MMWR Morb Mortal Wkly Rep. 2013 Aug 16;62(32):642-4.
On December 3, 2011, a South Carolina woman visited a local emergency department (ED) with an overnight history of shortness of breath, diaphoresis, chills, and intermittent paresthesia. The patient was transferred to a referral hospital, where she became comatose and developed multiorgan failure. The patient did not report a history of an animal bite. However, family members subsequently revealed that bats had been observed in the patient's home during the previous summer. Family members also reported that the patient had sought information on bat removal from a local county service, but was not advised of the risk for rabies associated with bat exposures and was not referred for public health consultation. CDC confirmed infection with a rabies virus variant associated with Mexican free-tailed bats (Tadarida brasiliensis) on December 14, after which the patient received hospice care. She died on December 19. This report summarizes the patient's clinical course and the associated public health investigation. This case highlights the importance of strong partnerships among public health officials and diverse non-health-care partners to ensure appropriate referral of persons exposed to bats in their homes for prompt and appropriate risk assessment, postexposure prophylaxis (PEP) recommendations, and information on safe, effective, and humane bat exclusion methods.
2011 年 12 月 3 日，一名南卡罗来纳州妇女因夜间呼吸急促、出汗、寒战和间歇性感觉异常到当地急诊部就诊。患者被转往一家转诊医院，在那里她昏迷不醒，并出现多器官衰竭。患者未报告动物咬伤史。然而，家属随后透露，去年夏天曾在家中观察到蝙蝠。家属还报告说，患者曾向当地县服务部门寻求蝙蝠清除信息，但未被告知与蝙蝠接触相关的狂犬病风险，也未被转介接受公共卫生咨询。美国疾病控制与预防中心（CDC）在确认感染与墨西哥游离尾蝠（Tadarida brasiliensis）相关的狂犬病病毒变异株后，于 12 月 14 日发布了此病例，此后患者接受了临终关怀。她于 12 月 19 日去世。本报告总结了患者的临床过程和相关的公共卫生调查。该病例强调了公共卫生官员和不同非卫生保健伙伴之间建立强大伙伴关系的重要性，以确保及时、适当地评估家中接触蝙蝠的人员的风险，提供接触后预防（PEP）建议，并提供有关安全、有效和人道的蝙蝠排除方法的信息。
