The Centers for Disease Control just released a report about a young girl who survived rabies. She is only the third unvaccinated U.S. person to ever recover from rabies. Generally, once a person shows the symptoms of rabies, the disease is fatal. Suspected rabies must be treated before symptoms appear.

In May of 2011, an 8-year old girl from a rural county in California was brought to a local emergency room and admitted to the hospital. Over the past week, she had suffered from a progressive sore throat, difficulty swallowing, and weakness. She began having trouble breathing and was placed on a ventilator and given intravenous fluids. Paralysis and encephalitis set in, and she was placed in an induced comatose state. She was treated for possible bacterial pneumonia, and was tested for enterovirus and West Nile virus. Finally, a test for rabies proved positive and more specific treatments were begun.

A week after admission, she spontaneously moved her head. Over the next few days, she moved her head more, then began moving her arms and then her legs. With progressive improvement in her strength, she was removed from the ventilator after 15 days. She was discharged from the hospital 37 days later and continued rehabilitation as an outpatient. At the time of discharge, she showed no signs of cognitive impairment and was able to walk and perform activities of daily living.

The public health investigation found that free-roaming unvaccinated cats at the girl’s school were the possible source of the rabies infection. The girl admitted that she had handled the cats on several occasions. She was scratched by two different cats approximately 9 weeks and 4 weeks before the beginning of her illness, but was not bitten. The local health department collected the cats at the school for observation. All collected cats remained healthy with no signs of rabies. The most recent rabid cat in California was reported in 2008 from the same California county where the girl lived. Two cases of human rabies have been attributed to cats since 1960.

The family owned pot-bellied pigs, pet birds, dogs, and horses. The dogs and birds were healthy but one horse had died several months earlier. The horse was exhumed for brain testing for rabies but results were inconclusive. Inspection of the girl’s home by the health department found no evidence of bat infestation.

The girl’s classmates were surveyed and two were identified who had possible contact with her saliva during wrestling practice. They were given preventive rabies vaccine, along with eight members of the girl’s family and 17 health workers who had treated the girl.

This case study points out the important, but little known, fact that you do not have to be bitten by a rabid animal to get rabies. Rabies can also be spread through a scratch from the animal, or if the animal’s saliva or brain tissue comes in contact with a person’s mucous membranes or an open wound. Any time there is suspected exposure to a possibly rabid animal, administration of rabies vaccine must be considered, because there is no proven cure. This girl was extremely lucky. (Source: Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, “Recovery of a Patient from Clinical Rabies – California, 2011.” 2/2/12)