Human
rabies transmitted from wild animals is rarely reported in endemic countries like India, where nearly 95% deaths occur due to
bites from rabid dogs. In this paper, we report an incidence of rabid fox
bites in a village in southern part of India involving 18 individuals, including 4 children. All people had category III exposures, including
bites on the face and neck. The attacking fox was killed by the forest department and buried immediately. The victims of the fox
bite did not receive appropriate and adequate postexposure treatment. Thirteen days after the
bite, one of the
bite victims developed typical symptoms of
furious rabies and died 2 days later in a local hospital. His brain tissue, obtained at autopsy, was strongly positive for
rabies by fluorescent antibody technique (FAT) and virus isolation. Panic prevailed in the community and the rest of the 17 cases were referred to our institute for advice and further management. Only 35% of them had protective levels of rabies virus
neutralizing antibodies (RVNA). All of the patients were administered with an 8-site intradermal regimen with purified chick embryo cell (PCEC)
vaccine and were followed up regularly. All of them developed adequate titers (>0.5 IU/mL) of RVNA 7 days later. They were under regular follow-up and after nearly 2 years none have developed
rabies. The partial
Nucleoprotein (N) gene sequencing of the virus isolate from the patient who died of
rabies had close homology with species I (prototype
rabies) sequences available in GenBank and our own past isolates from dogs and humans, thus confirming that virus spillover from wildlife to domestic dogs continues to occur. This episode should prompt health authorities to focus more attention on training rural medical practitioners in state-of-the-art modern prophylactic measures.