Human Rabies Case Under Investigation

Albany, October 4, 2000 – State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H., said today that tests indicate that an adult male patient who is hospitalized at Glens Falls Hospital is infected with the rabies virus.

Dr. Novello said the New York State Department of Health is working closely with Warren County public health officials, and Glens Falls Hospital in the disease investigation.

The patient, who is not from the United States, was visiting the Glens Falls area and was admitted to the hospital late last week when symptoms became evident. The preliminary clinical diagnosis of rabies was followed today by test results from the New York State Health Department's Wadsworth Center's rabies laboratory, where microscopic examination of samples confirmed rabies infection.

It is not known how the patient contracted the disease, but evidence indicates he was not infected in this country. The incubation period for rabies is variable, but can take from two weeks to several months. In rare instances, incubation periods of over one year have been reported. The patient only arrived in the United States on September 22, and there is no evidence that he contracted the disease here.

Health officials stress that there is no risk to anyone who may have had casual contact with the patient. Rabies is primarily transmitted through bites, and only rarely through broken skin or mucous membrane exposure to infected saliva or spinal fluid. Close contacts, including hospital staff who have been caring for the patient, will be evaluated to determine if they need rabies post–exposure treatment.

"There has never been a documented case of human–to–human transmission of rabies," Dr. Novello said. "However, post–exposure treatment may be considered for those who had close, personal contact with the patient, such as care–givers. State Health Department staff will help to assess which individuals, if any, may be at risk and should be vaccinated."

Human post–exposure treatment consists of a dose of rabies immune globulin, followed immediately by the first of five doses of rabies vaccine. The remaining doses are given on days three, seven, 14 and 28 following the initial injection. Post–exposure treatment is effective if started soon after exposure and administered according to the Centers for Disease Control and Prevention (CDC) protocol.

State health officials have notified the CDC about the case, which will facilitate investigation of possible exposure to individuals overseas. Because the patient is not from this country, it may be difficult to determine how the exposure occurred. Further laboratory tests are underway to identify the particular strain of rabies virus that infected the patient.

Rabies is a viral disease affecting the central nervous system. It is transmitted from infected animals to humans, and is almost always fatal once symptoms occur. However, prompt immunization after exposure is an effective treatment against rabies, preventing the onset of symptoms.

The last human case of rabies in New York State occurred in 1995. The patient was a 13 year old Connecticut girl who was hospitalized and later died at Westchester Medical Center. Two years earlier, in 1993, an 11 year old Sullivan County girl died at Westchester Medical Center after becoming ill while vacationing with her family in the Adirondacks. Both girls were infected with a strain of bat rabies. Previous to those cases, there had not been a human rabies case in New York State in 40 years.

Warren County residents with specific questions about rabies may contact Warren County Health Services at 518–761–6580. Residents of other counties should contact their local health department.

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