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Vampire Diaries: Getting Back to My Roots Through a Deadly Outbreak

Categories: General, Vectorborne

By Lizette Durand

Dr. Ivan Vargas of the Peruvian Ministry of Health displays a vampire bat captured in Peru.  

Setting the Scene

Last August, villagers in a secluded section of Peru fell prey to blood sucking vampire bats infected with rabies.  It sounds like the premise for the next vampire movie, but this wasn’t a story line thought up in Hollywood, it was the real deal. Rabies is a deadly disease that affects the central nervous system and is most commonly transferred to humans through a bite from a rabid animal. The early symptoms of rabies in people are similar to that of many other illnesses, including fever, headache, and general weakness or discomfort. As the disease progresses, more specific symptoms appear and may include insomnia, confusion, paralysis, hallucinations, agitation, increased salivation, and hydrophobia (fear of water). Death usually occurs within days of the onset of these symptoms. Fortunately, rabies can be prevented by administering vaccine and immunoglobulin after an exposure occurs.  However, this only works if the vaccine is given before symptoms appear. In the remote jungles of the Amazon this can be difficult.

A bat captured in the Baguas Province of the Peruvian Amazon near the site of the most recent human rabies outbreak.

A bat captured in the Baguas Province of the Peruvian Amazon near the site of the most recent human rabies outbreak.

When I first heard about the outbreak in Peru I was studying the herpes virus, a completely different and almost benign virus when compared to rabies. At first glance, the report was terrifying, over 500 people bitten and four deaths, most of which were children. I immediately started wondering: why such a massive outbreak? Why now? Why were so many people bitten, adults and children, yet it seemed that mostly children were dying? This was highly unusual because rabies is normally a fatal virus. So why did it seem that adults were immune, even protected from the virus? With all these questions and more my wonder was soon replaced by excitement about the outbreak investigation that I knew would follow. What were they going to find? How were they going to control the spread? How were they going to help those already sick? After about five minutes of gazing off into space, envying the scientist, epidemiologist, and pathologists who would find the answers to these questions, I returned to my work on what now seemed a rather boring virus.

Dreams of being a Disease Detective

Investigating an outbreak has always been a fantasy of mine. I remember being fascinated watching the old 1970’s movie Andromeda Strain and while most of my classmates took watching the movie as an opportunity to sleep, I watched in awe as the scientists searched for the cause and cure of the outbreak. My fascination for being a “disease detective” stuck with me as I grew older and I focused my schooling on microbiology and Zoonotic diseases (disease that is spread from animals to humans). I came to CDC in March as part of a six week Epidemiology Elective Program where I participate in a current public health project to learn more about public health and applied epidemiology through hands on experience. I never thought in my wildest dreams that I would get to take part in an international outbreak investigation, but that’s exactly what happened!

My Big Break

Typical houses from Amazonian communities in the Bagua Province of Peru.

Typical houses from Amazonian communities in the Bagua Province of Peru.

Vampire bats spreading rabies has become a growing problem in the Amazon. In Peru, outbreaks of rabies have been occurring with increasing frequency with 4 separate outbreaks reported within the last 2 years. Vampire bats continue to bite people in multiple communities in the Amazon due to unknown reasons. Some people think it’s due to deforestation or other ecological or agricultural changes causing a lack of food for the bats while others blame human encroachment. When a new outbreak was identified in January of this year, the Peruvian Government realized they needed help and called on CDC just a few weeks before I started my program there in Atlanta. As luck would have it I was assigned to the rabies research team when I arrived. As soon as I heard about CDC’s involvement in the rabies investigation I told my supervisor I wanted to go. Not only would this fulfill my life-long dream of participating in an outbreak investigation, but I would be going back to the country where my family is from (that’s right, I’m Peruvian!).

Waiting to find out if I would be able to join the team in Peru was a rollercoaster ride. There were all kinds of hurdles to over come and the clock was ticking, we only had a week to get all of my paper work in order. I finally got the green light just three days before we were scheduled to leave. This left little time for me to prepare. Because I was the most novice person on the team I had to read up on everything I could about rabies, how it is spread, how it is treated, and how it can be prevented. I spent the next few days pouring over hundreds of research papers on the subject. In the end I had learned a lot about rabies and this knowledge would come in handy during the meetings in Lima.

Going Back to My Roots

Having been to Lima numerous times, my parents are originally from there, I was thrilled to being going back to do something that would help the citizens of Peru. I have to admit though, it was a little strange not to be greeted by my cousins and the rest of my extended family when I got off the plane, but I reminded myself that I was here to work and help those afflicted by the outbreak.

Amy Turmelle, a bat biologist with CDC’s rabies team, displays a bat captured in Peru.  The bats are captured using mist nets and samples are collected for rabies testing and pathogen discovery.

Amy Turmelle, a bat biologist with CDC’s rabies team, displays a bat captured in Peru. The bats are captured using mist nets and samples are collected for rabies testing and pathogen discovery.

Once we arrived we joined members of the Peruvian Ministry of Health and National Institute of Health in Lima to talk about how to handle vaccinating the villagers. Staff with the Ministry of Health and doctors who had traveled to the villages briefed our team on what had been happening. I will never forget the description one doctor gave of the symptoms his young patient was experiencing; it was heart breaking and really put our mission into perspective.

As a student participant, I spent most of my time watching, observing and learning. However, once I became more comfortable with the situation, I started to realize how I could actually help and participate. There were questions and concerns about the different vaccines and protocols, having just spent numerous hours reading about the current practices, I was able to offer some advice.

Dr. Jorge Gomez from the Peruvian Ministry of Health interviews residents of the Peruvian Amazon during a survey investigating populations at high risk of vampire bat exposures.

Dr. Jorge Gomez from the Peruvian Ministry of Health interviews residents of the Peruvian Amazon during a survey investigating populations at high risk of vampire bat exposures.

The experience was great because I got to see first-hand how countries respond to outbreaks. The different offices and people involved, how they work together to accomplish a shared goal, the delicate art that is negotiating, a little giving and taking, learning to listen to the concerns of others and how to be diplomatic with those who don’t agree with what you are proposing. The conversations were many and the days were long, but in the end 883 people were evaluated for bat bite exposures and 717 were treated with the rabies vaccine. In addition, Peruvian Ministry of Health officials are planning to broaden their response activities to address the problem of human rabies in the Amazon region as a whole by performing a pre-exposure vaccination campaign among these populations at high risk of exposure to  vampire bats.  CDC remains involved in the planning and implementation of this pioneering approach to human rabies prevention. Future research hopes to answer some of the remaining questions such as why children are being disproportionately affected and what can we do to prevent further outbreaks.

Blog author, Lizette Durand and her father in Peru

Blog author, Lizette Durand and her father in Peru

For me, this opportunity was indescribably amazing, not only because I got to finally experience an outbreak investigation, but also because I got to do it in a country where my family roots are.

Public Comments

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this blog is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

  1. June 21, 2011 at 2:50 pm ET  -   Cheryl Deitrich

    Lizette, thank you for sharing your very interesting research. Your blog & writing are consuming.

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  2. June 22, 2011 at 11:11 am ET  -   thomy tonia

    Thank you for sharing your experience. it must have been very rewarding to be able to do something, let alone for a place where your parents originate friom. keep up the good work!

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  3. June 23, 2011 at 7:25 am ET  -   Mary

    Awesome!

    I wasn’t interested in rabies, but once I got into your story, I had to read it to the end.
    My son just got a BS in micro/cellular biology and back when he started on that line of schooling, his goal was to work at the CDC to help find a cure for a disease. Hence your story struck a cord and I found it totally consuming. Thanks for sharing. Any tips you can provide for my son and his goal would be appreciated.

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  4. June 27, 2011 at 1:20 pm ET  -   Tom

    Thank you! – Some questions:
    Do bats die of rabies or are they just carriers?
    Did the captured bats come up positive for rabies?
    What methods are used to control the bat population?
    Are livestock affected by the rabies in bats?

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  5. July 7, 2011 at 2:19 pm ET  -   Lizette

    Thanks everyone for the positive comments. It was such a great experience and I just feel so lucky that I was able to participate. To answer a few questions:

    Mary, I would definitely suggest that your son look into a PhD program, since he wants to work at the CDC, Emory should be on his list of schools to check out.

    Tom, from what I know, bats seem to just be carriers of rabies, I don’t believed that they die from the disease, however, there are always exceptions to the rule. To my knowledge, those results aren’t available yet. There are a variety of methods utilized in different parts of the world to control bat population, such as: depopulation, trapping, bat proofing homes, use of repellents, etc. Finally, yes, bats are known to bite livestock and other mammals.

    Hope this helps!

    Thanks for reading,
    Lizette

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  6. AUTHOR COMMENT July 14, 2011 at 4:41 pm ET  -   Blog Administrator

    Tom, thanks for reading below are answers to your questions from some of the CDC rabies experts.

    Bats do indeed die when infected with rabies virus and there is no evidence to support the idea of a carrier state in bats or any other species. None of the bats captured in our recent trips have shown evidence of active rabies virus infection. Vampire bat eradication does not appear to be effective in preventing human or animal rabies and is therefore not recommended. Prevention strategies have generally focused on vaccination of domestic animals, exposure avoidance, and education on post-exposure measures (i.e. hand washing and postexposure prophylaxis). As mentioned in the blog, new strategies including pre-exposure vaccination of populations at high risk of exposure are currently being explored. All mammals are susceptible to rabies including mammals that are livestock. For example, outbreaks of rabies in cattle due to vampire bats occur regularly and can have significant economic impact.

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  7. July 16, 2011 at 10:31 am ET  -   John Elias

    Thank you for posting your story. There hasn’t been cases of human or domesticated animal rabies in our community, according to our P Heallth Dept. I have _had_ to administer a post-bite protocol to one little patient once who suffered an unprovoked attack by a vagrant dog which could not be found.

    Since infected bats do die of rabies, is it possible they bite indiscriminately (in these outbreaks) because they’re sick, is it part of the natural history of their disease?

    Bats also get sick from being bitten or only when biting an infected animal, is it known?

    Thanks for a terrific site & blog.

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  8. August 4, 2011 at 6:19 pm ET  -   nature made fish oil review

    First of all I would like to say terrific blog! I had a quick question which I’d like to ask if you do not mind. I was curious to know how you center yourself and clear your thoughts prior to writing. I’ve had a difficult time clearing my thoughts in getting my ideas out. I do take pleasure in writing but it just seems like the first 10 to 15 minutes are lost just trying to figure out how to begin. Any recommendations or tips? Thank you!

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  9. January 5, 2012 at 10:03 am ET  -   research proposal

    Such a small think. ;-) But such a great idea

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  10. March 16, 2012 at 3:11 pm ET  -   Jason

    Thanks for the interesting post.
    In the second paragraph you suggest that exposed adults were somehow surviving the virus, while children were succumbing to it. Did that turn out to be the case? I imagine it would have been difficult to medically verify, but were there adults who claimed to have been exposed and then been symptomatic, but survived?
    Is there a place where one can find more on case histories of human cases of vampire bat rabies and its progression?

    Link to this comment

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