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A woman who died in the UK after contracting rabies while on holiday in Morocco was diagnosed with the disease after a psychiatrist was called in to assess her symptoms, an inquest has heard.
Yvonne Ford, 59, died in Barnsley hospital on 11 June, four months after she was scratched by a puppy in February while on a beach in the north African country.
A jury at Sheffield coroner’s court was informed on Tuesday that Ford, a Barnsley native, had decided against seeking medical treatment as she considered it to be minor injury, and had simply cleaned the wound with a wet wipe.
It was only when Ford and her family returned to England that she began to exhibit symptoms, which were diagnosed as rabies only after she was referred to the mental health facility at Barnsley hospital.
Alexander Burns, the psychiatrist who assessed Ford, told the jury that he had been asked to see her as his colleagues at the hospital had had difficulty diagnosing her, and believed that her symptoms could suggest a mental health problem.
Rabies, a virus transmitted through saliva that causes brain inflammation, can lead to symptoms such as extreme anxiety, hallucinations and dizziness, as well as fatigue, problems consuming water and a shutdown of the central nervous system.
Burns said he had initially suspected that Ford was suffering from Lyme disease, caused by tick bites, before being informed by her husband of the dog scratch in Morocco. He also said that the short-stay unit that had been looking after Ford had been unaware of the scratch.
After learning of the scratch, Burns became “concerned that the diagnosis may be rabies, in the context of … the various neurological symptoms” and sought further expertise into the disease, as he had never come across it before in his career.
Upon researching the disease, Burns said it “became clear that all of Yvonne’s symptoms could be explained by that diagnosis”.
After the diagnosis, Ford was transferred to Sheffield Royal Hallamshire hospital’s infectious disease unit, where she died days later.
Katharine Cartwright, an infectious diseases expert from Sheffield teaching hospitals, told the jury there had been only 26 confirmed cases of rabies in the UK since 1946, but the disease had a 100% fatality rate once symptoms began to show.
However, she said post-exposure vaccinations could help if administered before symptoms presented themselves, and that vaccinating dogs and other animals that could carry rabies had been incredibly effective at eradicating the disease from the UK.
Since Ford’s death, her family have attempted to raise awareness of the prevalence of rabies around the world. Her daughter, Robyn Thomson, has joined the charity Mission Rabies in immunising dogs in countries such as Cambodia and Malawi.
Speaking to the Guardian in January, Thomson said she and her family had been shocked by her mother’s diagnosis, and had chosen to help people in Ford’s memory, saying: “I want to turn what happened into a positive, and I want to help people like Mum.”
