Case report: Rapid ante-mortem diagnosis of a human case of rabies imported into the UK from the Philippines
Article first published online: 14 NOV 2002
Copyright © 2003 Wiley-Liss, Inc.
Journal of Medical Virology
Volume 69, Issue 1, pages 150–155, January 2003
How to Cite
Smith, J., McElhinney, L., Parsons, G., Brink, N., Doherty, T., Agranoff, D., Miranda, M. E. and Fooks, A. R. (2003), Case report: Rapid ante-mortem diagnosis of a human case of rabies imported into the UK from the Philippines. J. Med. Virol., 69: 150–155. doi: 10.1002/jmv.10253
- Issue published online: 15 NOV 2002
- Article first published online: 14 NOV 2002
- Manuscript Accepted: 29 JUL 2002
- molecular diagnostic tests
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. J. Med. Virol. 69:150–155, 2003. © 2003 Wiley-Liss, Inc.