Dog-Mediated Human Rabies Death, Haiti, 2016

Abstract

Haiti has experienced numerous barriers to rabies control over the past decades and is one of the remaining Western Hemisphere countries to report dog-mediated human rabies deaths. We describe the circumstances surrounding a reported human rabies death in 2016 as well as barriers to treatment and surveillance reporting.

Human death from suspected rabid dog bite in Zamfara State, Nigeria

“…The incubation period observed in this case is consistent with 1-3 months previously stated by the World Health Organization, and also coincides with the results of other studies (World Health Organization, 2013;Wallace et al, 2016;Ahmad et al, 2017;Qi et al, 2018;Tran et al, 2018). Preceding reports have indicated a shorter incubation period in cases with category III exposure site on the upper limb (Wallace et al, 2016;Qi et al, 2018). Bite on the hands has been considered as one of the factors leading to a shorter eclipse period in rabies exposure, due to the decreased length to travel by the viral inoculum to reach the central nervous system and greater number of neurons (Singh et al, 2017).…”

“…After the victim was bitten, it took almost two months before the onset of clinical signs while death ensued within 10 days following the noticeable symptoms. The incubation period observed in this case is consistent with 1-3 months previously stated by the World Health Organization, and also coincides with the results of other studies (World Health Organization, 2013;Wallace et al, 2016;Ahmad et al, 2017;Qi et al, 2018;Tran et al, 2018). Preceding reports have indicated a shorter incubation period in cases with category III exposure site on the upper limb (Wallace et al, 2016;Qi et al, 2018).…”

“…Hence, this case can basically be classified as probable rabies. The recognized clinical signs and course of the illness in this case were similar to the previously reported exposures describing rabies in humans who died after being bitten by a suspected rabid dog (Wallace et al, 2016;Tran et al, 2018). Although the surveillance of rabies in humans has not been well carried out in Nigeria, the first documented rabies case in Zamfara State was detected in a sheep that had been bitten by an aggressive stray dog (Ahmad et al, 2017).…”

“…This incident occurred in a rural area at the peak of the farming season, during which outdoor activities of the farmers increased, leading to an enhanced chance of contact with the stray dog and potential exposure to rabies. Previous studies support this view, which showed that most human rabies-related deaths are being recorded from rural communities (Wallace et al, 2016;Tarantola et al, 2017;Qi et al, 2018;Tran et al, 2018). However, access to highly effective intervention such as timely PEP, has been considered challenging especially in rabies-endemic developing countries, where most exposures occur in rural areas (Tarantola et al, 2017).…”

Meeting the urgent need for rabies education in Haiti

“…This article addresses the third objective, rabies education for health officials, clinicians and community members. MSPP and PAHO officials in Haiti stated that health officials and clinicians urgently needed training on (i) rapid and timely post‐exposure prophylaxis (PEP); (ii) care for people who have been bitten by potentially rabid animals; and (iii) proper procedures for reporting these bites to health authorities (Millien et al., ; Wallace, et al, ). Such training and educational outreach could save lives if more bite victims receive appropriate PEP and care immediately after they are bitten (World Health Organization, 2013).…”