Notes from the Field : Rabies Outbreak Investigation — Pedernales, Dominican Republic, 2019

Abstract

On 13 July 2018, a child from Pedernales, Dominican Republic, died after developing clinical signs and symptoms consistent with rabies. Because of the child's signs and symptoms, history of having been bitten by a dog 4 months earlier, and not having a received postexposure prophylaxis (PEP), the patient was reported as having a probable case of rabies to the Ministerio de Salud Publica (MSP; i.e., Ministry of Public Health). This case was the first reported from Pedernales Province in >30 years. During 29 November-20 December 2018, two additional probable rabies cases (based on clinical signs and history of dog bites) in children were reported from this province. The second patient did not receive any PEP. The third patient began PEP 10 days after being bitten and received 4 doses of vaccine before symptom onset; no rabies immunoglobulin was available in the province. All three children died from rabies encephalitis. All three cases were confirmed by detection of rabies-specific antigen and nucleic acid in patients' biologic specimens by direct florescent antibody and real-time reverse transcription-polymerase chain reaction testing at CDC.