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Ann Neurol. Phylogenetic and epidemiologic evidence of multi-year incubation in human rabies

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  • Ann Neurol. Phylogenetic and epidemiologic evidence of multi-year incubation in human rabies

    [Source: Annals of Neurology, full page: (LINK). Abstract, edited.]


    Brief Communication

    Phylogenetic and epidemiologic evidence of multi-year incubation in human rabies


    Torrey A. Boland MD<SUP>1</SUP>, Declan McGuone MB, BCh, BAO<SUP>3</SUP>, Jenelle Jindal MD<SUP>2</SUP>, Marcelo Rocha MD, PhD<SUP>2</SUP>, Melissa Cumming MS<SUP>4</SUP>, Charles E. Rupprecht VMD, MS, PhD<SUP>5</SUP>, Taciana Fernandes Souza Barbosa<SUP>6</SUP>, Rafael de Novaes Oliveira<SUP>7</SUP>, Catherine J. Chu MD<SUP>2</SUP>, Andrew J. Cole MD<SUP>2</SUP>, Ivanete Kotait<SUP>7</SUP>, Natalia A. Kuzmina PhD<SUP>8</SUP>, Pamela A. Yager<SUP>8</SUP>, Ivan V Kuzmin MD, PhD<SUP>9</SUP>, E. Tessa Hedley-Whyte MD<SUP>3</SUP>, Catherine M. Brown DVM MSc MPH<SUP>4</SUP>, Eric S. Rosenthal MD<SUP>2</SUP>
    <SUP></SUP>
    DOI: 10.1002/ana.24016

    Copyright © 2013 American Neurological Association

    Author Information: <SUP>1</SUP>Department of Neurological Sciences, Rush University Medical Center, Chicago, IL <SUP>2</SUP>Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA <SUP>3</SUP>C S Kubik Laboratory for Neuropathology, Department of Pathology Massachusetts General Hospital, Harvard Medical School, Boston, MA <SUP>4</SUP>Massachusetts Department of Public Health, Hinton State Laboratory, Jamaica Plain, MA <SUP>5</SUP>The Global Alliance for Rabies Control, Manhattan, Kansas <SUP>6</SUP>Instituto Evandro Chagas, Pará, Brazil <SUP>7</SUP>Instituto Pasteur, Sao Paulo, Brazil <SUP>8</SUP>Centers for Disease Control and Prevention, Atlanta, GA <SUP>9</SUP>Aravan, LLC, Lilburn, GA

    <SUP>*</SUP>Address correspondence to: Torrey Boland, MD Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison St, Suite 1106, Chicago, IL 60612torrey.boland@gmail.com, phone 267-978-6643, fax 312-563-2206

    Publication History: Accepted manuscript online: 29 AUG 2013 08:35AM EST - Manuscript Accepted: 19 AUG 2013 - Manuscript Revised: 1 AUG 2013 - Manuscript Received: 24 MAY 2013


    Abstract

    Eight years after emigrating from Brazil, an otherwise healthy man developed rabies. An exposure prior to immigration was reported. Genetic analysis revealed a canine rabies virus variant found only in the patient's home country, and the patient had not traveled internationally since immigrating to the United States. We describe how epidemiological, phylogenetic, and viral sequencing data provided confirmation that rabies encephalomyelitis may present after a long, multi-year incubation period, a consideration that previously has been speculated without the ability to exclude a more recent exposure. Accordingly, rabies should be considered in the diagnosis of any acute encephalitis, myelitis, or encephalomyelitis.


    ANN NEUROL 2013. © 2013 American Neurological Association


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