Resumen de Estudio de caso de rabia humana transmitida por murciélago hematófago en Yucatán, México.

Salvador Gómez Carro, Martín L. Ortiz Alcaraz, Eusebio Jiménez Ríos, Saúl de Los Santos Briones, Enrique Marín Pech

• español

  Introducción. En 1998 en Yucatán se registró el último caso de rabia humana transmitido por perro. En 2001 ocurrió el primer caso en una niña de 4 años transmitido por un animal silvestre, pero sin reportarse ningún caso en humanos por agresión directa de vampiro.

  Caso clínico epidemiológico. Se estudió a una menor de 12 años fallecida por un síndrome febril y de encefalitis viral que se sospechó por virus rábico, aún sin el antecedente o evidencia de agresión por algún animal. Se obtuvo la cobertura de vacunación antirrábica de perros y gatos de la localidad afectada, realizando estudio de los contactos y de las condiciones de la vivienda y áreas aledañas.

  Discusión. Se identificó como probable causa la mordedura inadvertida de un vampiro, facilitada por una vivienda precaria colindante a una cueva de quirópteros. El diagnóstico se confirmó postmortem por el Instituto Nacional de Referencia Epidemiológica reportando la variante antigénica V5 de murciélago hematófago. Se destaca la importancia de realizar acciones preventivas en la comunidad ante la sospecha del diagnóstico de rabia humana. Se concluye que es necesaria la vigilancia zoonótica colateral para detectar nichos de murciélagos hematófagos en localidades rurales.

• English

  Introduction. The last known case of human rabies in Yucatan transmitted by a dog was registered in 1998. In 2001 the fi rst case transmitted by a wild animal was reported in a 4 year old girl. However, there had not previously been a case registered by vampire bats.

  Epidemiologic clinical case. The results of the study done on the body of a 12 year old girl from the state of Yucatan showed she died from febrile syndrome and viral encephalitis. These symptoms are consistent with the rabies virus infection; however, there was no supporting report or evidence of aggression by a domestic or wild animal. As a result, investigations were carried out to identify any indicators relating affected to: animal aggression, co-existence with domestic animals, anti-rabies vaccination in these domestic animals, recent human and animal contacts of the individual, and inspection of housing conditions and the surrounding area.

  Discussion. A further epidemiologic study identifi ed that an unexpected bite from a vampire bat was the probable cause of the infection. This conclusion was supported by the investigation which showed that her housing conditions were precarious, and the house was located next to a cave which is a common habitat for vampire bats.

  The diagnosis was confi rmed post-mortem by The National Institute of Epidemiologic Reference which found the AgV5 rabies antigenic variant of a bat. In conclusion, we stress the importance of carrying out preventative measures to detect and keep a watch on colonies of vampire bats when there is a suspected diagnosis of rabies in a rural community