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Published Date: 2019-06-04 14:40:09
Subject: PRO/AH/EDR> Rabies (32): Americas, Brazil (PA) susp, RFI
Archive Number: 20190604.6503047
RABIES (32): AMERICAS, BRAZIL (PARA) SUSPECTED, REQUEST FOR INFORMATION
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Date: Fri 31 May 2019
Source: G1 [in Portuguese, trans. Corr.SB, abridged, edited]
https://g1.globo.com/pa/santarem-regiao/noticia/2019/05/31/paciente-de-ruropolis-da-entrada-no-hms-com-suspeita-de-raiva-humana.ghtml


The epidemiology department of the Santarem public health network in western Para is investigating a case of suspected human rabies in a patient who arrived in the city on Thursday night [30 May 2019) from Ruropolis, in Para state.

The patient, a boy only 9 years old, who came from Ruropolis with a referral to TOD (treatment out of domicile) is hospitalized at the Municipal Hospital Dr Alberto Tolentino Sotelo (HMS/Santarem Municipal Hospital). Due to the suspicion of human rabies, the child was placed in an isolation room, where he is receiving medication and going through collection of material for [laboratory] examination.

Through a notice, the Municipal Hospital reported that the epidemiology team at HMS, led by 2 infectious diseases experts, is monitoring the case. Among possible diseases, human rabies is suspected.

Blood, and saliva tests are in the process of being collected and will be sent to the authorized laboratory in Belem. The results should arrive the next week [week of 3 Jun 2019].

Also according to the notice, the clinical picture of the patient is serious. He is intubated in the unit's isolation room.

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[As my ProMED-Port colleague RNA commented this account lacks any information on how this boy might have been exposed and when, when did his symptoms start, and whether he is receiving the appropriate post-exposure immune serum and vaccine. Treatment of human rabies cases once symptoms have started is difficult and rarely successful though latterly, with better knowledge, there have been successes.

HealthMap/ProMED-mail map of Brazil: http://healthmap.org/promed/p/65112.
Ruropolis is a municipality in the state of Para in the northern region of Brazil. The municipality contains part of the Trairao National Forest, in which logging is permitted subject to a management plan. It also holds part of the Tapajos National Forest, a 549 067 hectares (1 356 770 acres) sustainable use conservation unit created in 1974 (https://en.wikipedia.org/wiki/Rur%C3%B3polis). This amount of woodland raises the possibility that this boy, if he has rabies, was infected by a bat. Bat rabies is common in Brazil. Of course it could have been from a rabid dog. - Mod.MHJ

More information on the results of testing and epidemiologic information such as route of transmission and location of exposure would be greatly appreciated. - Mod.MPP]

See Also

Rabies (25): Americas, Brazil (SC) human 20190507.6459316
Rabies (15): Americas, Brazil (RS) bat, cattle 20190409.6413470
2018
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Rabies (25): Americas (Brazil) 20180519.5805172
Rabies (04): Americas (USA, Brazil) bat, human, Milwaukee protocol 20180111.5553455
2017
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Rabies (24): Americas (Brazil) vampire bat, human exp, fatal 20170601.5075386
Rabies (05): Americas (Brazil) vampire bat, human exp 20170116.4768775
2016
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Rabies, human, bat - Brazil: (CE) 20161102.4602888
Rabies, equine - Brazil: new study 20160110.3924945
2015
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Rabies - Brazil: (RN ex PB) human, feline exposure 20150901.3616621
2012
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Rabies, bovine - Brazil (04): (RS) 20120419.1107099
Rabies, human - Brazil (03): (CE) 20120314.1070531
Rabies, human - Brazil (02): (CE) 20120310.1066763
Rabies, bovine - Brazil: (PA) 20120223.1050775
Rabies, human, bovine - Mexico, Brazil 20120123.1018767
with more reports back to 1999
.................................................rna/mhj/mj/mpp

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