1例罕见长病程狂犬病

患者,女,22岁,农民,黑龙江人。患者于19年前被自家疯犬咬伤面部,该犬当时被打死。并到当地卫生所进行简单消毒和缝合。当时没有打狂犬疫苗和血清(以后也没补打)。数日后伤口自愈,其他无不良反应,一直没引起注意。在18岁时(咬后15年)开始出现身上发紧,咬伤面部先出现痒,咬伤疤痕较前明显。19岁时除上述症状外,又出现怕声音。此时仍能进行日常劳动,仍没引起注意,20岁时(咬后17年)饭量较前减少,感到周身乏力,咬伤部位有麻、痒,伴头痛、头昏仍怕声,此时认为神经衰弱。21岁时(咬后18年)冬季感到面部有蚁走感。22岁时(咬后19年)出现双上肢蚁走感,…     

A new field record for bat longevity

A new longevity record has been established for a free-living bat-41 years for a male Brandt's bat, Myotis brandtii. The exceptional longevity of bats generally, and this species in particular, should make bats of special interest for researchers studying mechanisms of slow aging.     

Circumstances of bat encounters and knowledge of rabies among Minnesota residents submitting bats for rabies testing

Minnesota residents who submitted a bat to the Minnesota Department of Health for rabies testing in 2003 were surveyed by telephone regarding the circumstances of the bat encounter and their knowledge of bats and rabies. Of 442 bats submitted for testing, 12 (3%) tested positive for rabies, and 410 (93%) tested negative; 17 (4%) bats were unsuitable for testing, and three (1%) had equivocal results. A case-control study found that rabid bats were more likely than non-rabid bats to be found in September, found outside, found in a wooded area, unable to fly, acting ill, or acting aggressively. Rabid bats were not more likely than non-rabid bats to be found during the day or to have bitten someone. While most persons submitting bats for rabies testing were aware that bats can carry rabies, few knew they should submit the bat for testing until they sought the advice of an animal control officer, veterinarian, or healthcare provider.     

Laboratory investigation of human deaths from vampire bat rabies in Peru.

In the spring of 1996, multiple cases of an acute febrile illness resulting in several deaths in remote locations in Peru were reported to the Centers for Disease Control and Prevention (CDC). The clinical syndromes for these cases included dysphagia and encephalitis. Because bat bites were a common occurrence in the affected areas, the initial clinical diagnosis was rabies. However, rabies was discounted primarily because of reported patient recovery. Samples of brain tissue from two of the fatal cases were received at CDC for laboratory confirmation of the rabies diagnosis. An extensive array of tests on the formalin-fixed tissues confirmed the presence of both rabies viral antigen and nucleic acid. The virus was shown to be most closely related to a vampire bat rabies isolate. These results indicate the importance of maintaining rabies in the differential diagnosis of acute febrile encephalitis, particularly in areas where exposure to vampire bats may occur.     

Fatal case of human rabies infection: A case report

Rationale: Rabies, as an acute viral disease of the mammal's central nervous system(CNS), with a high mortality rate, is transmitted to humans through the bite of a rabid animals, especially canine and feline. Patient concerns: An Afghan man, aged 50 years was bitten by a fox in a farm around the Qom-Tehran road, Central Iran in 2018. The patient visited the doctor after the bite, however the period between incidence and hospital visit was not established and no indication was given whether the bite site injury was thoroughly washed. The patient was neither referred to the health center for vaccination(post-exposure prophylaxis) nor an effective therapeutic measures was applied. Forty-five days post-exposure, the patient presented with symptoms such as headache, fever, tingling and burning sensation and was referred to the Centers for Disease Control and Prevention(CDC) unit of Qom Provincial Health Center. Diagnosis: Rabies infection. Interventions: Forty-five days after the animal bite, in CDC of Qom Health Center, he received rabies post-exposure prophylaxis treatment and was referred to an infectious diseases physician. Based on the history of animal bites, the patient was classified as probable case of rabies. The clinical symptoms of rabies appeared in patient after hospitalization. Outcomes: Ultimately the patient died in hospital 4 days after hospitalization(50 days after the occurrence of animal bite). After referring the patient to the CDC, the patient's saliva(0.5-1 mL) was sampled three times every 3-6 hours and tested by PCR. Human rabies was confirmed by Department of Virology in the Pasteur Institute of Iran. Lessons: Physicians and clinicians have responsibilities to be critical in observations and take prompt actions in case of animal bites, as rabies usually develops within 7 to 14 days, and delayed intervention after the onset of symptoms, vaccine and serum injections cannot lead to the survival of the patient.     

Host and viral ecology determine bat rabies seasonality and maintenance

Rabies is an acute viral infection that is typically fatal. Most rabies modeling has focused on disease dynamics and control within terrestrial mammals (e.g., raccoons and foxes). As such, rabies in bats has been largely neglected until recently. Because bats have been implicated as natural reservoirs for several emerging zoonotic viruses, including SARS-like corona viruses, henipaviruses, and lyssaviruses, understanding how pathogens are maintained within a population becomes vital. Unfortunately, little is known about maintenance mechanisms for any pathogen in bat populations. We present a mathematical model parameterized with unique data from an extensive study of rabies in a Colorado population of big brown bats (Eptesicus fuscus) to elucidate general maintenance mechanisms. We propose that life history patterns of many species of temperate-zone bats, coupled with sufficiently long incubation periods, allows for rabies virus maintenance. Seasonal variability in bat mortality rates, specifically low mortality during hibernation, allows long-term bat population viability. Within viable bat populations, sufficiently long incubation periods allow enough infected individuals to enter hibernation and survive until the following year, and hence avoid an epizootic fadeout of rabies virus. We hypothesize that the slowing effects of hibernation on metabolic and viral activity maintains infected individuals and their pathogens until susceptibles from the annual birth pulse become infected and continue the cycle. This research provides a context to explore similar host ecology and viral dynamics that may explain seasonal patterns and maintenance of other bat-borne diseases.     

Genetic divergence of rabies viruses from bat species of Colorado, USA

Molecular epidemiological studies have linked many cryptic human rabies cases in the United States with exposure to rabies virus (RV) variants associated with insectivorous bats. In Colorado, bats accounted for 98% of all reported animal rabies cases between 1977 and 1996. The genetic divergence of RV was investigated in bat and terrestrial animal specimens that were submitted for rabies diagnosis to the Colorado Department of Public Health and Environment (CDPHE), Colorado, USA. RV isolates from animal specimens across the United States were also included in the analysis. Phylogenetic analyses were performed on partial nucleoprotein (N) gene sequences, which revealed seven principal clades. RV associated with the colonial big brown bat, Eptesicus fuscus, an bats of the genus Myotis were found to segregate into two distinct clades (I and IV). Clade I was harbored by E. fuscus and Myotis species, but was also identified in terrestrial animals such as domestic cats and striped skunks (Mephitis mephitis). Clade IV was divided into subclades IVA, IVB, and IVC; IVA was identified in E. fuscus, and Myotis species bats, and also in a fox; subclades IVB and IVC circulated predominantly in E. fuscus. Clade II was formed by big free-tailed bat (Nyctinomops macrotis) and striped skunk (Mephitis mephitis) samples. Clade III included RVs that are maintained by generally solitary, migratory bats such as the silver-haired bat (Lasionycteris noctivagans) and bats of the genus Lasiurus. Big brown bats were found to harbor this RV variant. None of the Colorado specimens segregated with clades V and VII that harbor RVs associated with terrestrial animals. Different species of bats had the same RV variant, indicating active inter-species rabies transmission. In Colorado, animal rabies occurs principally in bats, and the identification of bat RVs in cat, gray fox Urocyon cinereoargenteus), and striped skunks demonstrated the importance of rabies spillover from bats to domestic and terrestrial wildlife species.     

Donovanosis. Apropos of a new case of granuloma inguinale in France

We report a new case of granuloma inguinale in France. A 47 years old Turkish man living in France for eight years had an ulcerovegetative lesion on the corona sulcus and inner aspect of the prepuce for three months. Donovanosis was established by granulation time smears and Giemsa's stain showing Donovan bodies inside large mononuclear cells. Complete resolution occurred after treatment with ampicillin for three weeks and later doxycycline for a month. Granuloma inguinale is rare in France and must not be forgotten. Epidemiologic data, clinical manifestations and therapeutic indications are reviewed.     

绵阳市猫抓伤致狂犬病死亡调查

狂犬病是一种人、兽(畜)共患的死亡率极高的传染病,多由携带狂犬病毒的犬、狼、猫等肉食动物咬伤或抓伤而感染[1].肇事动物以犬最为常见,但绵阳市安县于2009-02发生了因猫抓伤导致狂犬病并死亡的案例,具体情况如下.     

A probable case of alveolar echinococcosis in Normandy, France

Echinococcus multilocularis induced liver infection was diagnosed in a Moroccan patient. Diagnosis was based on CT scan results and Western Blot test. Contamination probably occurred in France, in the Cherbourg area where the patient travelled frequently and ate wild berries. This case and other recently reported cases outside the usual endemic areas (Besan?on and the Massif Central) suggest that the Echinococcus multilocularis epidemic has moved towards the west of France. French gastroenterologists should be aware of this parasitic disease.     

Trends in national surveillance data for bat rabies in the United States: 2001-2009

Rabies remains an important public health concern in the United States, with most human cases associated with bat rabies virus variants. Cases of rabies virus (RV) infection in bats are widely distributed across the continental United States and elsewhere in the Americas. In this retrospective study, data on bats submitted to state laboratories for RV diagnosis between 2001 and 2009 were analyzed to investigate epidemiological trends in the United States. Season, region, and roosting habits were the primary risk factors of interest. During the study interval, more than 205,439 bats were submitted for RV diagnosis, and 6.7% of these bats were rabid. Increased odds of a submitted bat being rabid were associated with species that exhibit inconspicuous roosting habits, bats originating in the Southwest, and bats submitted for diagnosis during the fall. Periodic analysis of zoonotic disease surveillance is recommended to detect changes in trends regarding geographic distribution, seasonal fluctuations, and host associations; this is particularly necessary, as existing trends may be influenced by climate change or other emerging factors.     

Pneumomediastinum as initial presentation of paralytic rabies: A case report

Background  

Rabies is readily diagnosed when it presents as the classic furious form. Paralytic and atypical forms can pose significant problems in diagnosis. Catastrophic incidents included 7 organ transplant recipients who died of rabies recently in United States and Germany. Although rabies remains top in the lists of differential diagnosis of encephalitis in rabies endemic area, its complication may divert physicians from making a relevant management. We encountered an unusual case of paralytic rabies who presented with spontaneous pneumomediastinum.