Home >News > ProMED翻訳情報(386回) ~バリ島で発生した犬咬傷による人の死亡事例~

ProMED翻訳情報(386回) ~バリ島で発生した犬咬傷による人の死亡事例~





Date: 15 May 2015      Source: The Bali Post [edited]



As reported by The Bali Post, the victim’s husband told authorities that both he and his wife together with a relation had been bitten on the leg by a dog on 15 May 2015. Four days after suffering the bites, the dog was euthanized, and an examination of the dog’s brain yielded a positive result for rabies.


Bali Post紙が報じているように、犠牲者の夫は、「自分と妻はいずれも、2015年5月15日に、イヌに足を咬まれた」と当局に語った。咬まれてから4日後、そのイヌは安楽殺され、犬の脳組織の試験により狂犬病陽性と診断された。


As recommended by health authorities, the couple received VAR (anti rabies) injections on 20 May 2015, but the woman began developing clinical symptoms of the disease on 26 May 2015. She fell into a coma and was declared dead at the Negara General Hospital on 27 May 2015.


保健当局が推奨しているように、その夫婦は2015年5月20日にVAR(抗狂犬病ワクチン)の接種を受けた。しかし、女性は5月26日に疾病の症状を呈し始めた。彼女は昏睡に陥り、27日にNegara General Hospitalで死亡した。


The head of the Jembrana Health Service, Dr Putu Suasta, told the press that the deceased woman — who had received 2 VAR injections — did not succumb to rabies but, instead, suffered an infection of the brain.


Jembrana Health ServiceのトップであるPutu Suasta医師は、報道陣に、「死亡した女性は、2回VARの接種を受けたが、狂犬病を防ぐには至らず、代わりに脳組織への感染を受けてしまった」と話した。


The husband of the dead woman complained to Radar Bali that the VAR vaccine was only administered on 20 May 2015, a full 5 days after reporting the bite to health authorities.


妻を亡くした夫は、VARは、保健当局に咬まれたことを報告してから丸々5日経って、やっと20日に投与を受けることができたと、Radar Bali紙に訴えた。




[On the island of Bali, the 1st cases of rabies in humans and dogs were confirmed in 2008 on Bukit Peninsula. Despite control efforts in 2008-2009, rabies spread across the island. In the following 3 years, over 130 people died from rabies (primarily people who did not receive post-exposure prophylaxis [PEP]), and PEP was given to over 130,000 people with dog bites. This outbreak resulted in considerable fear and anxiety and cost over USD 17 million.


バリ島における人とイヌの狂犬病事例としては、2008年にBukit Peninsulaで確認されたものが最初である。2008-2009年にかけての(狂犬病の)コントロールの努力にも関わらず、狂犬病は島全体に広がった。続く3年の間に、130人以上の人々が狂犬病によって命を落とし(その多くの人々は、暴露後の予防措置[post-exposure prophylaxis: PEP]を受けていなかった)、イヌに咬まれた130,000人以上の人々がPEPを受けた。このアウトブレイクは少なからぬ恐怖と不安をもたらし、17,000,000USドル以上もの損害額を計上した。


According to recent WHO documentation (http://www.expat.or.id/medical/rabies.htm), the incubation period for rabies is 5 days to 1-3 years (with an average upper range of 2 months), with symptoms appearing within 30 to 50 days following exposure. In dogs, this incubation period is shorter and generally 14 to 60 days. A key factor in determining how quickly rabies will develop is how close the virus comes to nerve endings when the bite or other exposure occurs. Incubation also depends upon the severity of the associated soft tissue damage and the amount of virus introduced, but the distance of the bite from the brain is the most significant factor.




If the head of an animal or a person is severely bitten, symptoms may appear in as few as 14 days. Under rare circumstances, symptoms may not develop for a year or longer. The farther the bite is from nerve endings, the longer it takes to reach the nervous system and develop an infection. Therefore, post-exposure treatment with vaccines can still be effective in preventing rabies even with delays, especially if the bite was peripheral rather than central. It is also true that the bite of a rabies-infected animal does not invariably cause disease.




The disease is usually contracted from the bite of a rabid animal, but on rare occasions, contact of virus-laden saliva with broken skin may be sufficient to transmit infection. There have also been reported cases of human-to-human rabies transmission by corneal transplants, which demonstrates the importance of not using transplant tissue from anyone who died of a neurological illness of unknown cause.




It seems likely that, in this case, the victim did not die as a result of rabies virus infection but rather as a consequence of a non-specific fatal reaction. Further information would be welcomed from an informed source. – Mod.CP