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Case Reports
. 2021 Dec 1;15(1):575.
doi: 10.1186/s13256-021-03164-y.

Rabies is still a fatal but neglected disease: a case report

Y A Amoako  1   2 , P El-Duah  3   4 , A A Sylverken  3   5 , M Owusu  3   6 , R Yeboah  3 , R Gorman  3 , T Adade  3 , J Bonney  3 , W Tasiame  3   4 , K Nyarko-Jectey  7 , T Binger  3 , V M Corman  4 , C Drosten  4 , R O Phillips  3   8
Affiliations
Case Reports

Rabies is still a fatal but neglected disease: a case report

Y A Amoako et al. J Med Case Rep. .

Abstract

Background: Rabies, caused by a lyssavirus, is a viral zoonosis that affects people in many parts of the world, especially those in low income countries. Contact with domestic animals, especially dogs, is the main source of human infections. Humans may present with the disease only after a long period of exposure. Nearly half of rabies cases occur in children <15 years old. We report on a fatal case of rabies in a Ghanaian school child 5 years after the exposure incident, and the vital role of molecular tools in the confirmation of the diagnosis.

Case presentation: The patient, an 11-year-old junior high school Ghanaian student from the Obuasi Municipality in Ghana, presented with aggressive behavior, which rapidly progressed to confusion and loss of consciousness within a day of onset. Her parents reported that the patient had experienced a bite from a stray dog on her right leg 5 years prior to presentation, for which no antirabies prophylaxis was given. The patient died within minutes of arrival in hospital (within 24 hours of symptom onset). Real-time polymerase chain reaction testing of cerebrospinal fluid obtained after her death confirmed the diagnosis of rabies. Subsequent phylogenetic analysis showed the virus to belong to the Africa 2 lineage of rabies viruses, which is one of the predominant circulating lineages in Ghana.

Conclusion: The incubation period of rabies is highly variable so patients may only present with symptoms long after the exposure incident. Appropriate molecular testing tools, when available as part of rabies control programmes, are vital in confirming cases of rabies.

Keywords: Diagnostic testing; Ghana; Incubation period; Rabies.

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Conflict of interest statement

The authors declare that they have no competing interests

Figures

Fig. 1.
Fig. 1.
Phylogenetic tree comparing Lyssavirus genotypes. Tree was generated using maximum likelihood reconstruction by the general time reversible model with a gamma distribution and proportion of invariable sites (GTR+I+G). The tree is based on whole genome sequences and was rooted with a Mokola virus (Genotype 3). Tips were labeled with accession numbers and virus names in brackets. The sequence obtained in this study is shown by bold type font
Fig. 2.
Fig. 2.
Phylogenetic tree comparing rabies viruses from Africa. Tree was generated using maximum likelihood reconstruction by a transition model with a gamma distribution and proportion of invariable sites (TIM1+G+I). The tree is based on complete nucleoprotein sequences and rooted with the Africa 4 lineage branch. Tips are labeled with accession numbers and country of origin in brackets. The sequence obtained in this study is shown by a bold type font
See this image and copyright information in PMC

References

    1. WHO. Rabies. https://www.who.int/news-room/fact-sheets/detail/rabies. Accessed 7 Aug 2020.
    1. CDC. Rabies. https://www.cdc.gov/rabies/about.html. Accessed 7 Aug 2020.
    1. Laryea D, Owusu R, Arthur J, Agyemang E, Spangenberg K. Human rabies in Kumasi: a growing public health concern. Afr J Curr Med Res. 2017;1:1.
    1. Punguyire DT, Osei-Tutu A, Aleser EV, Letsa T. Level and pattern of human rabies and dog bites in Techiman Municipality in the Middle Belt of Ghana: a six year retrospective records review. Pan Afr Med J. 2017;28:281. doi: 10.11604/pamj.2017.28.281.14218. - DOI - PMC - PubMed
    1. Kenu E, Ganu V, Noora CL, Adanu R, Lartey M. Management of dog bites by frontline service providers in primary healthcare facilities in the Greater Accra Region of Ghana, 2014–2015. Infect Dis Poverty. 2018;7(1):18. doi: 10.1186/s40249-018-0398-3. - DOI - PMC - PubMed

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