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

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Rabies is a fatal viral zoonosis caused by lyssavirus, prevalent globally, particularly in low-income nations.
• Domestic animal contact, primarily dogs, is the main transmission route to humans.
• Children under 15 represent nearly half of all rabies cases.

Observation:

• An 11-year-old Ghanaian student presented with acute neurological symptoms including aggressive behavior, confusion, and loss of consciousness.
• The patient had a history of a stray dog bite on her leg five years prior, with no post-exposure prophylaxis administered.
• The patient died within 24 hours of symptom onset.

Findings:

• Real-time polymerase chain reaction (PCR) testing on cerebrospinal fluid confirmed rabies post-mortem.
• Phylogenetic analysis identified the causative virus as belonging to the Africa 2 lineage, common in Ghana.
• The case illustrates a rabies incubation period of at least five years.

Implications:

• Rabies incubation periods are variable, emphasizing the need for vigilance even years after exposure.
• Molecular diagnostic tools are crucial for accurate rabies case confirmation, especially in resource-limited settings.
• Effective rabies control programs should integrate advanced molecular testing capabilities.