India: Two reports of humans with rabies biting other people
Two separate reports, from Madhya Pradesh state and Ludhiana in India, tell accounts of people infected with the rabies virus who later went on to bite other people.
In the first report from Madhya Pradesh as reported in the Daily Bhaskar, which has since been unavailable, a six-year-old boy was bitten by a rabid dog in January. The dog reportedly died the next day and according to family members, the 6-year-old boy developed rabies and bit 5 of them before his death in June.
In a second unusual and related account, the Times of India reports in Ludhiana, a person that was ”bitten by a street dog” got rabid and started running after other patients to bite them at the Civil Hospital, where he was undergoing treatment.
Says Dr Avinash Jindal, specialist physician who treated the patient Gurdiyal Singh at Civil Hospital: “The patient was brought to our hospital yesterday (Friday) in the emergency after he got aggressive. He was first checked by the psychiatrist as he reported of severe aggression symptoms. This morning, while we were checking him, he got more aggressive and started running after people there. He, in fact, bit a 25-year-old patient at the hospital. When I took his history, his attendant told me that he was bitten by a stray dog about 10 days ago. Suspecting him to be suffering from hydrophobia, we did a simple test and brought water in front of the patient. He got convulsions and suffered from laryngeal spasms, thus confirming that he indeed is suffering from rabies. I later gave him antibiotics and anti-convalescents.”
These two accounts of humans with reported rabies getting aggressive and attacking is clearly unusual.
As a moderator for the infectious disease website, ProMED-mail notes:
Both reports describe victims exhibiting rabies-like symptoms following a dog bite and in turn transmitting rabies by bite to other human victims. Neither incident has been corroborated independently. Likewise, rabies virus infection has not been confirmed by laboratory diagnostics in the case of either of the dogs responsible for the initial bites, or the initial human victims, or the hospitalised patients reputed to have been bitten by the supposedly rabid humans. Transmission of rabies from one human to another by bite, although not impossible, is unlikely, and, according to the US CDC, has not happened (http://www.cdc.gov/rabies/transmission/exposure.html).
According to the World Health Organization, Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus. The disease affects domestic and wild animals, and is spread to people through close contact with infectious material, usually saliva, via bites or scratches.
More than 55 000 people die of rabies every year mostly (95%) in Asia and Africa.
Post-exposure prophylaxis (PEP) consists of:
- local treatment of the wound, initiated as soon as possible after exposure;
- a course of potent and effective rabies vaccine that meets WHO recommendations; and
- the administration of rabies immunoglobulin, if indicated.
Effective treatment soon after exposure to rabies can prevent the onset of symptoms and death.
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