Title : Investigation of wild canid-mediated human rabies death, Brazil, 2021
Abstract:
Rabies is an acute viral disease with extremely high lethality, still causing approximately 59,000 human deaths worldwide every year. Despite being a disease studied for many years and having a very efficient prophylaxis, a high incidence rate is observed in developing countries. Because the rabies virus has various reservoirs (all mammals), controlling viral circulation is not an easy task for health surveillance teams, especially in rural areas, as domestic animals (dogs and cats) actively participate in the virus's infectious cycle, and wild animals such as bats and foxes also enter in this ecological niche. And right now, we report a case of a 2-year-old boy who tragically succumbed to human rabies in northeastern Brazil. Initially, the child had a history of being attacked on the legs by a cat, according to the family`s report. Some nervous symptoms appeared 35 days after the aggression by the animal, but there was an association with an allergy to the polio vaccine two days before the onset of symptoms, and the cat was still alive. Through Sanger sequencing and on-site epidemiological investigation, we have confirmed, for the first time, this case of human rabies linked to the wild canid variant in an area of the Amazon-Cerrado transition. Despite attempts at treatment following the Recife protocol, the child passed away on November 3, 2021. Our findings highlight the interrelationship between humans, the variant virus, and animals, focusing on the importance of thorough medical history-taking by medical services in these rural areas. This highlights the impact on global public health in the Amazon-Cerrado transition region of northeastern Brazil, due to the re-emergence of wild canid-mediated human rabies, sounding a significant alert for health surveillance services in remote areas away from urban centers.
