title: Fatal human rabies caused by European bat Lyssavirus type 2a infection in Scotland.
abstract: 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.
authors.affiliation: Department of Infectious Diseases, Ninewells Hospital and Medical School, University of Dundee, Dundee, Scotland. dilip.nathwani@tuht.scot.nhs.uk
authors.forename: D
authors.initials: D
authors.lastname: Nathwani
authors.forename: P G
authors.initials: PG
authors.lastname: McIntyre
authors.forename: K
authors.initials: K
authors.lastname: White
authors.forename: A J
authors.initials: AJ
authors.lastname: Shearer
authors.forename: N
authors.initials: N
authors.lastname: Reynolds
authors.forename: D
authors.initials: D
authors.lastname: Walker
authors.forename: G V
authors.initials: GV
authors.lastname: Orange
authors.forename: A R
authors.initials: AR
authors.lastname: Fooks
mesh_terms: D000818:Animals; D001733:Bites and Stings; D002685:Chiroptera / Q000821:virology*; D017809:Fatal Outcome; D006801:Humans; D018114:Lyssavirus / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D011818:Rabies / Q000401:mortality / Q000821:virology*; D018353:Rhabdoviridae Infections / Q000401:mortality / Q000821:virology*; D012606:Scotland