title: Human Rabies - Missouri, 2014.
abstract: On September 18, 2014, the Missouri Department of Health and Senior Services (MDHSS) was notified of a suspected rabies case in a Missouri resident. The patient, a man aged 52 years, lived in a rural, deeply wooded area, and bat sightings in and around his home were anecdotally reported. Exposure to bats poses a risk for rabies. After two emergency department visits for severe neck pain, paresthesia in the left arm, upper body tremors, and anxiety, he was hospitalized on September 13 for encephalitis of unknown etiology. On September 24, he received a diagnosis of rabies and on September 26, he died. Genetic sequencing tests confirmed infection with a rabies virus variant associated with tricolored bats. Health care providers need to maintain a high index of clinical suspicion for rabies in patients who have unexplained, rapidly progressive encephalitis, and adhere to recommended infection control practices when examining and treating patients with suspected infectious diseases.
authors.forename: P Drew
authors.initials: PD
authors.lastname: Pratt
authors.forename: Kathleen
authors.initials: K
authors.lastname: Henschel
authors.forename: George
authors.initials: G
authors.lastname: Turabelidze
authors.forename: Autumn
authors.initials: A
authors.lastname: Grim
authors.forename: James A
authors.initials: JA
authors.lastname: Ellison
authors.forename: Lillian
authors.initials: L
authors.lastname: Orciari
authors.forename: Pamela
authors.initials: P
authors.lastname: Yager
authors.forename: Richard
authors.initials: R
authors.lastname: Franka
authors.forename: Xianfu
authors.initials: X
authors.lastname: Wu
authors.forename: Xiaoyue
authors.initials: X
authors.lastname: Ma
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Wadhwa
authors.forename: Todd G
authors.initials: TG
authors.lastname: Smith
authors.forename: Brett
authors.initials: B
authors.lastname: Petersen
authors.forename: Miriam
authors.initials: M
authors.lastname: Shiferaw
mesh_terms: D000818:Animals; D002685:Chiroptera; D004660:Encephalitis / Q000209:etiology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D011634:Public Health; D011818:Rabies / Q000175:diagnosis*; D011820:Rabies virus / Q000235:genetics / Q000302:isolation & purification*