2023-10-14 10:30:00
A woman, scratched by a wild cat, was admitted to Reims hospital. The patient died of rabies two days later despite rapid treatment. An update on what to do in the event of contact with a suspicious animal.
A woman died of rabies in France despite rapid treatment. Thursday October 12, 2023, the Reims University Hospital (Marne), announced the death of a patient suffering from rabies, admitted on October 7, 2023 and died 2 days later. Accompanied by a man, the French woman had presented herself at the hospital the previous Saturday.
She had been injured by a cat a few weeks earlier in a Maghreb country. The healthcare staff identified the symptoms of rabies and treated him appropriately, hospitalizing him in intensive care. She unfortunately succumbed to the illness two days later. The man, who was asymptomatic, was administered a post-exposure prophylactic vaccination and placed under surveillance. Before that, no case had been observed in France since 1924.
What are the risky situations?
In France, three situations are considered at risk:
bites, scratches and other contact with saliva on wounds or mucous membranes in a country where rabies circulates in dogs or wildlife (Guyana included); contacts with bats, all over the world, particularly in mainland France; bites, scratches and contact with wounds or mucous membranes with an animal that has traveled illegally outside the European Union in anti-rabies vaccination.
What to do in case of contact?
In the event of contact with a suspicious animal, treatment consists of immediate cleaning wounds with soap and water for 15 minutes and the application of an antiseptic. There prophylaxis includes a vaccine and an anti-rabies immunoglobin, antibodies, for the most severe exposures. “In 2022 in France, 2,391 people received post-exposure prophylaxis in a French anti-rabies center, including 62.2% of people exposed abroad,” explains the Pasteur Institute.
Fever, pain, tingling, burning…
Done on time, prevention is 100% effective. “Treatment must be carried out quickly after exposure, before the appearance of the first symptoms which sign an inexorably fatal development,” adds the Pasteur Institute. After an incubation which can last 2 to 3 months, the first symptoms are a fever accompanied by pain and tingling or burning at the site of the injury.
Two forms of rage
There are two forms of rabies, as detailed by the WHO: “The “furious” form, with hyperactivity of the patient, excitability, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or fresh air). Death occurs within a few days due to cardiorespiratory arrest.
The paralytic form concerns approximately 20% of human cases. The evolution is then less spectacular and generally longer than for furious rabies. The muscles gradually become paralyzed, starting from the site of the injury. The coma sets in slowly and the patient eventually dies.
59,000 deaths per year worldwide
Paralytic rabies cases are often misdiagnosed, contributing to underreporting of the disease.” The virus affects the central nervous system and “leads to progressive and fatal inflammation of the brain and spinal cord.”
Worldwide, rabies is responsible for 59,000 deathsmainly in Asia and Africa and most often after the bite of a rabid dog.
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