MMWR Morb Mortal Wkly Rep. 2009 Jul 10;58(26):713-6.
Compared with rabies in developing countries, human rabies is rare in the United States, but animal rabies is common. In the United States, most human rabies cases are associated with rabid bats, whereas in developing countries, dogs are the most common reservoir and vector species. In March 2008, a case of imported human rabies in a recently arrived, undocumented Mexican immigrant was laboratory confirmed by public health officials in California. The rabies virus isolated from the patient was a previously uncharacterized variant most closely related to viruses found in Mexican free-tailed bats (Tadarida brasiliensis). The molecular and phylogenetic characterizations of this rabies virus variant have been described previously. This report summarizes the epidemiologic investigation and the ensuing public health response. A total of 20 persons, mostly household contacts, received postexposure prophylaxis (PEP) because of potential exposure to rabies virus from the patient. The findings underscore the difficulties encountered in the diagnosis and epidemiologic investigations of imported human rabies cases and the importance of a coordinated public health response across multiple international jurisdictions.
与发展中国家的狂犬病相比，人类狂犬病在美国较为罕见，但动物狂犬病却很常见。在美国，大多数人类狂犬病病例与狂犬病蝙蝠有关，而在发展中国家，狗是最常见的储存宿主和传播媒介物种。2008年3月，加利福尼亚州的公共卫生官员通过实验室确诊了一例刚抵达美国的无证墨西哥移民输入性人类狂犬病病例。从患者身上分离出的狂犬病病毒是一种以前未鉴定的变种，与在墨西哥无尾蝙蝠（巴西无尾蝠）中发现的病毒关系最为密切。该狂犬病病毒变种的分子和系统发育特征此前已有描述。本报告总结了流行病学调查及随后的公共卫生应对措施。共有20人，主要是家庭接触者，因可能接触到患者的狂犬病病毒而接受了暴露后预防（PEP）。这些发现凸显了输入性人类狂犬病病例诊断和流行病学调查中遇到的困难，以及多个国际辖区协调公共卫生应对措施的重要性。
