Investigation on the First Imported Rabies Case in 2013

Yen-Chang Tuan, Min-Nan Hung, Mei-Fang Chuang, Hui-Chen Lin,Ying-Ying Tsai, Mei-Ju Chen, Chiou-Yueh You, Chao-Ching Chang

2013 Vol.29 NO.16

Correspondence Author： Yen-Chang Tuan

Abstract：

      On May 10, 2013, a medical center in Kaohsiung reported a suspected rabies case. The patient was a Filipino laborer who arrived in Taiwan on April 7, 2013. He started complaining pain in his right hand on May 3. By May 9, he had gradually developed nausea, vomiting, loss of appetite, sore throat, fever, conscious disturbance, generalized weakness, right hand twitches, and unsteady gait. He was seen by physicians in four different medical establishments in Pingtung. On May 9, he went to the emergency of a medical center in Kaohsiung, and was found to have high fever, slurred speech, conscious disturbance, multiple organ failure, and healed bite marks were observed on his right middle finger and inner thigh. His family indicated that the patient was bitten by a dog on March 10, 2013, while he was still in Cagayan, the Philippines, but did not seek medical attention following the incident. On May 10, physicians at the hospital reported the patient as a suspected rabies, and then was confirmed by the Research and Diagnostic Center of the Centers for Disease Control. The patient died on May 25. In accordance to the Rabies Manuel, case investigation and contact risk assessment were conducted. There were 15 contacts at the factory, 37 at the medical center, and 7 in other healthcare establishments. Post-exposure prophylaxis was given to 10 persons, but only 9 persons completed prophylactic treatment. Rabies in humans is very rare in Taiwan. The experience from this case may serve as a reference for future rabies control.