Nathwani D, McIntyre P G, White K, Shearer A J, Reynolds N, Walker D, Orange G V, Fooks A R
Department of Infectious Diseases, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland.
Clin Infect Dis. 2003 Aug 15;37(4):598-601. doi: 10.1086/376641. Epub 2003 Jul 31.
We wish to report the first recorded case of indigenous human rabies caused by a bat bite in the United Kingdom in 100 years. This instructive case report highlights a number of key lessons: first, bites from insectivorous bats indiginous to the United Kingdom can cause rabies in humans; second, rabies immunization is essential for bat-handlers, and postexposure treatment for rabies is essential for patients bitten by bats; third, patients able to give a history who present with acute flaccid paralysis and/or presumptive viral encephalitis should be asked if they have been bitten by bats, irrespective of travel history, or this history should be obtained from family or friends; fourth, antemortem diagnosis of bat rabies (EBLV type 2a infection) in humans is possible using RT-PCR.
我们希望报告英国100年来首例有记录的因蝙蝠叮咬导致的本土人类狂犬病病例。这份具有启发性的病例报告突出了一些关键经验教训:第一,英国本土食虫蝙蝠的叮咬可导致人类感染狂犬病;第二,对于接触蝙蝠者,狂犬病免疫至关重要,对于被蝙蝠咬伤的患者,狂犬病暴露后治疗必不可少;第三,对于出现急性弛缓性麻痹和/或疑似病毒性脑炎且能够提供病史的患者,无论其旅行史如何,均应询问是否被蝙蝠咬伤,或应从家人或朋友处获取这一病史;第四,使用逆转录聚合酶链反应(RT-PCR)有可能在生前诊断人类的蝙蝠狂犬病(欧洲蝙蝠狂犬病病毒2a型感染)。