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Whole Genome Sequencing for Rapid Characterization of Rabies Virus Using Nanopore Technology
Published on: August 18, 2023
Imported human rabies in Switzerland, 2012: a diagnostic conundrum
A N Deubelbeiss1, Ch Trachsel, E B Bachli
1Institute of Veterinary Virology, Laenggass-Strasse 122, CH-3012 Berne, Switzerland.
Summary
A rare imported human rabies case in Switzerland highlights diagnostic challenges. Phylogenetic analysis identified the virus as an American bat rabies strain, emphasizing the need for prompt postexposure prophylaxis.
Area of Science:
- Neurology
- Infectious Diseases
- Virology
Background:
- Human rabies is uncommon in Western Europe and often difficult to diagnose without a known exposure history.
- This case underscores the importance of considering rabies in patients with unexplained encephalitis, especially those with travel history.
Observation:
- A U.S. citizen developed progressive encephalitis and coma after presenting with shoulder pain in Iraq.
- The patient was transferred through the UAE to Switzerland, where he ultimately died.
Findings:
- Autopsy revealed severe encephalitis, with rabies diagnosed via rapid fluorescent focus inhibition test (RFFIT) and fluorescence antibody testing (FAT).
- Molecular analysis identified the causative agent as an American bat rabies virus strain (Tadarida brasiliensis-associated).
Implications:
- This case highlights the diagnostic difficulties of rabies without a clear exposure history.
- Prompt postexposure prophylaxis (PEP) was administered to close contacts and healthcare workers, crucial for preventing further transmission.
