A Tragic Case of Rabies Misdiagnosis
A grandmother from the UK, Yvonne Ford, died from rabies four months after being scratched by a stray puppy in Morocco. An inquest revealed that her condition was initially misdiagnosed as a mental health issue, leading to a delay in proper treatment.
Yvonne Ford, a company director, began experiencing symptoms such as headaches and anxiety in May last year. Her condition worsened, and she was admitted to Barnsley Hospital on June 2. She exhibited symptoms like nausea, hallucinations, severe agitation, panic attacks, difficulty eating, and hydrophobia, which is a fear of water. These symptoms caused her to spit and made it impossible for her to drink.
Doctors at the hospital struggled to determine the cause of her illness and considered the possibility of a mental health disorder. As a result, she was referred to psychiatrist Dr. Alexander Burns four days after her admission. Dr. Burns asked about her recent travel history, suspecting Lyme disease, which can be contracted through tick bites. However, the family mentioned a trip to Florida but confirmed she had not been bitten by any insects.
At this stage, Yvonne was diagnosed with delirium, and she expressed concerns about developing dementia. However, her husband, Ron Ford, later revealed that she had been scratched on the leg by a dog while on holiday in Morocco. The scratch was so minor that she treated it with a wet wipe.
Dr. Burns immediately became concerned that Yvonne might have contracted rabies due to her symptoms and referred her to a specialist infectious diseases team at Royal Hallamshire Hospital in Sheffield. Unfortunately, her condition continued to deteriorate, and she passed away on June 11.
Dr. Burns shared his experience during the inquest, stating, “She was sat in bed, wide-eyed and perplexed and spitting into a bowl. I was concerned the diagnosis might be rabies in the context of having a stray dog bite three months ago.” He explained that he researched more about rabies and realized that all of Yvonne’s symptoms could be attributed to the disease.
Dr. Katharine Cartwright, a consultant in infectious diseases, highlighted the severity of rabies. She noted that rabies has the highest mortality rate of any infection, and once symptoms appear, it is 100% fatal with no cure. She mentioned that there have only been 26 reported cases of rabies in the UK since 1946, and out of 100 cases in the US, only half were correctly diagnosed before death.
The inquest heard that Yvonne was described as being “bitten” by the stray dog, although her husband clarified that it was actually a scratch. During the inquest, it was also revealed that Yvonne visited her GP in March and April of last year with headaches and an insect bite reaction, which was later diagnosed as hives. However, these symptoms were not linked to rabies, as the incubation period for the virus can range from one month to three months, and sometimes longer.
The inquest is being conducted before a jury because it involves a death from a notifiable disease. Mr. Ford expressed his frustration during the proceedings, stating that the family was “panicking like hell” because they felt their wife was not receiving adequate care.
The UK has been free of rabies since 1922, except for rabies-like viruses found in some wild bat species. The last death caused by rabies in a UK animal, other than bats, was in 1902. Measures such as dog licensing, euthanasia of stray dogs, and quarantining helped eliminate the virus.
Western Europe is considered low risk for rabies by the World Health Organization (WHO), while countries in Eastern Europe are classified as “moderate risk,” and African and Middle Eastern countries are “high risk.” Popular tourist destinations such as Egypt, Tunisia, Morocco, and Turkey carry a high risk of rabies transmission through dogs.
The inquest continues, shedding light on the importance of early diagnosis and awareness of rabies, especially for those who have traveled to high-risk areas.
