Confirmation of Human Rabies Infection in Texas

Posted: May 10, 2006

On May 9, 2006, the Centers for Disease Control and Prevention (CDC), working together with Harris County Public Health and Environmental Services (HCPHES) and the Texas Department of State Health Services (TDSHS), confirmed a diagnosis of rabies as the cause of illness in a Texas teenager, who has been hospitalized with encephalitis. This advisory provides information about this case, an update for states that may receive inquiries due to public concerns about rabies, and criteria for conducting risk assessments to determine the need for postexposure prophylaxis (PEP).

Four to six weeks prior to admission, the patient had awakened due to direct contact with a live bat in his bedroom. The bat was removed from the home and was not available for testing. Bats are a widely distributed reservoir of rabies throughout the United States. The child did not present for medical attention until after symptoms had developed, thus rabies PEP was not administered. Diagnosis was made on the basis of a positive direct fluorescent antibody test for rabies virus antigen on a nuchal skin biopsy. Further analysis of clinical specimens is ongoing in an effort to establish a likely animal source for the infection, based upon viral characterization.

HCPHES and TDSHS, in collaboration with CDC, are continuing to conduct investigations to identify contacts of the patient among family members, the local community, and health-care workers and to identify other persons who may have had contact with the bat at the same time as the patient. Human rabies PEP is recommended only in situations in which potentially infectious material (e.g. saliva) from a rabid animal or human is introduced via a bite, or comes into direct contact with broken skin or mucous membranes. More detailed information regarding evaluation for and administration of PEP is available here.

Additional information about rabies and its prevention is available from HCPHES at 713-212-0200, TDSHS at 512-458-7455, and CDC, telephone 1-800-CDC-INFO or at http://www.cdc.gov/rabies. This website is updated as new information becomes available.