The death of a 25-year-old Bogota woman from rabies in January has prompted an alert in Colombia, according to a El Tiempo report last week (computer translated).
The woman was reportedly bitten on a finger by a cat in December that was acquired five months prior from the Tequendama area in Cundinamarca.
According to the report, after taking the cat home last summer, the animal showed signs of illness and was taken the same day to a veterinarian. However, presence of rabies was not suspected and the cat was discharged.
Post exposure rabies prophylaxis (PEP) was not sought and the patient only washed the wound with a disinfectant.
However, the cat became increasingly aggressive and had to be euthanized by a veterinarian in December.
The woman began showing symptoms of dizziness, accompanied by pain in the elbow and loss of sensitivity in the right arm on Jan. 10 prompting a visit to her doctor where the diagnosis was vertigo.
The severity of the symptoms increased to difficulty breathing, changes in behavior, sweating and numbness in the arms and she was admitted to the hospital a few days later.
During the hospitalization she presented a rapid neurological and respiratory deterioration and, after multiple laboratory tests, in addition to the report (a little late) of the family on the bite of the cat, the diagnosis of rabies encephalitis was inferred. She died on Jan. 21 and rabies was confirmed.
This is the second human rabies death in Colombia caused by the wild variety of the virus in the past fifteen months. There has been about three dozen human rabies deaths in the past 12 years.
According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.
Rabies infected animals can appear very aggressive, attacking for no reason. Some may act very tame. They may look like they are foaming at the mouth or drooling because they cannot swallow their saliva. Sometimes the animal may stagger (this can also be seen in distemper). Not long after this point they will die. Most animals can transmit rabies days before showing symptoms.
Initially, like in many diseases, the symptoms of rabies are non-specific; fever, headache and malaise. This may last several days. At the site of the bite, there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.
Worldwide, it is estimated that there are more than 69,000 deaths due to rabies annually.
Human rabies is prevented by administration of rabies vaccine and rabies immune globulin.