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March 25, 2008

Date: 21 Mar 2008

Source: The Santa Barbara Independent [edited]

http://independent.com/news/2008/mar/21/16-year-old-dies-rabies-santa-maria/

16-Year-Old Dies of Rabies in Santa Maria – Public Health Officials Trying to Track Down Traveling Companion

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Rabies is what killed a 16-year-old in Santa Maria on Tuesday [18 Mar 2008], and public health officials are trying to track down a companion who recently traveled with the teenager from Mexico. The boy came into the Marian Medical Center on [18 Mar 2008] delirious and drooling, and was having trouble breathing. He required resuscitation immediately, but doctors were not able to save his life.

"If you start showing symptoms," said Dr. Eliot Schulman, the county's Public Health director, "it is unusual to survive. That means your brain is infected, and there is no direct treatment for it."

In the United States, it is extremely rare for humans to contract rabies, and that's especially true locally. "The last case in Santa Barbara was

80 years ago," said Schulman, citing a 1927 incident.

There are cases in the United States, said Schulman, but they usually come from a wild animal bite; on the West Coast, that usually means a bat or a skunk while raccoons are usually the culprits on the East Coast. Domestic animals very rarely have rabies these days, though within the past 5 years, rabies detected on a dog traveling through Santa Barbara County and in a dead cat that had been bitten by a bat. The majority of human cases of rabies in the United States since 1980 have been associated with the bat variant rabies virus.  According to CDC statistics 21 of the 36 human cases (58 percent) since 1980 have been associated with bat variants (for more details, see

http://www.cdc.gov/mmwr/preview/mmwrhtml/00056176.htm

Cases occurring in other countries in Asia, Africa and Latin America tend to be associated with canine bites.

Officials believe that the boy contracted the disease in Mexico, because he had not been in the United States long enough to have had the disease take its course. As well, rabies is much more common in Mexico and Central America. For that reason, Schulman bets that the culprit was probably a rabid dog, though future tests by the state lab in Richmond will eventually determine what type of animal was responsible. Oddly, they could not find any bite marks on the victim.

The time from bite to death from rabies is variable, and depends on where the bite occurs. If it's closer to the brain, the disease can take hold rather quickly. However, if caught early, post-exposure prophylaxis will cure a victim in most cases.

In this case, the 16-year-old's 8 housemates have been identified and will be treated, even though casual contact is highly unlikely to spread the disease. But since direct contact with saliva of an affected person may pass the disease, officials are still on the lookout for the

16-year-old's traveling companion, who is believed to be in either Santa Barbara or Ventura counties.

If you have any further information on an individual who might have been this traveling companion, please contact me immediately.

Rick Johnson