If you are planning a trip abroad, you might want to make sure you are up to date with your rabies vaccination. An American woman lost her life to the viral disease after being bitten by a dog while on a yoga retreat in India.
The Centers for Disease Control and Prevention recently revealed that the 65-year-old Virginia woman had spent seven weeks in the South Asian country, during which time she was bitten on the right hand by a puppy. Instead of seeking medical treatment, she opted to clean the wound herself.
Over a month after returning home, on May 3, 2017, she started experiencing pain in her right arm. She waited three days and then decided to go to urgent care. They misdiagnosed her with carpal tunnel syndrome, sending her home with anti-inflammatory drugs and hydrocodone. However, the CDC reports she checked into the hospital on May 7 with symptoms including shortness of breath, anxiety, insomnia, and difficulty swallowing. Once again, she was misdiagnosed, this time with a panic attack. The anxiety meds she was given failed to work, and she didn’t make it out of the parking lot before she was back in the emergency room for shortness of breath and claustrophobia. She was again misdiagnosed with a panic attack.
On May 8 she was delivered to the hospital via ambulance for pain in her arm and shoulder, shortness of breath, anxiety and progressive paresthesia – numbness or a burning sensation of the extremities. A neurological exam was conducted and she showed signs of ataxia, the loss of control of bodily functions. Her lab results also revealed elevated cardiac enzymes and electrocardiogram results suggested acute cardiac ischemia with atypical chest pain. The patient underwent emergency cardiac catheterization, indicating normal coronary arteries.
That evening the woman became “progressively agitated and combative” and was reported to be gasping for air when she tried to drink water. At that point the hospital staff asked the woman’s husband about animal exposure, and he revealed that she had been bitten by a puppy on her trip. Additionally, there were no reports that she had undergone a health screening before her international travels, nor received a rabies vaccination - not only in preparation for her trip, but ever in her life.
On May 9 she was placed on a ventilator, showing signs of a severe brain infection. On May 11 she was officially diagnosed with rabies and over the next 10 days doctors attempted to save her life to no avail. After being put in a medically induced coma, her family decided to halt all treatment on May 21 and she died shortly after.
What is rabies?
According to the CDC, rabies is transmitted through saliva or brain/nervous system tissue and usually from a rabid animal. The only way to get it is by coming into contract with these exact bodily excretions and tissues. Human-to-human transmission is very rare, and has only occurred among eight recipients of transplanted corneas as well as three recipients of solid organs.
The early symptoms of rabies in humans include fever, headache, and general weakness or discomfort. As the disease progresses, other more more specific symptoms may appear, including insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficulty swallowing, and hydrophobia, the fear of water. Within days of these symptoms, death usually occurs.
While canine rabies was eliminated from the United States in 2004 because of vaccinations, the CDC maintains it remains an epidemic in 122 countries and India has “the world’s largest incidence of dog-mediated human rabies deaths.” In the last 10 years, just nine people have died from rabies in the United States following exposure abroad.
If you believe you have been exposed to rabies through an animal bite, the CDC recommends washing the wound thoroughly with soap and water and seeking medical attention. Your physician will likely treat the trauma wound before deciding if you need a vaccination.
The government agency hopes that by sharing this tragic story, it will encourage individuals traveling abroad to “seek pretravel guidance, including recommended vaccination and prophylactic measures.”
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