Case report: Rapid ante-mortem diagnosis of a human case of rabies imported into the UK from the Philippines
Case report: Rapid ante-mortem diagnosis of a human case of rabies imported into the UK from the Philippines
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DOI：
10.1002/jmv.10253
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发表时间：
2003-01-01
影响因子：
12.7
通讯作者：
Fooks, AR
中科院分区：
文献类型：
--
作者：
Smith, J;McElhinney, L;Fooks, AR
英国没有狂犬病，最后一次人类死于本土狂犬病是在1902年。然而，在1946年至2000年期间，据报道，联合王国有20人在国外狂犬病流行地区被咬伤和感染而死亡。对疑似人类狂犬病病例的快速诊断影响到对可能与受害者接触的人采取抗狂犬病暴露后预防措施。此外，人类狂犬病病例的发生需要紧急调查，以支持患者管理政策。2001年5月，一宗由菲律宾传入英国的人类狂犬病个案得到确认。伦敦大学学院医院收治了一名55岁男子，其临床症状和暴露于狂犬病的病史一致。唾液、脑脊液和皮肤活检（来自伤口部位和颈后）提交常规的死前诊断技术。现有的诊断技术，包括荧光抗体试验（FAT）、小鼠接种试验（MIT）和狂犬病组织培养接种试验（RTCIT），都未能检测到病毒。相比之下，半巢式逆转录聚合酶链反应（RT-PCR）和自动测序在样品提交后36小时内证实了唾液和皮肤标本中存在经典狂犬病毒（基因型1）。随后的系统发育分析表明，该分离株与目前在菲律宾流行的犬变种密切相关。(C) 2003 Wiley-Liss, Inc。
The United Kingdom is free from rabies, with the last human death from indigenous rabies recorded in 1902. However, between 1946 and 2000, 20 deaths were reported in the United Kingdom in people who were bitten and infected while abroad in rabies endemic areas. The rapid diagnosis of suspected human rabies cases influences the use of anti-rabies post-exposure prophylaxis for potential contacts with the victim. In addition, the occurrence of a human rabies case requires urgent investigation to support patient management policies. In May 2001, a case of human rabies imported into the United Kingdom from the Philippines was identified. A 55-year-old man was admitted to University College Hospital, London, with clinical symptoms and a history consistent with exposure to rabies. Saliva, cerebrospinal fluid), and skin biopsies (from the wound site and nape of the neck) were submitted for conventional ante-mortem diagnostic techniques. Established diagnostic techniques, including the fluorescent antibody test (FAT), mouse inoculation test, (MIT) and the rabies tissue culture inoculation test (RTCIT), failed to detect the virus. In contrast, hemi-nested reverse transcription-polymerase chain reaction (RT-PCR), followed by automated sequencing confirmed the presence of classical rabies virus (genotype 1) in both the saliva and skin specimens within 36 hr of sample submission. Subsequent phylogenetic analysis demonstrated that this isolate was closely related to that of canine variants currently circulating in the Philippines. (C) 2003 Wiley-Liss, Inc.