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Phylogenetic and epidemiologic evidence of multiyear incubation in human rabies
Author(s) -
Boland Torrey A.,
McGuone Declan,
Jindal Jenelle,
Rocha Marcelo,
Cumming Melissa,
Rupprecht Charles E.,
Barbosa Taciana Fernandes Souza,
de Novaes Oliveira Rafael,
Chu Catherine J.,
Cole Andrew J.,
Kotait Ivanete,
Kuzmitalia A.,
Yager Pamela A.,
Kuzmin Ivan V.,
HedleyWhyte E. Tessa,
Brown Catherine M.,
Rosenthal Eric S.
Publication year - 2014
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.24016
Subject(s) - rabies , rabies virus , epidemiology , lyssavirus , virology , incubation period , encephalitis , myelitis , encephalomyelitis , phylogenetic tree , molecular epidemiology , biology , medicine , virus , incubation , pathology , immunology , genotype , rhabdoviridae , multiple sclerosis , genetics , spinal cord , psychiatry , biochemistry , gene
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. ANN NEUROL 2014;75:155–160