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Rabies death reported in detention facility
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A Guatemalan national being held in a US Immigration and Customs Enforcement detention facility in Texas died of rabies on June 11, 2013, prompting 25 individuals, including other inmates, law enforcement personnel and health care workers, to receive postexposure prophylaxis, according to an MMWR report.
Seven days after being apprehended, the patient experienced insomnia, anxiety, nausea and dysphagia, as well as multiple incidents of hypersalivation and expectoration. He developed pneumomediastinum that resolved without surgical intervention. He was febrile, and his mental and respiratory status continued to deteriorate. Serum testing with enzyme-linked immunosorbent assay (ELISA) detected rabies virus antibodies. The patient underwent experimental rabies treatment that was unsuccessful.
The CDC and the Texas Department of State Health Services began rabies contact investigations at four detention facilities, a medical clinic and two hospitals to identify people at risk for rabies due to direct physical contact. The investigation identified 378 detainees, 320 law enforcement officers and 44 health care workers who were potentially exposed. After risk assessments were completed, 25 individuals were recommended to receive postexposure prophylaxis.
“Detention facility settings provide extensive opportunities for disease transmission, including rabies, and a complex network of potential disease contacts,” the investigators wrote. “Law enforcement and public health officials, when working cohesively, can quickly identify potentially exposed persons and provide life-saving medical recommendations.”
Disclosure: The researchers report no relevant financial disclosures.
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