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Updated: Apr 1, 2026
Field Postmortem Rabies Rapid Immunochromatographic Diagnostic Test for Resource-Limited Settings with Further Molecular Applications
Published on: June 29, 2020
Paralytic rabies outbreak mimicking guillain-Barré syndrome in French Amazonia
Nathalie Deschamps1,2, Claire Mayence3, Perrine Parize4
1Neurology Department, University Hospital of Guyane, Cayenne, French Guiana, France.
Background:
In the Amazonian region, vampire bats are the primary reservoir of rabies virus, causing sporadic and lethal human rabies cases that often remain unnoticed. Managing human cases in this region is challenging and further complicated by atypical clinical forms and the potential exposure to various toxic compounds, particularly among gold miners.
Methods:
We carried out clinical, electrical, biological and histological analysis of concurrent cases of progressive motor neuronopathy and fatal encephalitis in a context of regular exposure to bat bites of gold miners living in a small and remote gold mine camp in Amazonia, in French Guiana, South America.
Findings:
We analyzed a spatio-temporal cluster of three suspected rabies cases in 2024 with a fatal outcome, with concomitant onset of acute bilateral lower-limb paralysis without demyelination, two of which occurred presumably two weeks after a bat-bite. Electroneuromyography suggested the involvement of the anterior horn of the spinal cord, as described in furious forms of rabies. None of the cases exhibited other cardinal signs of the furious form. Confirmation of rabies was obtained for them on sera and brain biopsies collected ante- and post-mortem respectively.
Interpretation:
The concurrent occurrence of disease, the axonal motor neuropathy mimicking the motor form of Guillain Barré syndrome in the context of paralytic rabies, lead to diagnostic-wandering. This underscores the importance of thinking about vampire bat rabies virus in the presence of any atypical neurological picture in patients living in exposed areas in Latin America.
Insights
Rabies from vampire bats in Amazonia presents atypical neurological symptoms, mimicking other conditions like Guillain-Barré syndrome. Early recognition of paralytic rabies is crucial for timely diagnosis and treatment in at-risk populations.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Vampire bats are primary rabies reservoirs in Amazonia, causing often unnoticed, fatal human cases.
- Management is complicated by atypical rabies presentations and co-exposure to toxins, especially in gold miners.
Purpose of the Study:
- To investigate concurrent cases of motor neuronopathy and encephalitis in gold miners exposed to bat bites.
- To analyze a spatio-temporal cluster of suspected rabies cases with unusual clinical presentations.
Main Methods:
- Clinical, electrical, biological, and histological analyses were performed.
- Electroneuromyography and post-mortem brain biopsies were utilized for diagnosis.
Main Results:
- Three fatal rabies cases occurred, presenting with acute bilateral lower-limb paralysis without demyelination, two weeks post-bat bite.
- Electroneuromyography indicated spinal cord involvement, but cardinal signs of furious rabies were absent.
- Rabies was confirmed via sera and brain biopsies.
Conclusions:
- Atypical paralytic rabies can mimic motor neuronopathy and Guillain-Barré syndrome, causing diagnostic challenges.
- Vampire bat rabies should be considered in atypical neurological cases from exposed regions in Latin America.
