Investigation of a human case of rabies in the United Kingdom

Johnson, Nicholas; Lipscomb, David Wade; Stott, Robin; Rao, G. Gopal; Mansfield, Karen L.; Smith, Jemma; McElhinney, Lorraine M.; Fooks, Anthony R.

doi:10.1016/s1386-6532(02)00131-2

Cited by 33 publications

(23 citation statements)

References 16 publications

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“…Despite the successful use of the highly sensitive hnRT-PCR in this case, however, ante-mortem material from a second UK human rabies case, imported from Nigeria in June 2001, proved consistently negative by all methods employed (Johnson et al, 2002). Clinical diagnosis in the latter case was confirmed only on postmortem brain material.…”

Section: Discussionmentioning

confidence: 71%

Case report: Rapid ante‐mortem diagnosis of a human case of rabies imported into the UK from the Philippines

Smith¹,

McElhinney²,

Parsons³

et al. 2002

Journal of Medical Virology

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The United Kingdom is free from rabies, with the last human death from indigenous rabies recorded in 1902. However, between 1946 and 2000, 20 deaths were reported in the United Kingdom in people who were bitten and infected while abroad in rabies endemic areas. The rapid diagnosis of suspected human rabies cases influences the use of anti-rabies post-exposure prophylaxis for potential contacts with the victim. In addition, the occurrence of a human rabies case requires urgent investigation to support patient management policies. In May 2001, a case of human rabies imported into the United Kingdom from the Philippines was identified. A 55-year-old man was admitted to University College Hospital, London, with clinical symptoms and a history consistent with exposure to rabies. Saliva, cerebrospinal fluid), and skin biopsies (from the wound site and nape of the neck) were submitted for conventional ante-mortem diagnostic techniques. Established diagnostic techniques, including the fluorescent antibody test (FAT), mouse inoculation test, (MIT) and the rabies tissue culture inoculation test (RTCIT), failed to detect the virus. In contrast, hemi-nested reverse transcription-polymerase chain reaction (RT-PCR), followed by automated sequencing confirmed the presence of classical rabies virus (genotype 1) in both the saliva and skin specimens within 36 hr of sample submission. Subsequent phylogenetic analysis demonstrated that this isolate was closely related to that of canine variants currently circulating in the Philippines.

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Section: Discussionmentioning

confidence: 71%

Case report: Rapid ante‐mortem diagnosis of a human case of rabies imported into the UK from the Philippines

Smith¹,

McElhinney²,

Parsons³

et al. 2002

Journal of Medical Virology

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“…Genotypes 2 to 4 are widely distributed throughout Africa (18), whereas genotypes 5 and 6 are distributed throughout Europe (22). The United Kingdom is considered "rabies-free," with only occasional cases of human rabies arising from contact with rabid animals while abroad (15,24). However, in 1996 a positive case of EBLV type 2 was found in a Daubenton's bat (Myotis daubentonii) in Sussex (30).…”

mentioning

confidence: 99%

Development of a Real-Time, TaqMan Reverse Transcription-PCR Assay for Detection and Differentiation of Lyssavirus Genotypes 1, 5, and 6

Wakeley¹,

Johnson²,

McElhinney³

et al. 2005

J Clin Microbiol

133

148

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Several reverse transcription-PCR (RT-PCR) methods have been reported for the detection of rabies andrabies-related viruses. These methods invariably involve multiple transfers of nucleic acids between different tubes, with the risk of contamination leading to the production of false-positive results. Here we describe a single, closed-tube, nonnested RT-PCR with TaqMan technology that distinguishes between classical rabies virus (genotype 1) and European bat lyssaviruses 1 and 2 (genotypes 5 and 6) in real time. The TaqMan assay is rapid, sensitive, and specific and allows for the genotyping of unknown isolates concomitant with the RT-PCR. The assay can be applied quantitatively and the use of an internal control enables the quality of the isolated template to be assessed. Despite sequence heterogeneity in the N gene between the different genotypes, a universal forward and reverse primer set has been designed, allowing for the simplification of previously described assays. We propose that within a geographically constrained area, this assay will be a useful tool for the detection and differentiation of members of the Lyssavirus genus.

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“…Despite the availability of safe and effective human vaccines, human rabies victims continue to increase in many countries. 2,15,16,21,22 Rabies transmission occurs mainly through the bite of a rabid animal, and saliva is the major source of virus spread. 4,5,7,9 Rabies surveillance depends on reporting of the number of laboratory-confirmed human rabies cases through the structures of the World Health Organization.…”

Section: Discussionmentioning

confidence: 99%

“…One important mode of non-bite transmission is person-to-person via organ transplantation, in particular corneal transplants. 4,6,7,9,12,13,15 Such transmission has occurred in eight recipients in five countries: Thailand (two cases), India (two cases), Iran (two cases), the United States (one case) and France (one case). 12,15,17 Eye banks can play a major role in reducing the possibility of rabies transmission through stringent guidelines for the acceptance of cornea donors.…”

Section: Discussionmentioning

confidence: 99%

“…4,6,7,9,12,13,15 Such transmission has occurred in eight recipients in five countries: Thailand (two cases), India (two cases), Iran (two cases), the United States (one case) and France (one case). 12,15,17 Eye banks can play a major role in reducing the possibility of rabies transmission through stringent guidelines for the acceptance of cornea donors. 13,15,16,21 The two cases discussed in this report occurred accidentally, and they led to the screening of donor corneas for rabies using FAT in the WHO Collaborating Center for Reference and Research on Rabies, Pasteur Institute of Iran.…”

Section: Discussionmentioning

confidence: 99%

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Six fatal cases of classical rabies virus without biting incidents, Iran 1990–2010

Simani

Fayaz

Rahimi

et al. 2012

Journal of Clinical Virology

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Prevention and control of this fatal disease require a sensitive surveillance system to follow 'suspected' animal and human rabies cases thoroughly through the improved reporting system, which contains the history of exposure, clinical examinations, symptoms and laboratory results. This study describes some notable human rabies infections and their transmission modes to prevent occupational accidents.

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Investigation of a human case of rabies in the United Kingdom

Cited by 33 publications

References 16 publications

Case report: Rapid ante‐mortem diagnosis of a human case of rabies imported into the UK from the Philippines

Case report: Rapid ante‐mortem diagnosis of a human case of rabies imported into the UK from the Philippines

Development of a Real-Time, TaqMan Reverse Transcription-PCR Assay for Detection and Differentiation of Lyssavirus Genotypes 1, 5, and 6

Six fatal cases of classical rabies virus without biting incidents, Iran 1990–2010

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