. They have also launched an investigation into the circumstances surrounding the woman’s attendance at the emergency department and are working close with the Health Protection Agency (HPA).
Rabies is usually transferred through saliva when an infected animal bites, and dogs are the most common transmitter to humans. Over 55,000 people are estimated to die from this every year, and most cases occur in developing nations – especially south and south-east Asia.
Following the woman dying from rabies, disease control experts revealed a second possible case being investigated in a patient from Leeds. The HPA said the patient sought medical attention after being bitten by a dog while overseas. The patient wasn’t linked to the confirmed case in London, however. The agency was notified that a patient from Leeds sought medical treatment, and an investigation is underway to determine if the bite led to an infection, a spokeswoman added.
London School of Hygiene and Tropical Medicine travel medicine expert Dr Ron Behrens says the prognosis is bleak for humans infected with rabies – only one or two people are known to have survived rabies encephalitis, which is when the disease has reached the brain. Despite this, infected persons should seek medical advice. Rabid dogs in the early stages of the disease don’t behave unusually, he added, while the disease can incubate for anywhere between weeks to years without any signs after being infected. There is about 24 hours where treatment with an antibody can prevent rabies from entering the nervous system, he added.
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