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RABIES (29): EUROPE, ASIA (NORWAY ex PHILIPPINES) HUMAN, DOG
最後に、[1]から[5]の報道資料をモデレーターがその内容をまとめていますので、翻訳は最後のモデレーターのコメントのみといたします。
[1]
Date: Wed 15 May 2019
Source: Dagbladet, Norway [in Norwegian, machine trans., abridged,
edited] <https://www.dagbladet.no/nyheter/haper-var-solstrales-dod-kan-redde-andre/71081098>
The family and relatives of Birgitte Kallestad wanted to say goodbye to the young woman under sheltered and private frames.
At 1:00 p.m. today [Wed 15 May 2019], the 24-year-old was buried in the upbringing municipality of Fjell in Hordaland.
"Intangible to all of us, her goodness became her path. Nevertheless, according to Birgitte's heart, it is now possible to give a gift to the Animal Protection. It's a great way to honor her memory," priest Maria Tveiten said in the memorial in the Foldnes church.
On [Mon 6 May 2019], she died of rabies at Forde central hospital in Sogn og Fjordane, which was the bioengineer's own workplace.
It is the 1st time since 1812 that rabies -- also known as dog madness -- was registered on Norway's mainland.
The 24-year-old was infected by bites on her fingers from a dog puppy when she and friends were traveling in the Philippines in February this year [2019]. The death of the fun-loving, young woman has made a deep impression on all she knew.
Shortly after her death, the family sent out a statement through a spokesperson, Jens Eikas, a communicator, about what had happened. The death and the family's openness have focused on a risk factor in about 150 countries but have gone under the radar here at home.
"Our dear Birgitte loved animals. Our fear is that such fate may happen to others who have a warm heart like her. We want rabies vaccine to be included in the program for travellers to locations where the disease is present, and that people become more aware of the danger. If we manage to achieve this, the death of our sunbeam cansave others. Warm greetings from the family." The family's thoughts about the future have also made an impression in a country with many on the road.
Birgitte discovered a helpless puppy at the roadside when she and her friends were on a moped trip in the Philippines. Birgitte picked it up in a basket and took it to the house where they were staying.
There, the puppy got on, playing with everyone and nibbling the new playmates in the fingers, as puppies do. But Birgitte, with her daily ballast as a health worker, was not afraid that these little bites were not sterile, the family reported after her death.
She got sick long after she came home, and after several doctor visits one of the doctors suggested that she should be checked for rabies. The family boasts of the follow-up she received from the health service.
The Norwegian Institute of Public Health has not received reports [of illness] from the others on the trip to the Philippines or in the house where [the friends] played with the puppy in the garden.
Several people in Birgitte Kallestad's vicinity have been vaccinated against rabies in retrospect. The vaccination may have an effect on the virus.
Professor OLrjan Olsvik at the University of Tromso has informed the VG that the rabies [virus] in most cases lies in the body for up to a few months before [the infected person] becomes ill. But the infection can also lie in the body several years before it strikes.
Rabies is widespread especially in southeast Asia and Africa. Dogs are the source of human infection in far more than 90% of cases.
[Byline: Oystein Andersen]
--
Communicated by: ProMED-mail <promed@promedmail.org>
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[2]
Date: Wed 8 May 2019
Source: VG, Norway [in Norwegian, machine trans., abridged, edited]
<https://www.vg.no/nyheter/innenriks/i/e8ql8R/kvinne-doede-av-rabies-familien-er-veldig-beroert>
The family, who live in the municipality, wants to be spared from inquiries from the press. Eikas is appointed as the spokesperson of the family. The rabid-infected woman died on Monday [6 May 2019] night as a result of the very serious viral disease.
"She was also at an age where she has a large network [of friends], and with many close. The family is very affected by [her death]", says Eikas. Crisis staff have therefore been established in the Sotra municipality, west of Bergen.
"All the relatives live here. We have established a crisis team when we know that some of the relatives want such a contact," confirms vice president Steinar Nesse.
The woman is from a village with few inhabitants, and the councilor believes that everyone here knows the person. "It is a terrible matter, and it is the 1st time in 200 years that someone has died of rabies in Norway," says Nesse.
The woman lived in Forde and died at Forde central hospital with her closest family around her. Only on Tuesday [7 May 2019] was the municipality informed that the woman is from Fjell.
"It is very heavy and vulnerable for the family," says health manager Terje Handal in the municipality. He says that a crisis team was established before the municipality was contacted by Helse Forde.
- What does such a crisis team consist of?
"People in psychiatry, a municipal psychologist, a health nurse, and a doctor. All are needed, and those who are best qualified when it comes to crisis management," he says.
Fjell Mayor Marianne Sandahl Bjoroy tells VG that the crisis team has been in contact with the relatives. "This is very sad for the relatives, who are probably left with many unanswered questions," she says. "The municipality of Fjell will set up for them and give them the help they need as long as they want it."
Municipal consultant at Forde, Oystein Furnes, says that the municipality has not had treatment responsibility for the patient during the course of the disease, but that they had contact with her at the very beginning when she started to get symptoms. He does not want to comment on the symptoms in the case in question but says, on a general basis, that the disease often gives rise to diffuse symptoms
at 1st, such as agitation, anxiety, and depression, before it gradually becomes more serious.
"The woman was admitted to Forde central hospital on Thursday [2 May 2019] but consulted a doctor several times before this, according to Furnes. She was admitted to the emergency room for 24 hours but was discharged again."
"What we can see here is that it has been quite natural that there has been contact with the primary health service. If one had suspected that it was a serious illness, one would, of course, admit her to the hospital, which she eventually became."
- Was there any other illness suspected before she was admitted?
"In all cases, different explanations of symptoms will be considered."
VG has asked whether the woman was vaccinated before or after the incident, but Helse Forde says they cannot answer this. "We do not endorse any information about anything in the process," says Trine Hunskar Vingsnes, vice president, Helse Forde. "Between 25 and 30 employees at Forde central hospital are vaccinated againstrabies. There are also a number of health workers in Forde municipality after contact with the infected woman."
- Do these get any kind of further follow-up?
"It doesn't seem to have been needed. We have had close contact with them, and they have open lines if they want to talk. We have received feedback that they feel well taken care of," says Furnes.
[Byline: Lone Lohne, Ingvild Silseth, and Carina Hunshamar]
--
Communicated by: ProMED-mail <promed@promedmail.org>
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[3]
Date: Sun 12 May 2019
Source: The Atlanta Journal-Constitution [edited]
<https://www.ajc.com/news/national/woman-dies-from-rabies-after-bites-from-stray-puppy-during-vacation/IAh5X7jggO8lrbmjKltdpL/>
Norwegian tourist Birgitte Kallestad was such an animal lover, she didn't think twice about stopping for a stray puppy she spotted on the side of the road while on vacation with friends in the Philippines in February [2019].
Kallestad, 24, picked up the puppy and took it with her back to the resort where she was staying, washed it, and played with it, according to the BBC, never thinking she was in any danger. The puppy did bite her several times, news reports indicate, but she didn't think much about that either; after all, it was just a baby.
A health worker herself, she washed the cuts out and didn't seek further treatment, according to a family statement given to Norway's state-owned broadcaster NRK, USA Today reported.
When Kallestad returned home to Norway, she actually felt fine for a while. It wasn't until 28 Apr [2019] that she was 1st admitted to a hospital, her family said, but by then the illness was so far advanced that doctors had a hard time diagnosing it. When they did, it was too late. Kellestad died from rabies last Monday [6 May 2019].
[Byline: Shelby Lin Erdman]
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Communicated by: ProMED-mail <promed@promedmail.org>
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[4]
Date: Fri 10 May 2019
Source: AFP via Channel News Asia [edited]
<https://www.channelnewsasia.com/news/world/norwegian-woman-dies-of-rabies-after-rescuing-puppy-in-the-11523118>
A 24-year-old Norwegian woman died this week of rabies, after she was bitten by a puppy she rescued while on vacation in the Philippines, her family announced.
In February [2019], while on holiday with friends, Birgitte Kallestad found a "helpless" puppy on the side of the road during a scooter ride. "Birgitte put the puppy in a basket and brought him home. She cleaned it and cared for it, and to her joy, it started healing. They played with the puppy in the garden" of the resort where they were staying, the family said in a statement published on Thursday [9 May 2019] evening. "After a while, the puppy started trying to bite them, like
puppies do. It nipped their fingers when they were playing," the statement continued.
The young woman, a hospital employee, started feeling ill after her return to Norway and was put into intensive care at Forde hospital, where she worked and where she passed away on Monday [6 May 2019] evening.
According to the Norwegian Institute of Public Health, the last recorded case of rabies contracted by a human in mainland Norway dates back to 1815, and to 1826 for an animal.
According to the family no one in the group of friends had been vaccinated against rabies. "Our dear Birgitte loved animals. Our fear is that this will happen to others who have a warm heart like hers," her family said.
At least 59 000 people worldwide die each year worldwide from the animal-borne disease, according to the World Health Organization (WHO). More than 99% of victims are concentrated in Asia, Africa, and South America.
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Communicated by: ProMED-mail Rapporteur Kunihiko Iizuka
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[5]
Date: Fri 10 May 2019
Source: USA today [edited]
<https://www.usatoday.com/story/news/world/2019/05/10/norwegian-woman-dies-rabies-after-dog-bite-philippines/1163989001/>
A Norwegian tourist has died after she was infected with rabies months ago from a stray puppy in the Philippines, Norwegian media reported. Birgitte Kallestad, 24, died earlier this week, her family said in astatement Thursday [9 May 2019], according to NRK, Norway's state-owned broadcaster.
Kallestad and her friends were in the Philippines in February [2019] and spotted the puppy on the side of the road, NRK reported. The woman grabbed the puppy and bathed it after bringing it back to where they were staying, but soon the small dog began nibbling on her and her friend's fingers, the family said, according to NRK. No one thought much of it, and Kallestad, a health worker, washed the small cuts out, NRK reported. But when the woman returned home to Norway, she fell ill.
According to Verdens Gang, a Norwegian tabloid, Kallestad went to doctors multiple times before her death, but none connected her symptoms to rabies. The tabloid reported that doctors said it was the 1st rabies-related death in the Scandinavian country in 200 years.
Rabies is a deadly, viral disease that infects the central nervous system. Post-exposure vaccines are used to prevent progression of the disease, according to the Centers for Disease Control and Prevention.
Symptoms -- such as fever, headache, and weakness or discomfort – can appear similar to other diseases at 1st. Other more serious symptoms develop later, including insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation (increase in saliva), difficulty swallowing, and hydrophobia (fear of water), the CDC says.
Rabies deaths are rare in the United States, though wild animals do still carry the virus. In the Philippines, there is a "high risk" of contracting rabies, the World Health Organization said in 2013.
"Our dear Birgitte loved animals," her family said, according to the BBC. "Our fear is that this will happen to others who have a warm heart like her."
[Byline: Ryan W. Miller]
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Communicated by: ProMED-mail <promed@promedmail.org>
[In ProMED-mail's initial posting on this tragic event (archive no.http://promedmail.org/post/20190509.6461913), we stated that the report lacked detail. The additional media reports presented above have added several significant pieces of information:
ProMEDにおけるこの悲劇的な出来事の最初の投稿（アーカイブNo.http://promedmail.org/post/20190509.6461913）では、詳細な報告が不足していた。メディアによる上記の追加情報は、いくつかの重要な情報を提供してくれている。
- The visited rabies-affected country was the Philippines;
- The victim showed her 1st clinical signs in Norway, on 28 Apr 2019, more than 2 months after her exposure to the rabid animal;
- The diagnosis was delayed;
- Some (or all?) of her travelmates, who may have been exposed to the rabid animal, have undergone (or are undergoing) post-exposure treatment (PET) in Norway;
- Potentially exposed personnel in the hospital have undergone PET; and
- Last, but certainly not least, the rabid animal in the Philippines was a collected, unwell puppy dog.
-狂犬病に感染した訪問国は、フィリピンであった。
-彼女が狂犬病罹患動物に暴露された2か月以上後の2019年4月28日にノルウェーで最初の臨床兆候を示した。
-診断は遅れた。
-狂犬病罹患動物に暴露されたかもしれない旅行の同行者の一部（または全員？）は、ノルウェーで暴露後ワクチン接種（PET）を受けた（または実施中）。
-病院内で暴露された可能性のある人はPETを受けた。
-最後に、しかし決して無視できないこととして、フィリピンで捕獲された狂犬病罹患動物は、具合の悪い子犬であった。
The latter piece of information deserves special attention. Stray puppies are notorious rabies vectors, in particular exposing children who are often involved in such situations, while exercising close contact with the to-become pets. The clinical signs of rabies in puppies may often be non-typical if not misleading, and – inparticular if the animals retain residual maternal immunity – show minimal abnormalities while being infective.
後に得られた情報は、特に注目すべきである。放浪している子犬は狂犬病の媒介動物としてよく知られており、特にペットとするための馴化を行うような状況で子供が暴露される。子犬における狂犬病の臨床兆候は、まぎらわしいとまでは言わないが、しばしば非典型的であり、特に移行抗体が存在している時には、感染時でも最小限の異常しか示さない。
Every veterinary clinician in rabies-stricken regions is expected to know this, in many cases from their own experience. Also, residents of countries where rabies is prevalent, and visitors to these countries, should know that a "friendly" wild animal (e.g., foxes), which come close in a seemingly fearless way to humans, may be just rabid. Vets and public health professionals are supposed to educate the public. This information should be delivered to all: both visitors to rabies-affected countries as well as local residents.
狂犬病発生地域の全ての臨床獣医師は、多くの場合、彼らの経験から、そのことを知っていると思われる。また、狂犬病が流行している国の住民やそれらの国を訪れる旅行者も、人を怖がらずに寄って来る「人懐っこい」野生動物（例えば、キツネ）が、まさに狂犬病感染動物かもしれないことを知るべきである。獣医師や公衆衛生の専門家は、人々を教育することになっている。この情報は、地域住民と同様に、狂犬病発生国を訪れる旅行者にも届けられるべきである。
Members of the public should refrain from collecting strange, stray puppies or offspring of other, non-domestic canids (e.g., foxes, jackals, etc.). Such activities
should remain exclusively in the hand of the authorities or qualified/certified agencies.
一般の人々は、見知らぬ放浪している子犬やその他の飼育されていないイヌ科動物（例えば、キツネ、ジャッカルなど）などの子供を捕まえるのを避けるべきである。
このような活動は、もっぱら、専門家または有資格者や認定者の手にゆだねられるべきである。
It remains to be known if all co-travelers of the late Birgitte have been traced back and undergone PET. The incubation period for rabies is typically 1-3 months but may vary from less than a week to more than 2 years. Due to the potentially long incubation period for rabies, there is no time limit for giving PET, and all potentialexposures should be risk-assessed. This and much more useful updated information on PET is available in the recently (April 2019) published "Guidelines on managing rabies post-exposure" (Public Health England, April 2019, 40 pages) at
<https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/800017/PHE_guidelines_on_rabies_post-exposure_treatment.pdf>.
- Mod.AS
亡くなったBirgitteの同行者の全員が追跡され、PETを受けたかどうかは、未だ分かってはいない。狂犬病の潜伏期は、典型的には1か月から3か月であるが、1週間以下から2年以上までの幅がある。狂犬病には、潜在的に長い潜伏期間があるために、PETを受けるタイムリミットは存在せず、暴露された可能性がある人は全てリスク評価を受けるべきである。PETに関するこれらや役立つ最新の情報は、最近（2019年4月）に出版された、以下の「狂犬病暴露後管理ガイドライン」（イングランド公衆衛生サービス、2,019年4月、40ページ）で手に入る。<https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/800017/PHE_guidelines_on_rabies_post-exposure_treatment.pdf>.
-モデレーターA.S.
HealthMap/ProMED-mail maps:
Norway: <http://healthmap.org/promed/p/107>
Philippines: <http://healthmap.org/promed/p/158>]
[See Also:
Rabies (27): Europe, Asia (Norway ex SE Asia) human, dog
http://promedmail.org/post/20190509.6461913
Rabies (24): Asia (Qatar ex Nepal) human, sylvatic exposure suspected,
comment http://promedmail.org/post/20190504.6454635
Rabies (18): Asia (Qatar ex Nepal) human, sylvatic exposure susp.,
comment http://promedmail.org/post/20190416.6425196
Rabies (17): Asia (Qatar ex Nepal) human, sylvatic exposure suspected,
comment http://promedmail.org/post/20190411.6416702
Rabies (16): Asia (Qatar ex Nepal) human, sylvatic exposure suspected
http://promedmail.org/post/20190410.6412045
2018
----
Rabies, human - UK: (England) ex Morocco, ex feline
http://promedmail.org/post/20181113.6142425
2015
----
Rabies - USA (49): (NJ) ex Egypt, canine, human exposure
http://promedmail.org/post/20151218.3872882
Rabies - France (02): (LR) ex Algeria, canine, human exposure, OIE
http://promedmail.org/post/20150525.3383986
Rabies - France: (LR) ex Algeria, canine, human exposure
http://promedmail.org/post/20150524.3382864
Rabies - France ex Mali: 2014
http://promedmail.org/post/20150425.3322855
Rabies - UK: (N Ireland) human, susp ex enzootic country
http://promedmail.org/post/20150425.3322790
2014
----
Rabies - Netherlands ex India (03): (TN) canine, human, comments
http://promedmail.org/post/20140827.2727166
Rabies - Netherlands ex India (02): (TN) canine, human, comments
http://promedmail.org/post/20140826.2724516
Rabies - Netherlands ex India: (TN) canine, human
http://promedmail.org/post/20140825.2721553
Rabies - USA (03): (TX) ex Guatemala, human
http://promedmail.org/post/20140609.2529466
Rabies - France ex Mali http://promedmail.org/post/20140404.2381608
2013
----
Rabies - Netherlands (03): (ZH, NH) ex Bulgaria, canine, OIE, NOT
http://promedmail.org/post/20131210.2104119
Rabies - France (02): (VO) ex Morocco, feline, OIE
http://promedmail.org/post/20131104.2037811
Rabies - Netherlands (02): (ZH,NH) ex Bulgaria, canine, OIE
http://promedmail.org/post/20131022.2013679
Rabies - Netherlands: ex Haiti, canine, human
http://promedmail.org/post/20130625.1791201
Rabies - Spain (03): (CM) ex Morocco, travel alert
http://promedmail.org/post/20130622.1786776
Rabies - USA (11): (TX) ex Guatemala, human
http://promedmail.org/post/20130616.1775355
Rabies - Spain (02): (CM) ex Morocco, canine, human exp
http://promedmail.org/post/20130615.1773946
Rabies - Spain: (CM) ex Morocco, canine, OIE
http://promedmail.org/post/20130607.1760455
Rabies - Taiwan: ex Philippines
http://promedmail.org/post/20130515.1715913]
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