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Wiley, Annals of Neurology, 1(75), p. 155-160

DOI: 10.1002/ana.24016

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Phylogenetic and Epidemiologic Evidence of Multiyear Incubation in Human Rabies

Journal article published in 2014 by Torrey A. Boland, Declan McGuone, Jenelle Jindal, Marcelo Rocha, Melissa Cumming, Charles E. Rupprecht, Taciana Fernandes Souza Barbosa, Rafael de Novaes Oliveira, Catherine Jean Chu, Andrew James Cole, Ivanete Kotait, Natalia A. Kuzmina ORCID, Pamela A. Yager, Ivan V. Kuzmin, E. Tessa Hedley-Whyte and other authors.
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This paper is available in a repository.

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Abstract

Eight years after emigrating from Brazil, an otherwise healthy man developed rabies. An exposure prior to immigration was reported. Genetic analysis revealed a canine rabies virus variant found only in the patient’s home country, and the patient had not traveled internationally since immigrating to the United States. We describe how epidemiological, phylogenetic, and viral sequencing data provided confirmation that rabies encephalomyelitis may present after a long, multiyear incubation period, a consideration that previously has been hypothesized without the ability to exclude a more recent exposure. Accordingly, rabies should be considered in the diagnosis of any acute encephalitis, myelitis, or encephalomyelitis.