Published Date: 2014-06-09 19:20:41
Date: 8 Jun 2014
Source: Houston Chronicle [edited]
http://www.chron.com/news/texas/art...php?utm_source=twitterfeed&utm_medium=twitter
The death of a Guatemalan immigrant from rabies last year [2013] [Rabies - USA (11): (TX) ex Guatemala, human 20130616.1775355] at a Corpus Christi hospital set off an international search for others who may have been exposed. More than 700 people were assessed for rabies exposure in what Ryan Wallace, a rabies expert for the U.S. Centers for Disease Control and Prevention, called a "very rare scenario," the Corpus Christi Caller-Times reported (http://bit.ly/1kIVAJt).
HM-H, 28, began showing symptoms only several days after Border Patrol captured him [near Hidalgo] in South Texas following his illegal entry [on 9 May] 2013. At an immigrant detention center, M-H repeatedly visited its medical clinic with symptoms including excessive saliva, anxiety, insomnia, trouble swallowing, and a rapid heart rate, according to CDC reports. Nine days after his initial capture, M-H was taken to Christus Spohn Hospital Kleberg [Kingsville, on 18 May 2013]. Doctors discovered air between his chest and lungs. His condition worsened after he was taken to Christus Spohn Hospital Memorial in Corpus Christi, and he eventually needed a ventilator to breathe. His temperature hit 104 F [40 C].
"On the surgery ICU side, they couldn't figure out what was wrong with him," said Dr. Andy Russell, an emergency medicine resident at Memorial. "He didn't seem to have any surgical issue. ... He was very unstable, teetering on multi-organ failure, but we couldn't figure out why."
His symptoms seemed to be textbook rabies, but there are only one to 6 rabies deaths in the U.S. each year. "The more we thought about it, the more we thought maybe he does have rabies," Russell said. Tests came back positive.
There's never been a laboratory-confirmed case of human-to-human rabies transfer, except for organ transplants. But M-H had traveled through 4 federal detention centers and 2 hospitals before being taken off life support on 11 Jun 2013. Health investigators identified 742 people who had been exposed to M-H. Ultimately, rabies vaccines were recommended for 23, among them, 3 agents who scuffled with him during his arrest, other detainees, and 5 health care workers.
The CDC was unable to determine how M-H had contracted the incurable virus. His virus was a close match to one in dogs in Guatemala, but no bite marks were found on his body, and his family did not recall him being bitten.
--
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[Although classically the rabies incubation period is 21 days, there are countless cases where it has been a multiple of months since any known exposure. And in wildlife reservoir species, it has the capacity to aestivate and hibernate. Though this report does not confirm that he originally came from Guatemala, the previous report had authorities in Guatemala question his family, so it can be so presumed. Whether M-H would have survived if the Kleberg clinicians had read his symptoms correctly from the start is a matter for conjecture.
For a map of Texas, go to: http://www.lib.utexas.edu/maps/united_states/texas_2002.jpg. Hildalgo is at the southernmost tip of Texas; see: http://www.fallingrain.com/world/US/TX/Hidalgo.html. For Texas, Mexico & Guatemala, go to: http://www.lib.utexas.edu/maps/americas/mexico_rel97.jpg.
Our rabies case had a long arduous trip to reach the US border before he fell ill. - Mod.MHJ
http://promedmail.org/direct.php?id=20140609.2529466
Date: 8 Jun 2014
Source: Houston Chronicle [edited]
http://www.chron.com/news/texas/art...php?utm_source=twitterfeed&utm_medium=twitter
The death of a Guatemalan immigrant from rabies last year [2013] [Rabies - USA (11): (TX) ex Guatemala, human 20130616.1775355] at a Corpus Christi hospital set off an international search for others who may have been exposed. More than 700 people were assessed for rabies exposure in what Ryan Wallace, a rabies expert for the U.S. Centers for Disease Control and Prevention, called a "very rare scenario," the Corpus Christi Caller-Times reported (http://bit.ly/1kIVAJt).
HM-H, 28, began showing symptoms only several days after Border Patrol captured him [near Hidalgo] in South Texas following his illegal entry [on 9 May] 2013. At an immigrant detention center, M-H repeatedly visited its medical clinic with symptoms including excessive saliva, anxiety, insomnia, trouble swallowing, and a rapid heart rate, according to CDC reports. Nine days after his initial capture, M-H was taken to Christus Spohn Hospital Kleberg [Kingsville, on 18 May 2013]. Doctors discovered air between his chest and lungs. His condition worsened after he was taken to Christus Spohn Hospital Memorial in Corpus Christi, and he eventually needed a ventilator to breathe. His temperature hit 104 F [40 C].
"On the surgery ICU side, they couldn't figure out what was wrong with him," said Dr. Andy Russell, an emergency medicine resident at Memorial. "He didn't seem to have any surgical issue. ... He was very unstable, teetering on multi-organ failure, but we couldn't figure out why."
His symptoms seemed to be textbook rabies, but there are only one to 6 rabies deaths in the U.S. each year. "The more we thought about it, the more we thought maybe he does have rabies," Russell said. Tests came back positive.
There's never been a laboratory-confirmed case of human-to-human rabies transfer, except for organ transplants. But M-H had traveled through 4 federal detention centers and 2 hospitals before being taken off life support on 11 Jun 2013. Health investigators identified 742 people who had been exposed to M-H. Ultimately, rabies vaccines were recommended for 23, among them, 3 agents who scuffled with him during his arrest, other detainees, and 5 health care workers.
The CDC was unable to determine how M-H had contracted the incurable virus. His virus was a close match to one in dogs in Guatemala, but no bite marks were found on his body, and his family did not recall him being bitten.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Although classically the rabies incubation period is 21 days, there are countless cases where it has been a multiple of months since any known exposure. And in wildlife reservoir species, it has the capacity to aestivate and hibernate. Though this report does not confirm that he originally came from Guatemala, the previous report had authorities in Guatemala question his family, so it can be so presumed. Whether M-H would have survived if the Kleberg clinicians had read his symptoms correctly from the start is a matter for conjecture.
For a map of Texas, go to: http://www.lib.utexas.edu/maps/united_states/texas_2002.jpg. Hildalgo is at the southernmost tip of Texas; see: http://www.fallingrain.com/world/US/TX/Hidalgo.html. For Texas, Mexico & Guatemala, go to: http://www.lib.utexas.edu/maps/americas/mexico_rel97.jpg.
Our rabies case had a long arduous trip to reach the US border before he fell ill. - Mod.MHJ
http://promedmail.org/direct.php?id=20140609.2529466