Posted on 01/09/2019 9:56:44 AM PST by Gamecock
A 65-year-old woman from Virginia died after being bitten by a dog while on a yoga retreat in Asia. According to a new case report from the CDC, the woman spent seven weeks touring India, and at one point was bitten on the right hand by a puppy, which exposed her to rabies. The woman cleaned the wound herself and thought nothing of it.
After returning home, she began to feel pain in her right arm over a month later. She waited three days before deciding to go to urgent care, where medical professionals misdiagnosed her with carpal tunnel syndrome and sent her home with anti-inflammatory meds. A few days later, she checked into the hospital with symptoms including anxiety, shortness of breath, insomnia, and trouble swallowing. This time doctors misdiagnosed her with a panic attack.
The woman was given anxiety medication and hardly made it out of the parking lot before returning to the emergency room claiming shortness of breath and claustrophobia. She was reassured that it was a panic attack.
The next day, continued pain in her arm and shoulder, shortness of breath, anxiety, and increasing paresthesia (think: pins and needles pain, numbness, and burning sensation of the skin) had the woman heading to a different hospital, this time by way of ambulance.
Lab work and exams were conducted, and the patient showed that she was losing control of her bodily functions. Blood wasn't flowing properly to her heart, and she had unusual chest pain, but a procedure that evaluates the heart for damage, muscle function, and blocked arteries didn't find anything abnormal.
The woman became more and more agitated and combative that evening and was reported to be gasping for air when she tried to drink water, leading the hospital staff to ask the woman's husband about possible animal exposure. He let the doctors know that she had been bitten by a dog on her overseas trip.
The following day—six days after her initial visit to urgent care—her health quickly deteriorated. She showed signs of severe brain inflammation and was placed on a ventilator. The woman was officially diagnosed with rabies and over the next 10 days, doctors aggressively tried to save her life. She was eventually put into a medically induced coma, and after those 10 days, the woman's family opted to stop treatment and she died.
Sadly, there have been no reports that the woman took action to protect herself before her travels, nor did she ever receive a rabies vaccination in her lifetime. If you are planning a trip abroad, it's important to prepare yourself by undergoing a health screening and receiving the appropriate vaccinations for your international travels, which may include a rabies vaccine.
While rabies infections are quite rare in the U.S. (only 23 cases have been reported since 2008), they can still happen. Many people are under the impression that infections are the result of contact with a foaming-at-the-mouth wild animal, like a raccoon or bat, but transmission is most often linked to dogs and strays in foreign countries. Also note that it doesn't take a full bite, but rather the virus could be passed from a scratch or even a rabid animal's saliva getting into an open wound.
Once you've been exposed to rabies, symptoms can mimic those of the flu, including headache, fatigue, and generally feeling unwell, and as the virus invades the central nervous system and infects the brain, victims can experience anxiety, confusion, hallucinations, fear of water, insomnia, and can even die.
If bitten by an unfamiliar animal, it's important to remain calm. “It’s not like a poison that would paralyze you instantly within 10 minutes,” Aaron Glatt, MD, chairman of medicine and a hospital epidemiologist at South Nassau Communities Hospital in Oceanside, New York, previously told Health. “You really need to get this addressed, but it is an infection that takes some time to spread in your body.”
Make sure to clean the bite thoroughly with soap and water, and then seek expert assistance. A doctor will administer a first dose of the post-exposure rabies vaccine, which can help prevent the virus from getting into the central nervous system, according to the World Health Organization. You’ll receive three more doses, spaced out over a 14-day period. You may also be treated with human rabies immune globulin, according to Dr. Glatt, which provides antibodies collected from people who have had rabies.
This actually hints at why I’m really not interested in visiting Asia. Or France.
In health care we talk about common vs uncommon conditions like this:
If you hear hoof-beats, it is more likely to be a horse (common issues) than a zebra (uncommon).
Sometimes we forget that our patients travel to places where there are a lot of zebras.
Note to self: Puppies in India are not cute, they are the devil!
Note to self: Puppies in India are not cute, they are the devil!
Who in their right mind goes to Asia for a yoga retreat?
Doctors seem to have a bad habit of writing off their female patients like this. If she’d have been a male, they’d have taken the patient seriously and run tests until they identified the problem. A pox on her doctors.
That’s where most ‘healthcare’ is going these days. Ignore the patient, trust the symptom lists.
Also why I would never be interested in a woman who thinks she has to go to Asia for yoga.
My wife was a nurse who some years ago had a patient who had traveled to Africa and was bitten by his own dog he brought with him, which had been bitten by some other animal. He contracted rabies, and by the time it was diagnosed after he returned home, it was too late.
Like you said...hoof-beats.
The symptoms are difficult to diagnose from, but once it takes hold, there isn’t much help for you. I am not surprised it was missed. Apparently, being nipped by his dog wasn’t even foremost in his mind.
No, bgill. That isn’t the case. Rabies is, by all accounts, difficult to diagnose symptomatically, and there is no single test, and the ones that are available are expensive and esoteric, not to be done one someone displaying those symptoms.
You are wrong on this.
Don’t let that stop you. I have lived overseas off, mostly on, since 1995. Rabies is not the problem. Except for this woman. It was definitely her problem. But, fear of rabies should not stop you from having an adventure.
No, really, she just came back from India, she's not normally like this. Sometimes.
See my post above. This is one of the reasons rabies is so deadly, people get a nip from a dog they try to pet, and don’t even give it a thought. Most times they wash the minor wound and that is the end of it.
If people get bitten by a raccoon, yes. If they get bitten by some other creature, sure. But a lot of people just do what she did and wash the hand with antiseptic soap.
I got bit by a cat once, one that belonged to a good friend and whom I had actually lived with, washed the wound, but ended up spending a week in the hospital and nearly lost my hand.
It wouldn’t have mattered. Once Rabies is symptomatic it is 100% fatal. There has been 1 exception, an experimental treatment where they pretty much had to turn the patients brain off. She survived but I dont know the degree of her recovery.
GP’s are “almost” useless other than their golden ability to write prescriptions.
I got misdiagnosed the last time I went to a doctor. I went home and googled my symptoms and immediately discovered I had Gout, and even found an effective natural cure (black cherry juice) that worked like a champ. The doctor did not know what it was and just told me to watch it and take care of my big, red, painful toe. This was at Swedish in Seattle.
And Puppies in Asia are delicious.
Currently have a new puppy (13 weeks old) to young to get rabies shot. He is a land shark (Golden Retriever), I have the arm and hands wounds to prove it. Got a tetanus shot the other day just in case. Running out of bandages, he might be an alpha dog... He gets his last round of shots in a couple of weeks that includes rabies. Would biting him back on the ear help.. lol
they found a skunk with rabies in our county. we hunt varmints with dogs and do skin out game...a huge fear for us who skinned out and touch hunting dogs is rabies...same age as the woman and do not travel. Does happen in the good old USA
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