Human rabies case investigation in Sathorn District, Bangkok, 26th October–1st November 2016

Abstract

Background: On 24^th October 2016, Bureau of Epidemiology received a notification of suspected human rabies death from Lerdsin hospital, second case in Bangkok. Bureau of Epidemiology and Institute for urban disease control (IUDC) jointly conducted an investigation on 26^th October 2016. The purposes of this investigation were to confirm the diagnosis, identify the possible source of infection and find the active case exposed to rabies.
Method: We reviewed medical records for clinical information, laboratory diagnosis. Health care workers and cases’ co-worker were interviewed for cases’ rabies exposure histories and possible human exposed to rabies. We reviewed reported confirmed animal rabies in www.thairabies.net to identify the possible source of infection.
Results: The Cambodian male showed clinical symptoms on 21^st October 2016. During admission, he had agitation and seizure, dyspnea and cardiac arrest later. Health care workers intubated the endotracheal tube and performed cardio-pulmonary resuscitation in the patient. The case was bitten by a suspected dog in Chonburi province; wound scar was found at his right calf. Forty-eight humans exposed to rabies that already had complete rabies post exposure prophylaxis.
Conclusion and Recommendation: Dog in Chonburi province was a possible source of rabies infection. Forty-eight human exposed to rabies were brought to be vaccinated and followed up until complete schedule. For human rabies prevention, people should notify public health authorities when they found death unexplainable dog.