Phylogenetic and Epidemiologic Evidence of Multiyear Incubation in Human Rabies
Phylogenetic and Epidemiologic Evidence of Multiyear Incubation in Human Rabies
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DOI：
10.1002/ana.24016
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发表时间：
2014-01-01
影响因子：
11.2
通讯作者：
Rosenthal, Eric S.
中科院分区：
文献类型：
--
作者：
Boland, Torrey A.;McGuone, Declan;Rosenthal, Eric S.
从巴西移民八年后，一名原本健康的男子患上了狂犬病。据报道，在移民之前曾接触过。基因分析显示，犬狂犬病病毒变种仅在患者的祖国发现，并且该患者自移民美国以来没有出国旅行过。我们描述了流行病学、系统发育和病毒测序数据如何证实狂犬病脑脊髓炎可能在漫长的多年潜伏期后出现，这是之前的假设，但无法排除最近的暴露。因此，在诊断任何急性脑炎、脊髓炎或脑脊髓炎时应考虑狂犬病。
Eight years after emigrating from Brazil, an otherwise healthy man developed rabies. An exposure prior to immigration was reported. Genetic analysis revealed a canine rabies virus variant found only in the patient's home country, and the patient had not traveled internationally since immigrating to the United States. We describe how epidemiological, phylogenetic, and viral sequencing data provided confirmation that rabies encephalomyelitis may present after a long, multiyear incubation period, a consideration that previously has been hypothesized without the ability to exclude a more recent exposure. Accordingly, rabies should be considered in the diagnosis of any acute encephalitis, myelitis, or encephalomyelitis.