Zoonoses control - Human rabies, Kentucky and Montana, 1996, United States of America

Overview

United States of America. In 1996, a 42-year-old woman in Kentucky and a 49-year-old man in Montana died from rabies.

Vitreous humour fluid and serum obtained at autopsy of the first patient both tested positive for rabies antibodies by indirect immunofluorescence, and the vitreous fluid was positive for rabies virus nucleic acid by reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. Nucleotide sequence analysis of the viral nucleic acid implicated a variant associated with the silver-haired bat (Lasionycteris noctivagans). While hospitalized, the patient had denied any history of animal bites, and an interview with her husband after her death did not establish a history of contact with bats or other animals. The couple lived in an old house in a rural area and reported frequently hearing noises in the chimney that sounded like birds. However investigation of the residence by the local health department did not detect evidence of bats in the house or chimney. Rabies post-exposure prophylaxis (PEP) was administered to 87 persons (5 family members and 82 health care workers) because of possible percutaneous or mucous membrane exposure to the patient’s saliva.