Rabies, Human - UK (05): (Northern Ireland) Ex South Africa

RABIES, HUMAN - UNITED KINGDOM (05): (NORTHERN IRELAND) EX SOUTH AFRICA
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


[1]
Date: Wed 14 Jan 2009
Source: The Nursing Times online [edited]


Rabies death in Northern Ireland sparks Health Protection Agency investigation
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The Health Protection Agency [HPA] has launched an investigation following
the death of a young woman from rabies in Northern Ireland last week [5-9
Jan 2009]. Officials from the agency are attempting to trace volunteers who
have worked at the Riverside Wildlife Rehabilitation and Environmental
Education Centre in Limpopo, South Africa.

The woman, who died last week, is thought to have acquired rabies following
a bite from a dog while working at the animal sanctuary in December 2006.
The centre has written to all those who volunteered there since July 2006
as a precaution and it is estimated that around 230 UK citizens have worked
there since that date. Volunteers are being advised that if they have been
bitten or scratched by a dog or mongoose within the centre or surrounding
area, they should seek medical advice.

Rabies vaccine is extremely effective at preventing the disease even if it
is given some time after an exposure. Dr David Brown, HPA rabies expert,
said: 'This is a tragic event and is a very real example of the need to get
health advice before you travel to countries where rabies is common or if
you know you will be working with animals. "Talk to your doctor or nurse
about whether or not a rabies vaccine is appropriate."

(byline: Richard Staines)

communicated by:
ProMED-mail
via HealthMap alerts

******
[2]
Date: Fri 16 Jan 2009
Source: HPA. Health Protection Report [edited]

Rabies, Human - United Kingdom (04) : (Northern Ireland) ex South Africa

RABIES, HUMAN - UNITED KINGDOM (04): (NORTHERN IRELAND) ex SOUTH AFRICA
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Wed 7 Jan 2009
Source: Daily Telegraph online [edited]


A woman who contracted rabies while working in an African animal
sanctuary has become the 1st Briton to die from this virus infection
in the past 4 years. The woman, from Northern Ireland, had been in a
critical condition in the intensive care unit of Belfast's Royal Victoria
Hospital since the condition was diagnosed in December [2008]. It is
thought she was infected with the virus -- which is invariably fatal
if not treated immediately -- after being scratched or bitten by a
rabid dog she had been helping to look after.

The woman had traveled to Africa a number of times over the last
couple of years but began to feel unwell after being home for several
months after her last trip in March 2008.

A statement from her brothers said: "We are devastated by the loss of
our sister. We are extremely proud not only of all she achieved in
life but also of the bravery with which she fought her illness. Her
courage was inspiring and typical of the passionate and determined
way in which she led her life. Her loss will leave a huge hole in all
our lives, and her family and friends will miss her terribly."

Since 1946, there have been 23 deaths among Britons infected with
rabies abroad. The most recent human case was in 2005 when a woman
became infected after being bitten by a dog in Goa, India and later
died in hospital in Liverpool. It is believed the Belfast patient may
have been infected as far back as December 2006 while working in an
animal sanctuary in South Africa. She sent home emails at the time
detailing how she had been scratched while separating 2 dogs. One of
the animals later had to be put down after it started foaming at the mouth.

The woman, who was in her 30s, worked as an adoption manager at the
Cats Protection centre at Dundonald [in Northern Ireland]. She is
believed to be the 1st person in Northern Ireland to have contracted
rabies for 70 years. The Eastern Health and Social Services Board in
Belfast led a multi-agency investigation into her case and insisted
the risk to the community was negligible; there is no documented case
of human-to-human transmission of rabies anywhere in the world. In
the UK, the last human death from [canine] rabies contracted
domestically was in 1902. The World Health Organization has estimated
the annual number of human rabies deaths to be between 40 000 and as
high as 70 000. Most of these deaths take place in developing
countries, particularly in South and Southeast Asia.

Communicated by:
ProMED-mail

[The length of the presumed incubation period is surprising but not
exceptional and probably contributed to the late diagnosis of the
unfortunate woman's condition. The vaccination status of the victim
is not revealed, but it must be presumed that she had not sought or
been offered post-exposure vaccination after sustaining a bite from a
aggressive canine while working in South Africa. The deceased woman
should have been offered protective anti-rabies vaccination prior to
her employment in an animal sanctuary, a high risk environment in a
rabies-endemic country.

Northern Ireland and the city of Belfast can be located on the
HealthMap/ProMED-mail interactive map of the United Kingdom at:
.
- Mod.CP]

Rabies, Human - United Kingdom : (Norther Ireland) ex South Africa

RABIES, HUMAN - UNITED KINGDOM (03): (NORTHERN IRELAND) ex SOUTH AFRICA
***********************************************************************
A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


Date: Fri 19 De 2008
Source: Health Protection Agency Report, Vol. 2, No. 51 [edited]



Case of imported rabies in the UK
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A case of imported human rabies has been identified in Northern
Ireland. The diagnosis was confirmed by tests on samples sent to the
United Kingdom National Reference Laboratory for Rabies at the
Veterinary Laboratory Agency, Weybridge, Surrey. The patient had
worked as a volunteer with animals in South Africa for short periods
during the past 2 years, and had close contact with various animals
including dogs. Rabies is endemic in South Africa where bites from
infected dogs are the main source of rabies in humans.

In the last 10 years there have been 3 previous cases of imported
human rabies in the UK. Although an estimated 55 000 cases of
classical rabies occur worldwide each year, there has never been a
virologically confirmed case of natural human to human transmission
of rabies. Despite the lack of evidence for human to human
transmission, some people who have been exposed to the secretions of
a patient with rabies may be offered post-exposure immunisation,
purely as a precautionary measure.

If bitten, scratched, or licked by a warm blooded animal in a
rabies-endemic country, people should wash the wound or site of
exposure (e.g., mucous membrane) with plenty of soap and water and
seek medical advice without delay, even if previously vaccinated. If
they do not seek medical treatment while abroad, they should still
seek it when they come home, even if some time after the event.

Following exposure an individual risk assessment should be undertaken
to determine the need for post-exposure prophylaxis (PEP) with rabies
vaccine and/or immunoglobulin. PEP is highly effective in preventing
rabies if given promptly and there have been no cases of rabies in
the UK in people who have received rabies post exposure prophylaxis.

Travellers should always be advised to seek travel health advice well
in advance of their visit overseas to ensure that the risks of all
travel associated illness, not just rabies, have been explained.
Although rabies vaccine is not routinely advised for all travellers,
pre-exposure immunisation is recommended for those:
- working abroad (e.g., veterinary staff or zoologists) who by the
nature of their work are at risk of contact with rabid animals;
- living in or travelling for more than one month to rabies-enzootic
areas unless there is reliable access to prompt, safe medical care;
- travelling for less than one month to enzootic areas but who may
be exposed to rabies because of their travel activities;
- those who would have limited access to post-exposure medical care.

This advice should be specifically brought to the attention of those
planning to do voluntary work with animals in rabies-endemic areas.

Further information on rabies prevention for the traveller is
available from the National Travel Health Network and Centre at:
. Detailed
information on rabies is available in chapter 27 of the Green Book [1].

Reference:
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(1) DH. Immunisation against infectious disease ("the Green Book").
Available at:
.

posted in the interest of the traveling public; by Walter M Woolf, V.M.D. .. Principal Owner & Managing Director - Air Animal Pet Movers .. providing relocating pet owners with pet moving logistics and solutions.