A woman died of rabies after being bitten by a puppy while on a yoga retreat.
The bite on her hand began to cause pain and burning sensations six weeks later when, back home in Virginia, US, she went to hospital thinking she’d been poisoned.
Left breathless and feeling ‘claustrophobic’ after being discharged from hospital, doctors thought she was suffering a panic attack and sent her home with medicine.
But her condition got quickly worse and, within days, she became aggressive, was left gasping for air and began to foam at the mouth.
Tests confirmed she had a strain of rabies found in dogs in India and medics sedated her with ketamine to reduce the risk of her spreading the virus to nurses.
Doctors tried ‘aggressive treatment’ but the married woman died on May 21, 2017, the Centers for Disease Control and Prevention (CDC) confirmed.
She is one of just nine people to have died of rabies in the US since 2008.
A 65-year-old woman from Virginia, US, contracted rabies after being bitten on the hand by a puppy when she was on a yoga retreat holiday in India in 2017 (stock photo)
CDC officials last week warned travellers to get vaccinated against rabies before going to countries where it spreads.
Rabies, a viral infection, can be vaccinated against but is difficult to cure, and is almost always fatal if people show symptoms.
In its report the CDC said the rural nature of and ‘community activities’ involved in the woman’s yoga holiday raised her risk of catching the virus.
Her early symptoms, seen by doctors on May 7, 2017, four days after her arm pain began, included breathlessness, anxiety, insomnia and struggling to swallow water.
‘The patient expressed concern about exposure to a toxic substance,’ the CDC report said.
She was given medication and discharged but, once in her car in the car park, she became claustrophobic and couldn’t breathe so went back into the hospital.
This was believed to have been a panic attack so she was given more medications and discharged again.
But the next day, May 8, she was becoming ‘progressively agitated and combative’ and ‘was noted to be gasping for air when attempting to drink water’.
Rabies: Death from a scratch
Most rabies cases result from being bitten by an infected dog (file image)
Rabies is a viral infection which targets the nervous system and the brain.
It is deadly in 100 percent of cases left untreated – and has an incubation period of 20 to 60 days.
It is only spread by infected animals to humans, most often through the animal biting or scratching the person.
It can also be spread by an animal’s saliva being in contact with a graze or cut on a human’s skin. The majority of rabies cases result from being bitten by an infected dog.
The symptoms of the illness include high temperatures, numbness at the area where the bite occurred and hallucinations. Some victims also have hydrophobia, which is a fear of water.
There are about 55,000 cases of rabies worldwide each year with most cases occurring in Africa and Asia.
Half of all rabies cases occur in India.
Her husband then revealed she had been bitten on the hand by a puppy while on a recent holiday in India.
Her tour operator helped her clean the wound but she did not receive any medical attention for the bite, he said.
The following day medics had to put a tube into her lungs to help her breathe because she was becoming increasingly tired and had low levels of oxygen in her body.
Over the course of the next week the woman’s condition deteriorated and, after diagnosing her with rabies, doctors tried various treatments including draining fluid from her spine.
She was given strong tranquilisers – ketamine and midazolam – to stop her ‘increased agitation’ and doctors noted she had ‘profuse oral secretions’.
On May 21 her family decided to withdraw life support and the woman died that day.
A total of 72 staff who treated the woman had to be given $235,000 (£184,000) worth of post-exposure treatment in case they also developed rabies.
In a warning to international travellers the CDC said: ‘Travelers to India, which has the world’s largest incidence of dog-mediated human rabies deaths, are recommended to receive pretravel rabies vaccination if they will be involved in outdoor activities (such as camping, hiking, biking, adventure travel, and caving) that put them at risk for animal bites.
‘In the event of a suspected rabies exposure, [medication] is recommended as soon as possible and has been shown to be highly effective at preventing rabies if administered prior to symptom onset (typically 3 weeks to 3 months after exposure).’