Sunday, November 30, 2008
From 2004 -- that awful transplant story
ATLANTA, Georgia (CNN) -- Rabies spread by organs taken from an infected donor has killed three transplant recipients, the Centers for Disease Control and Prevention said Thursday.
"This has never happened before," said Dr. Mitch Cohen, an infectious disease expert at the CDC, in a conference call with reporters.
A fourth recipient died during the actual transplant operation, before there was time to develop the disease, officials said.
Rabies was also determined to be responsible for the death of the organ donor.
The unprecedented case began nearly two months ago, shortly after an Arkansas man suffered a brain hemorrhage and died at Christus Saint Michael Healthcare Center in Texarkana, Texas.
The man's lungs, kidneys and liver were transplanted May 4.
The impact of the virus began to emerge within weeks.
The liver recipient died June 7; one kidney recipient died June 8 and the other kidney recipient died June 21. The patient who died was undergoing lung transplant surgery.
Though the risk of person-to-person transmission of rabies is low, the disease is nearly always fatal.
Health officials urged anyone who may have had contact with the infected patients to be tested for rabies, and patients at five hospitals were being sought.
In addition to the Texarkana hospital, the other facilities are Baylor University Medical Center in Dallas; the University of Alabama-Birmingham Hospital; Wadley Regional Medical Center, Texarkana, Texas; and Good Shepherd Medical Center Longview, Texas.
Cohen said rabies typically occurs in just one to three people in the United States in any given year, and is most often transmitted by the bite of an infected mammal.
Based on laboratory tests, health experts said they believe a bat infected the organ donor.
Rabies tests are not routine donor screening tests, Virginia McBride, public health organ donation specialist with the Health Resources and Services Administration, said.
The number of tests is limited because doctors have only about six hours from the time a patient is declared brain-dead until the transplantation must begin for the organs to maintain viability.
Potential donors are tested for other infectious diseases such as HIV, hepatitis B and C and syphilis, she said.
Person-to-person rabies transmission has been reported in only two cases, both of which occurred in Ethiopia via contact with saliva, Cohen said. One infection resulted from a bite, the other a kiss, he added.
That Venezuela Vampire Bat story
http://www.cbsnews.com/stories/2008/08/08/world/printable4334964.shtml
Vampire Bats Eyed For Venezuela Deaths
CARACAS, Venezuela, Aug. 8, 2008
(AP) At least 38 Warao Indians have died in remote villages in Venezuela, and medical experts suspect an outbreak of rabies spread by bites from vampire bats.
Laboratory investigations have yet to confirm the cause, but the symptoms point to rabies, according to two researchers from the University of California at Berkeley and other medical experts.
The two UC Berkeley researchers - the husband-and-wife team of anthropologist Charles Briggs and public health specialist Dr. Clara Mantini-Briggs - said the symptoms include fever, body pains, tingling in the feet followed by progressive paralysis, and an extreme fear of water. Victims tend to have convulsions and grow rigid before death.
Dr. Charles Rupprecht, chief of the rabies program at the U.S. Centers for Disease Control and Prevention in Atlanta, agreed with their preliminary diagnosis.
"The history and clinical signs are compatible with rabies," Rupprecht told The Associated Press on Friday. "Prevention is straightforward: Prevent bites and vaccinate those at risk of bites."
Venezuelan health officials are investigating the outbreak and plan to distribute mosquito nets to prevent bat bites and send a medical boat to provide treatment in remote villages on the Orinoco River delta, Indigenous Peoples Minister Nicia Maldonado told the state-run Bolivarian News Agency on Thursday.
Outbreaks of rabies spread by vampire bats are a problem in various tropical areas of South America, including Brazil and Peru, Rupprecht said.
He said researchers suspect that in some cases environmental degradation - including mining, logging or dam construction projects - may also be contributing to rabies outbreaks.
"Vampire bats are very adaptable," Rupprecht said. And when their roosts are disrupted or their normal prey grow scarce, "Homo sapiens is a pretty easy meal."
More study is needed to confirm through blood or other samples from victims that it is the rabies virus in Venezuela, researchers say.
At least 38 Warao Indians have died since June 2007, and at least 16 have died since the start of June 2008, according to a report the Berkeley researchers and indigenous leaders provided to Venezuelan officials this week.
All victims died within two to seven days from the onset of symptoms, Briggs said.
One village, Mukuboina, lost eight of its roughly 80 inhabitants
all of them children, he said.
During a study trip Briggs and Mantini-Briggs made through 30 villages in the river delta, relatives said the victims had been bitten by bats. The couple have worked among the Warao in Delta Amacuro state for years and were invited by indigenous leaders to study the outbreak.
"It's a monster illness," said Tirso Gomez, a Warao traditional healer who said the indigenous group of more than 35,000 people has never experienced anything similar.
Another tropical medicine expert, Dr. Daniel Bausch of Tulane University in New Orleans, agreed the symptoms and accounts suggest rabies transmitted by bats, and if confirmed, "probably a vaccination campaign would be in order."
The common vampire bat, which feeds on mammals' blood, swoops down and generally approaches its sleeping prey on the ground. The bat then makes a small incision with its teeth, and an anticoagulant in its saliva keeps the blood flowing while it laps up its meal with its tongue.
The researchers in Venezuela have begun taking precautions. Mantini-Briggs, a Venezuelan former health official, said she started to wonder about her own health Friday while talking with biologist Omar Linares, a bat expert at Caracas' Simon Bolivar University.
She remembered there was blood on her sheet after sleeping in a hammock in a village two weeks ago. Initially she dismissed it as nothing important, but she also remembered her finger hurt that morning and that she saw two small red dots there.
Linares suggested she get rabies shots immediately.
"They're vaccinating me," Mantini-Briggs said. "I'm sure a bat bit me."
Vampire Bats Eyed For Venezuela Deaths
CARACAS, Venezuela, Aug. 8, 2008
(AP) At least 38 Warao Indians have died in remote villages in Venezuela, and medical experts suspect an outbreak of rabies spread by bites from vampire bats.
Laboratory investigations have yet to confirm the cause, but the symptoms point to rabies, according to two researchers from the University of California at Berkeley and other medical experts.
The two UC Berkeley researchers - the husband-and-wife team of anthropologist Charles Briggs and public health specialist Dr. Clara Mantini-Briggs - said the symptoms include fever, body pains, tingling in the feet followed by progressive paralysis, and an extreme fear of water. Victims tend to have convulsions and grow rigid before death.
Dr. Charles Rupprecht, chief of the rabies program at the U.S. Centers for Disease Control and Prevention in Atlanta, agreed with their preliminary diagnosis.
"The history and clinical signs are compatible with rabies," Rupprecht told The Associated Press on Friday. "Prevention is straightforward: Prevent bites and vaccinate those at risk of bites."
Venezuelan health officials are investigating the outbreak and plan to distribute mosquito nets to prevent bat bites and send a medical boat to provide treatment in remote villages on the Orinoco River delta, Indigenous Peoples Minister Nicia Maldonado told the state-run Bolivarian News Agency on Thursday.
Outbreaks of rabies spread by vampire bats are a problem in various tropical areas of South America, including Brazil and Peru, Rupprecht said.
He said researchers suspect that in some cases environmental degradation - including mining, logging or dam construction projects - may also be contributing to rabies outbreaks.
"Vampire bats are very adaptable," Rupprecht said. And when their roosts are disrupted or their normal prey grow scarce, "Homo sapiens is a pretty easy meal."
More study is needed to confirm through blood or other samples from victims that it is the rabies virus in Venezuela, researchers say.
At least 38 Warao Indians have died since June 2007, and at least 16 have died since the start of June 2008, according to a report the Berkeley researchers and indigenous leaders provided to Venezuelan officials this week.
All victims died within two to seven days from the onset of symptoms, Briggs said.
One village, Mukuboina, lost eight of its roughly 80 inhabitants
all of them children, he said.
During a study trip Briggs and Mantini-Briggs made through 30 villages in the river delta, relatives said the victims had been bitten by bats. The couple have worked among the Warao in Delta Amacuro state for years and were invited by indigenous leaders to study the outbreak.
"It's a monster illness," said Tirso Gomez, a Warao traditional healer who said the indigenous group of more than 35,000 people has never experienced anything similar.
Another tropical medicine expert, Dr. Daniel Bausch of Tulane University in New Orleans, agreed the symptoms and accounts suggest rabies transmitted by bats, and if confirmed, "probably a vaccination campaign would be in order."
The common vampire bat, which feeds on mammals' blood, swoops down and generally approaches its sleeping prey on the ground. The bat then makes a small incision with its teeth, and an anticoagulant in its saliva keeps the blood flowing while it laps up its meal with its tongue.
The researchers in Venezuela have begun taking precautions. Mantini-Briggs, a Venezuelan former health official, said she started to wonder about her own health Friday while talking with biologist Omar Linares, a bat expert at Caracas' Simon Bolivar University.
She remembered there was blood on her sheet after sleeping in a hammock in a village two weeks ago. Initially she dismissed it as nothing important, but she also remembered her finger hurt that morning and that she saw two small red dots there.
Linares suggested she get rabies shots immediately.
"They're vaccinating me," Mantini-Briggs said. "I'm sure a bat bit me."
That Rabid Fox story
Chino Valley woman battles rabid fox
By T.M. Shultz, Courtesy of the Daily Courier
Thursday, November 06, 2008
A Chino Valley woman must undergo a series of rabies shots after battling a sick fox that bit her twice.
Thirty-year-old Michelle Felicepta said she was jogging late Monday afternoon on her favorite trail at the base of Granite Mountain when she saw the fox coming down onto the trail ahead of her. She stopped as the 10- to 15-pound animal turned and faced her. "I knew something was wrong when its eyes locked in on me," Felicepta said Wednesday during a telephone interview. As she started backing away, the fox lunged at her and bit her foot. Then it went for her knee. As it did, the woman instinctively grabbed it by the neck, trying to pull it away. "As soon as I grabbed its neck, it started thrashing and grabbed my left arm," Felicepta continued. The fox bit down hard, drawing blood. "The teeth were in real deep," Felicepta recalled.
She started looking around for a stick to pry its mouth open, but couldn't find one.
"I was choking him with my right hand and each time I (loosened) up my grip a little, he got a little bit of air and he'd start thrashing around and kind of screaming." Finally, believing the fox was rabid and knowing authorities would need to test it to make sure, she decided to run back to her car - parked about a mile and a half away - with the fox's mouth still clamped on her arm, her right hand gripped tightly around its throat. "Thank god for adrenaline," Felicepta said.
After reaching her car and popping open the trunk, she managed to pry the fox's mouth open. "I'd been choking that thing the whole time," Felicepta said, laughing at her own ferocity. She yanked off her sweatshirt, wrapped it around the fox and flung the animal into her trunk "as hard as I could," she added. Next, she hopped into her car and drove herself to Yavapai Regional Medical Center. On the way there, she finally got scared. "That's when it kind of sunk in," Felicepta said.
At the hospital, the fox also bit a Yavapai County Animal Control Officer as the officer was getting the animal out of the trunk, said Dwight D'Evelyn, spokesman for the Yavapai County Sheriff's Office. On Tuesday, the Arizona State Health Laboratory in Phoenix tested the fox and confirmed it had rabies. Felicepta will get five rabies shots over the next few weeks. The animal control officer will get only two or three because he had already received a pre-exposure rabies vaccination, D'Evelyn said.
Arizona's public health veterinarian, Elisabeth Lawaczeck, said Felicepta did the best she could under difficult circumstances. "It's kind of just bad luck when you're on a trail and get attacked," Lawaczeck said. Last year Yavapai County had six confirmed cases of rabies in wild animals. So far this year it has recorded 10. That's not unusual, Lawaczeck said. "Rabies is a cyclical disease because it wipes out the population that has it," she explained.
By T.M. Shultz, Courtesy of the Daily Courier
Thursday, November 06, 2008
A Chino Valley woman must undergo a series of rabies shots after battling a sick fox that bit her twice.
Thirty-year-old Michelle Felicepta said she was jogging late Monday afternoon on her favorite trail at the base of Granite Mountain when she saw the fox coming down onto the trail ahead of her. She stopped as the 10- to 15-pound animal turned and faced her. "I knew something was wrong when its eyes locked in on me," Felicepta said Wednesday during a telephone interview. As she started backing away, the fox lunged at her and bit her foot. Then it went for her knee. As it did, the woman instinctively grabbed it by the neck, trying to pull it away. "As soon as I grabbed its neck, it started thrashing and grabbed my left arm," Felicepta continued. The fox bit down hard, drawing blood. "The teeth were in real deep," Felicepta recalled.
She started looking around for a stick to pry its mouth open, but couldn't find one.
"I was choking him with my right hand and each time I (loosened) up my grip a little, he got a little bit of air and he'd start thrashing around and kind of screaming." Finally, believing the fox was rabid and knowing authorities would need to test it to make sure, she decided to run back to her car - parked about a mile and a half away - with the fox's mouth still clamped on her arm, her right hand gripped tightly around its throat. "Thank god for adrenaline," Felicepta said.
After reaching her car and popping open the trunk, she managed to pry the fox's mouth open. "I'd been choking that thing the whole time," Felicepta said, laughing at her own ferocity. She yanked off her sweatshirt, wrapped it around the fox and flung the animal into her trunk "as hard as I could," she added. Next, she hopped into her car and drove herself to Yavapai Regional Medical Center. On the way there, she finally got scared. "That's when it kind of sunk in," Felicepta said.
At the hospital, the fox also bit a Yavapai County Animal Control Officer as the officer was getting the animal out of the trunk, said Dwight D'Evelyn, spokesman for the Yavapai County Sheriff's Office. On Tuesday, the Arizona State Health Laboratory in Phoenix tested the fox and confirmed it had rabies. Felicepta will get five rabies shots over the next few weeks. The animal control officer will get only two or three because he had already received a pre-exposure rabies vaccination, D'Evelyn said.
Arizona's public health veterinarian, Elisabeth Lawaczeck, said Felicepta did the best she could under difficult circumstances. "It's kind of just bad luck when you're on a trail and get attacked," Lawaczeck said. Last year Yavapai County had six confirmed cases of rabies in wild animals. So far this year it has recorded 10. That's not unusual, Lawaczeck said. "Rabies is a cyclical disease because it wipes out the population that has it," she explained.
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