For the third time in 2015, Bolivian health officials are reporting a human rabies fatality, this time in a 8-year-old girl from  the rural municipality of Portachuelo in the eastern Santa Cruz region.

Image/CDC
Image/CDC

The child, according to health officials, was bitten by a puppy three months ago and the child’s mother did not report the bite until she was admitted with symptoms one week ago.

Fox News Latino reports that this is the first case of death from rabies recorded in the eastern Santa Cruz region in two and a half years.

Earlier this year, two other rabies deaths were reported in Bolivia–A 28-year-old woman in March and a 63-year-old man in May, both from Cochabamba.

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 veryaggressive, 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.Sometimesthe 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. Symptomsthen progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.

With the exception of Antarctica, rabies is endemic on all continents. Worldwide, it is estimated that there are more than 59,000 deaths due to rabies annually, with 95% in Africa and Asia.

According to the World Health Organization, dog rabies potentially threatens over 3 billion people in Asia and Africa. People most at risk live in rural areas where human vaccines and immunoglobulin are not readily available or accessible.

Poor people are at a higher risk, as the average cost of rabies post-exposure prophylaxis after contact with a suspected rabid animal is US$ 40 in Africa and US$ 49 in Asia, where the average daily income is about US$ 1–2 per person.