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      Human Rabies: A Reemerging Disease in Costa Rica?


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          Two human rabies cases caused by a bat-associated virus variant were identified in September 2001 in Costa Rica, after a 31-year absence of the disease in persons. Both patients lived in a rural area where cattle had a high risk for bat bites, but neither person had a definitive history of being bitten by a rabid animal. Characterization of the rabies viruses from the patients showed that the reservoir was the hematophagous Vampire Bat, Desmodus rotundus, and that a sick cat was the vector.

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          European Bat Lyssavirus Infection in Spanish Bat Populations

          From 1992 to 2000, 976 sera, 27 blood pellets, and 91 brains were obtained from 14 bat species in 37 localities in Spain. Specific anti-European bat lyssavirus 1 (EBL1)-neutralizing antibodies have been detected in Myotis myotis, Miniopterus schreibersii, Tadarida teniotis, and Rhinolophus ferrumequinum in the region of Aragon and the Balearic Islands. Positive results were also obtained by nested reverse transcription-polymerase chain reaction on brain, blood pellet, lung, heart, tongue, and esophagus-larynx-pharynx of M. myotis, Myotis nattereri, R. ferrumequinum, and M. schreibersii. Determination of nucleotide sequence confirmed the presence of EBL1 RNA in the different tissues. In one colony, the prevalence of seropositive bats over time corresponded to an asymmetrical curve, with a sudden initial increase peaking at 60% of the bats, followed by a gradual decline. Banded seropositive bats were recovered during several years, indicating that EBL1 infection in these bats was nonlethal. At least one of this species (M. schreibersii) is migratory and thus could be partially responsible for the dissemination of EBL1 on both shores of the Mediterranean Sea.
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            Australian bat lyssavirus infection: a second human case, with a long incubation period.

            In December 1998, a 37-year-old Queensland woman died from a rabies-like illness, 27 months after being bitten by a flying fox (fruit bat). Molecular techniques enabled diagnosis of infection with Australian bat lyssavirus (ABL), the second human case to be recognised and the first to be acquired from a flying fox. It must be assumed that any bat in Australia could transmit ABL; anyone bitten or scratched by a bat should immediately wash the wounds thoroughly with soap and water and promptly seek medical advice.
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              Emerging epidemiology of bat-associated cryptic cases of rabies in humans in the United States.

              In the United States, during the past half-century, the number of humans to die of rabies dramatically decreased to an average of 1-2 per year. Although the number of deaths is low, most deaths occur because individuals are unaware that they had been exposed to and infected with rabies virus, and, therefore, they do not seek effective postexposure treatment. Molecular epidemiological studies have linked most of these cryptic rabies exposures to rabies virus variants associated with insectivorous bats. In particular, virus variants associated with 2 relatively reclusive species, the silver-haired bat (Lasionycteris noctivagans) and the eastern pipistrelle (Pipistrellus subflavus), are the unexpected culprits of most cryptic cases of rabies in humans.

                Author and article information

                Emerg Infect Dis
                Emerging Infectious Diseases
                Centers for Disease Control and Prevention
                June 2003
                : 9
                : 6
                : 721-723
                [* ]Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica
                []Hospital Nacional de Niños, San José, Costa Rica
                []Ministerio de Agricultura y Ganadería, San José, Costa Rica;
                [§ ]Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (INCIENSA), San Isidro de Pérez Zeledón , Costa Rica
                []Epidemiología, Región Brunca, CCSS, Tres Ríos, Cartago , Costa Rica
                [# ]Epidemiología, Región Brunca, Ministerio de Salud de Costa Rica, San Isidro de Pérez Zeledón
                [** ]Centers for Disease Control and Prevention, Atlanta, Georgia, USA
                Author notes
                Address for correspondence: Xiomara Badilla, Programa de Análisis y Vigilancia Epidemiológica, Caja Costarricense de Seguro Social, P.O. Box: 466-2400, Desamparados, San José, Costa Rica; fax: (506) 257-9052; email: xbadilla@ 123456ccss.sa.cr

                Infectious disease & Microbiology
                costa rica,human rabies,dispatch,bat
                Infectious disease & Microbiology
                costa rica, human rabies, dispatch, bat


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