Hospital inquiry into rabies case

 

An investigation has been launched into how a woman suffering from rabies was reportedly turned away from a hospital emergency department.

The Health Protection Agency (HPA) has confirmed a case of the potentially fatal disease in a patient who had been bitten by a dog in South Asia.

The woman, believed to be a grandmother in her 50s, was reportedly turned away twice by doctors at Darent Valley Hospital in Dartford before she was finally diagnosed.

She is now being treated at London's Hospital for Tropical Diseases, which has reassured patients, visitors and staff there is no risk to them as a result of the case.

The HPA has also stressed there is no risk to the public, and said all family members and healthcare staff who have had contact with the patient have been assessed and offered a vaccination.

A spokesman for Darent Valley Hospital said an investigation was under way into the lady's attendance at its emergency department.

He said: "The UK is rabies free.

"If a patient does present at hospital with vague symptoms, a doctor is unlikely to consider rabies as a diagnosis unless the patient highlights wild animal contact in an at risk country.

"The hospital responded to the information supplied by the patient at the time.

"Although there are no cases of rabies being passed through human-to-human contact, the five members of staff that came into close contact with the patient are being vaccinated as a precautionary measure.

"We have launched an investigation into the circumstances around this lady's attendance at the emergency department and we are working closely with the Health Protection Agency."

Rabies is usually transferred through saliva from the bite of an infected animal, with dogs being the most common transmitter of rabies to humans.

More than 55,000 people are estimated to die from the disease every year, with most cases occurring in developing countries, particularly South and South-East Asia.

Dr Ron Behrens, travel medicine expert at the London School of Hygiene & Tropical Medicine, said the prognosis was "bleak" for people infected with rabies, with only one or two cases known to have survived rabies encephalitis - the disease once it reaches the brain.

But he urged anyone who had been bitten by an animal they thought might have rabies to seek medical advice.

Dr Behrens said symptoms resulted from inflammation of the brain from the virus.

"In the early stages, the symptoms are mild headaches, some anaesthetic feeling around the site of a bite and fever.

"There is often confusion and delirium - disorientation often associated with abnormal and sometimes violent behaviour."

He said a unique symptom is a fear of water, which means patients cannot drink or swallow.

He said they ultimately become comatose during the terminal stages.

"The prognosis is bleak as most patients with rabies encephalitis die," Dr Behrens said.

"Only one or two cases are known to have survived the disease.

"Once the patient has developed encephalitis, the management involves making the patient comfortable by sedation and paralysing them and placing them in an anaesthetic coma.

"At this stage, none of the vaccines or immunoglobulin has any benefit."

Dr Behrens said rabid dogs in their early stages do not behave unusually and the disease can incubate from weeks to years after infection with no signs.

If bitten by a rabid dog, there is roughly 24 hours where treatment with an antibody can prevent the virus entering the nervous system, he said.

"Unfortunately once the virus is in the nervous system the vaccine and immunoglobulin have minimal effect," he said.

He added that a "pre-exposure" course of three rabies vaccines would provide life-long protection, but was often expensive, and urged people to steer clear of animals in developing countries.

"If you are scratched, bitten or licked on an open wound and haven't received a pre-exposure course, you need to find a clinic that has rabies immunoglobulin immediately," he said.

"This is a very expensive and rare product and most centres outside capital cities and even in capital cities in many countries won't have it available.

"Immediate assessment at a tropical hospital or similar specialist centre is important if you are exposed to any animal bite.

"I suggest the course of pre-exposure vaccine be likened to an insurance vaccine against a rare problem.

"In countries such as India, 50,000 or more people every year die from rabies despite there being a very good preventative vaccine for both humans and animals."

Dr Brian McCloskey, director of the HPA for London, said: "It is important to stress that there is no risk to the general public as a result of this case or to patients and visitors at the hospital where the patient is receiving treatment.

"Despite there being tens of thousands of rabies cases each year worldwide, there have been no documented laboratory confirmed cases of human-to-human spread.

"Therefore, the risk to other humans or animals from a patient with rabies is considered negligible.

"However, to take every possible precaution, family members and healthcare staff who had close contact with the patient since they became unwell - which is when they are infectious - have been assessed and offered vaccination if appropriate."

PA

PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
News
Bryan Cranston as Walter White, in the acclaimed series 'Breaking Bad'
news
News
There have been various incidents of social media users inadvertently flouting the law
news

Sport
footballChelsea 6 Maribor 0: Blues warm up for Premier League showdown with stroll in Champions League
Arts and Entertainment
Princess Olga in 'You Can't Get the Staff'
tvReview: The anachronistic aristocrats, it seemed, were just happy to have some attention
Life and Style
tech

Board creates magnetic field to achieve lift

News
Renee Zellweger as Bridget Jones
i100
News
Those who were encouraged to walk in a happy manner remembered less negative words
science
Life and Style
Stack ‘em high?: quantity doesn’t always trump quality, as Friends of the Earth can testify
techThe proliferation of online petitions allows us to register our protests at the touch of a button. But do they change anything?
News
Bourgogne wine maker Laboure-Roi vice president Thibault Garin (L) offers the company's 2013 Beaujolais Nouveau wine to the guest in the wine spa at the Hakone Yunessun spa resort facilities in Hakone town, Kanagawa prefecture, some 100-kilometre west of Tokyo
i100
Sport
CSKA Moscow celebrate after equalising with a late penalty
footballCSKA Moscow 2 Manchester City 2: Premier League champions let two goal lead slip in Russia
Environment
Sudan, the last male northern white rhino
environmentThe death of a white northern rhino in Kenya has left the species with a single male. These are the other species on the brink
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    IT Project Manager

    Competitive: Clearwater People Solutions Ltd: Our client based in Chelmsford a...

    Business Intelligence Specialist - work from home

    £40000 per annum: Ashdown Group: An established and growing IT Consultancy fir...

    Business Intelligence Specialist - work from home

    £40000 per annum: Ashdown Group: An established and growing IT Consultancy fir...

    IT Manager

    £40000 - £45000 per annum + pension, healthcare,25 days: Ashdown Group: An est...

    Day In a Page

    Indiana serial killer? Man arrested for murdering teenage prostitute confesses to six other murders - and police fear there could be many more

    A new American serial killer?

    Police fear man arrested for murder of teen prostitute could be responsible for killing spree dating back 20 years
    Sweetie, the fake 10-year-old girl designed to catch online predators, claims her first scalp

    Sting to trap paedophiles may not carry weight in UK courts

    Computer image of ‘Sweetie’ represented entrapment, experts say
    Fukushima nuclear crisis: Evacuees still stuck in cramped emergency housing three years on - and may never return home

    Return to Fukushima – a land they will never call home again

    Evacuees still stuck in cramped emergency housing three years on from nuclear disaster
    Online petitions: Sign here to change the world

    Want to change the world? Just sign here

    The proliferation of online petitions allows us to register our protests at the touch of a button. But do they change anything?
    Ed Sheeran hits back after being labelled too boring to headline festivals

    'You need me, I don’t need you'

    Ed Sheeran hits back after being labelled too boring to headline festivals
    How to Get Away with Murder: Shonda Rhimes reinvents the legal drama

    How to Get Away with Murder

    Shonda Rhimes reinvents the legal drama
    A cup of tea is every worker's right

    Hard to swallow

    Three hospitals in Leicester have banned their staff from drinking tea and coffee in public areas. Christopher Hirst explains why he thinks that a cuppa is every worker's right
    Which animals are nearly extinct?

    Which animals are nearly extinct?

    Conservationists in Kenya are in mourning after the death of a white northern rhino, which has left the species with a single male. These are the other species on the brink
    12 best children's shoes

    Perfect for leaf-kicking: 12 best children's shoes

    Find footwear perfect to keep kids' feet protected this autumn
    Anderlecht vs Arsenal: Gunners' ray of light Aaron Ramsey shines again

    Arsenal’s ray of light ready to shine again

    Aaron Ramsey’s injury record has prompted a club investigation. For now, the midfielder is just happy to be fit to face Anderlecht in the Champions League
    Comment: David Moyes' show of sensitivity thrown back in his face by former Manchester United manager Sir Alex Ferguson

    Moyes’ show of sensitivity thrown back in his face... by Ferguson

    Manchester United legend tramples on successor who resisted criticising his inheritance
    Two super-sized ships have cruised into British waters, but how big can these behemoths get?

    Super-sized ships: How big can they get?

    Two of the largest vessels in the world cruised into UK waters last week
    British doctors on brink of 'cure' for paralysis with spinal cord treatment

    British doctors on brink of cure for paralysis

    Sufferers can now be offered the possibility of cure thanks to a revolutionary implant of regenerative cells
    Let's talk about loss

    We need to talk about loss

    Secrecy and silence surround stillbirth