29-year-old soldier in coma after rabid dog bite has passed away

The first victim of the rabid dog bite, a 29-year-old soldier who been left in a coma is now dead as the rabies virus has entered his brain. He passed away today evening.
The incident occurred three weeks ago when he was attacked by a rabid dog at the Tareythang army outpost.

It had been over 20 days since the patient of the first rabid dog bite was admitted, and there was no sign of improvement. Despite receiving immediate medical attention, the severity of the bite and subsequent infection plunged him into a coma, confining him to a hospital bed, where his condition remained critical until his death.

The patient has remained on ventilation until he passes away naturally as a result of nature taking its course.

The patient was in the critical care unit is on a ventilator with no brain function, according to a doctor. He was only hemodynamically alive with the aid of medication.

Bhutan does not practice euthanasia and so has to conform to the guidelines on withholding or withdrawing mechanical ventilation from a patient with brain stem death as prescribed by the Council, according to the Bhutan Medical Health and Council.

Once the virus enters the brain, it multiplies, causing swelling and a significant amount of virus is discovered in the saliva. The host becomes contagious. Because the virus is extremely fragile outside of the host, it alters the host’s behavior in order to spread to other victims.

The signs of rabies might appear in one of two clinical ways:

80% display the ‘furious’ form, where signs can include restlessness, sensitivity to sound and movement, wandering aimlessly into new areas, excessive reactions to people and animals, aggression, indiscriminate biting, and saliva that may drip from the mouth.

The other form is ‘dumb, where animals become lethargic, potentially paralyzed, and show other non-specific signs of illness.

It is 100% preventable if vaccinated on time.

The common source of rabies in Bhutan is dogs, and Bhutan records around seven thousand dog bites per year and has a population of 72,000 stray dogs.

People should wash a bite wound with soap and water and visit the hospital for anti-rabies vaccination immediately and complete all 4 doses and inform parents and teachers about dog bites.

In Bhutan, between 2006 and 2020, 18 human deaths due to rabies were recorded in the country.

Currently, The Ministry of Health and the National Veterinary Hospital are conducting public advocacy on Rabies in Thromde and all Gewogs under Sarpang Dzongkhag. Mass anti rabies vaccination in dogs and cats in the Thromde and all Gewogs Door-to-door surveillance for dog bites, cat bites, and scratches is all being done in close collaboration with Health counterparts. Risk assessment is an ongoing process.

Editor’s Note: The story has been updated online to reflect the death of the soldier.