title: Laboratory investigation of human deaths from vampire bat rabies in Peru.
abstract: In the spring of 1996, multiple cases of an acute febrile illness resulting in several deaths in remote locations in Peru were reported to the Centers for Disease Control and Prevention (CDC). The clinical syndromes for these cases included dysphagia and encephalitis. Because bat bites were a common occurrence in the affected areas, the initial clinical diagnosis was rabies. However, rabies was discounted primarily because of reported patient recovery. Samples of brain tissue from two of the fatal cases were received at CDC for laboratory confirmation of the rabies diagnosis. An extensive array of tests on the formalin-fixed tissues confirmed the presence of both rabies viral antigen and nucleic acid. The virus was shown to be most closely related to a vampire bat rabies isolate. These results indicate the importance of maintaining rabies in the differential diagnosis of acute febrile encephalitis, particularly in areas where exposure to vampire bats may occur.
authors.affiliation: Rabies Section, Viral and Rickettsial Zoonoses Branch, and Infectious Disease and Pathology Activity, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention,
authors.forename: C K
authors.initials: CK
authors.lastname: Warner
authors.forename: S R
authors.initials: SR
authors.lastname: Zaki
authors.forename: W J
authors.initials: WJ
authors.lastname: Shieh
authors.forename: S G
authors.initials: SG
authors.lastname: Whitfield
authors.forename: J S
authors.initials: JS
authors.lastname: Smith
authors.forename: L A
authors.initials: LA
authors.lastname: Orciari
authors.forename: J H
authors.initials: JH
authors.lastname: Shaddock
authors.forename: M
authors.initials: M
authors.lastname: Niezgoda
authors.forename: C W
authors.initials: CW
authors.lastname: Wright
authors.forename: C S
authors.initials: CS
authors.lastname: Goldsmith
authors.forename: D W
authors.initials: DW
authors.lastname: Sanderlin
authors.forename: P A
authors.initials: PA
authors.lastname: Yager
authors.forename: C E
authors.initials: CE
authors.lastname: Rupprecht
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000032:analysis; D001483:Base Sequence; D001921:Brain / Q000648:ultrastructure / Q000821:virology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000821:virology; D002685:Chiroptera / Q000821:virology*; D017931:DNA Primers / Q000737:chemistry; D004196:Disease Outbreaks; D004199:Disease Vectors; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006651:Histocytochemistry; D006801:Humans; D017403:In Situ Hybridization; D051379:Mice; D008813:Mice, Inbred ICR; D008969:Molecular Sequence Data; D009693:Nucleic Acid Hybridization; D010568:Peru; D016133:Polymerase Chain Reaction; D011818:Rabies / Q000175:diagnosis* / Q000401:mortality / Q000821:virology; D011820:Rabies virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D016415:Sequence Alignment; D012689:Sequence Homology, Nucleic Acid
chemical_list: D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral; D000956:Antigens, Viral; D017931:DNA Primers