Human Rabies Case Feared In N Ireland

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A reminder to travellers that if scratched or bitten by an animal, it is wise to seek medical advice/attention...

Source: http://news.sky.com/skynews/Home/UK...spected_Human_Rabies_Case_In_Northern_Ireland

Rabies Case Feared In N Ireland
3:51pm UK, Sunday December 14, 2008
A person in Northern Ireland has been taken ill with a case of suspected rabies.

The patient became sick after returning from a country associated with the fatal virus, and was likely to have been bitten by an infected animal there.

So far, tests have proved positive, with further assessments being undertaken to ensure the diagnosis is accurate.

After being initially treated in Ulster hospital, the patient has now been moved to the Royal Victoria hospital in nearby Belfast.

The Eastern Health and Social Services Board is leading the probe into what it says is "a highly likely case of human rabies".

The board insists the infected person "poses no risk to other patients or to visitors".

And it said: "Both hospitals are functioning normally and there is no risk to the provision of their services."

The risk to the wider community is negligible as there has never been a documented case of a human-to-human transmission of rabies anywhere in the world.

The deadly virus kills approximately 50,000 people a year, mostly in Africa and Asia, with only a small handful of patients known to have survived.

However, rabies is extremely rare in the UK, with only 23 cases being reported since 1946. The last man to die in Britain was a bat handler who contracted the disease in Scotland in 2002.

The last known case of human rabies in Northern Ireland was in 1938.

 

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Re: Human Rabies Case Feared In N Ireland

Source: http://www.belfasttelegraph.co.uk/n...d-in-critically-ill-rvh-patient-14109795.html

Rabies virus confirmed in critically ill RVH patient

By Victoria O?Hara
Tuesday, 16 December 2008

A critically ill woman who was being treated in a Belfast hospital with a suspected case of rabies has contracted the deadly disease, it was confirmed last night.

The woman, who was initially treated at the Ulster Hospital but later transferred to the Royal Victoria, had been abroad but began to feel unwell after being home for a number of months.

Following further tests, the Eastern Board last night said the patient has rabies ? but stressed that any risk to the wider community is negligible.

It is believed it is the first case in Northern Ireland for 70 years.

The Board said the patient poses no risk to other patients or visitors, and all its services are continuing as normal.

It added that ?all necessary steps? on infection control are in place for the protection of staff.

Health travel advice remains readily available to people through their GP and at local travel health clinics.

Northern Ireland Health Minister Michael McGimpsey received updates on the case at the weekend. He said: ?I am aware of this case and have been advised that the risk to other people?s health is extremely remote.?

?Healthcare staff who have had contact with this patient are being offered prophylaxis as a precautionary measure.?

Humans generally suffer from a fever before slipping into a coma, but there is no risk of sufferers spreading the disease to others.

The deadly disease affects the central nervous system but can be prevented through a vaccination programme.

A spokesman for the Eastern Board said it was leading a multi-agency investigation into the matter. The Board and its partner agencies are taking national expert advice from the Health Protection Agency and the Veterinary Laboratories Agency.

The partner agencies working with the Board include the Department of Health Social Services and Public Safety, the Department of Agriculture and Rural Development and the Communicable Diseases Surveillance Centre (Northern Ireland).

While rabies remains a very rare illness in the UK, there are around 70,000 cases in humans in other parts of the world each year, and people should remain vigilant of the risk from both rabies and other serious vaccine-preventable diseases, particularly in many parts of Africa, Asia and South America.

Cases of rabies acquired in the UK remain very rare ? the last human case involving a dog bite in the UK dates to 1902.

Since 1946, there have been 23 cases reported to the Health Protection Agency, with all of these having acquired the infection overseas, the most recent in 2005.

The last person to be diagnosed with rabies in Northern Ireland occurred in 1938.

Dr Maureen McCartney, a consultant in communicable disease control with the Eastern Board, urged travellers to take precautions when visiting countries where the disease is common.

These include places such as Asia, Africa and South America.

A number of incidents have also been reported in Eastern European countries.

?The disease is still widespread in a number of countries and people should remember to take the rabies vaccine,? explained Dr McCartney.

 

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Re: Human Rabies Case Feared In N Ireland

1. The recent rabies case in Northern Ireland was confirmed on December 15th 2008 and sadly the patient died on the 6th January 2009.

Wildlife Centre Traces Volunteers Following Death From Rabies
The Health Protection Agency is working with colleagues in South Africa and Northern Ireland to trace volunteers who have worked at the Riverside Wildlife Rehabilitation and Environmental Education Centre in Limpopo, South Africa. This follows the recent death from rabies of a young woman in Northern Ireland who had worked at the centre in December 2006.

The woman is thought to have acquired rabies following a bite from a dog whilst working at the animal sanctuary. The Centre has written to all those who have volunteered there since July 2006 as a precautionary measure.

It is understood that approximately 230 UK citizens have worked at the centre since July 2006. However, the number who have had direct contact with a dog or mongoose may be very small. Aside from dog bites, rabies can occasionally be transmitted by scratches or licks on the face or cuts. However simply touching or stroking a dog does not constitute a risk.

Volunteers are being advised that if they have been bitten, scratched or licked on the face or on an open wound by a dog or mongoose either within the Centre or in the surrounding area, they should seek medical advice from a health professional to determine whether they require preventive treatment with rabies vaccine. For UK citizens this should be from their GP or NHS Direct. Rabies vaccine is extremely effective at preventing rabies even when this is given some time after an exposure.

Dr David Brown, a rabies expert at the Health Protection Agency, 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. And remember not to touch animals when you are abroad as you cannot know that there is no risk."

"It is important that people intending to travel to endemic areas are reminded to consider pre-exposure vaccination, especially if they are going to be working with animals.

"All travellers should avoid contact with dogs and wild animals wherever possible, and must take action if an exposure occurs. If they are bitten, scratched, or licked by a warm blooded animal in a rabies-endemic country, they 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 they are previously vaccinated.

"If they do not seek medical treatment while abroad, they should still seek it when they come home, even if this is some time after the exposure event."

Although rabies vaccine is not routinely advised for all travellers, pre-exposure immunisation is recommended for those:

- working abroad (eg 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.
- who would have limited access to post-exposure medical care.

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

Notes

1. The recent rabies case in Northern Ireland was confirmed on December 15th 2008 and sadly the patient died on the 6th January 2009.

2. Volunteers may have received cuts and scratches while handling monkeys at the Centre however there have never been any reports of rabies among monkeys at the Centre or in the area. Therefore, provided such cuts and scratches were not licked by a dog or mongoose, this should not pose a risk for rabies.

3. GPs, A&Es and other health care professionals are being asked to be vigilant in assessing people who report dog bites which occurred at the same sanctuary in South Africa since July 2006.

4. Rabies is an acute viral infection that is extremely rare in the UK; the last case of classical rabies acquired in this country was a century ago, in 1902. Very occasionally cases occurring since then have all been acquired abroad, usually through dog bites. Since 1946, twenty-three cases have previously been reported in the United Kingdom, all imported. This is the 24th case. Since 2000, there have been 3 other cases; two unconnected cases occurred in 2001, imported from the Philippines and Nigeria, and one in 2005 followed a dog-bite in Goa. Transmission is usually through saliva via the bite of an infected animal; there are no documented cases of human-to-human transmission. A person who is bitten by a rabid animal but given treatment with rabies vaccines can expect not to develop rabies. Rabies vaccine is very safe and highly effective at preventing rabies, but should be given promptly once the risk has been identified.

5. Travellers should seek advice before travel about whether they need rabies vaccine; while this is generally not recommended for travel in Western Europe, for example, it may be recommended for visits of more than a month to some countries, especially developing countries where rabies is common in animals.

6. When travelling, stay away from stray or unattended animals.

7. If bitten in a country where rabies is present clean the wound thoroughly with soap and plenty of water and seek medical advice immediately. If a person has not had treatment in that country they should still seek medical advice immediately on return, even if the bite was weeks before.

8. Further information on rabies is available at the Agency's website.

9. Healthcare professionals and members of the public can find more information about travel health (including country specific advice) by logging onto the National Travel Health Network and Centre (NaTHNaC) website http://www.nathnac.org or the Fit for Travel website at http://www.fitfortravel.nhs.uk/
http://www.medicalnewstoday.com/articles/135444.php