Imported Human Rabies - Kentucky and Ohio, 2024

Area of Science:

• Infectious Diseases
• Virology
• Public Health

Background:

• Human rabies is rare in the U.S., often linked to foreign travel and domestic animal contact.
• A case in Kentucky involved a traveler from Haiti, presenting with neurological and respiratory symptoms.

Purpose of the Study:

• To analyze a rare U.S. human rabies case acquired internationally.
• To evaluate diagnostic delays and infection control practices.
• To emphasize the importance of early rabies suspicion and management.

Main Methods:

• Case report analysis of a patient with rabies acquired in Haiti.
• Review of clinical course, diagnostic testing timeline, and phylogenetic analysis.
• Assessment of contact tracing and post-exposure prophylaxis recommendations.

Main Results:

• Rabies was confirmed late in the clinical course, with phylogenetic analysis indicating a dog-maintained variant from Haiti.
• Significant delays occurred in rabies testing and diagnosis.
• Inconsistent adherence to standard precautions led to potential exposures, primarily among healthcare workers.

Conclusions:

• Early consideration of rabies and prompt public health consultation are vital.
• Universal adherence to standard infection control precautions is essential in all patient care.
• This case underscores the risk of acquiring rabies abroad and the need for vigilance.