An investigation has been launched after a 25-year-old man died from rabies in hospital in Perpignan, southern France.
The inquiry is seeking to trace the cause and origin of the infection, because rabies has been considered as ‘eradicated’ in France since 2001.
The man died on September 25 after having been admitted several days earlier, reported the AFP on September 30.
“A case of human rabies has been diagnosed in a patient in Perpignan. This person, who was admitted to hospital on September 18 at the Perpignan Hospital Centre after presenting symptoms consistent with rabies, died on September 25.
“The diagnosis of rabies was confirmed by the Centre national de référence de la rage (national rabies reference centre) at the Institut Pasteur,” said the Perpignan Centre hospitalier in a statement.
It added that “investigations are underway to determine the source of the contamination” but no further details will be disclosed “out of respect for the patient's family”.
The man who died was aged 25, of Algerian origin, and had been working in a garden centre in Perpignan, reported France 3 and l’Indépandant.
He is thought to have travelled to Algeria before he returned to France, and reportedly had scars on his back. It is not yet clear if this was the source of his rabies infection.
Rabies symptoms
The man is said to have been admitted to hospital suffering from classic rabies symptoms, including hydrophobia (a fear of water).
This symptom is a neurological effect of rabies, as the virus spreads through saliva, so any attempt to drink water to help swallow causes extremely painful spasms.
He later began to suffer from seizures and was admitted to intensive care.
The hospital attempted to help him by placing him in an induced coma, but “it didn’t work”, a source told Actu Perpignan.
The hospital confirmed that although rabies cannot be spread between humans (it is typically spread through animal bites), the health professionals working on the man were vaccinated as a precaution.
Vaccination is an effective way to slow the onset of the virus and reduce its severity, and gives professionals more time to save a patient if they are bitten by an infected animal.
Rabies infections
More than 50,000 people die of rabies worldwide each year, and the virus is still relatively common in animals and humans across much of Asia, Africa, and Eastern Europe.
The disease is a viral infection that usually affects animals (including cats, dogs, bats, monkeys, and foxes), but can be spread to humans through animal saliva – usually from a bite or severe scratch. Once symptoms show, rabies is nearly always fatal.
An anti-rabies vaccine was mandatory for cats and dogs in France between 1968 and 2001, as it was present nationwide at that time.
The last reported case of rabies in domestic animals in France before 2001 had been in 1998.
“France has been considered rabies-free since 2001,” said Hervé Bourhy, head of the Centre national de référence de la rage at the Institut Pasteur, to Ouest France. “[But] since 1980, there have been 15 deaths of French citizens infected abroad by dogs.”
The last case dates back to 2023, when a woman who had travelled to northern Africa contracted the virus there after being injured by a cat. She later died after being admitted to hospital in Reims (Grand Est).
In France, the virus only continues to be common in bats, and there has been a slight resurgence of it in the past six years.
Ukraine risks
Since the start of the Ukraine war, Ukrainians refugees coming to Western Europe with their pets have led to fears over an increase in the incidence of rabies.
Ukraine is considered to be a high-risk area for the disease, but European legislation on pets was relaxed in the case of families fleeing a warzone.
Yet, in mid-March, the Ministry of Agriculture met to discuss the issue, and one vet, Estelle Prietz-Ducasse (also the coordinator of the veterinary federation Vétérinaires Pour Tous), told Ouest France that “the challenge, in order to prevent rabies from returning to France, is to establish the conditions under which these domestic animals are allowed to enter the country”.
Animals entering France are usually “electronically identified, and undergo regular monitoring consultations, then are vaccinated against rabies”, the government states.
However, Mr Bourhy at the Institut Pasteur added that “the risk of reintroducing rabies via these Ukrainian animals remains low. Borders have always been porous; this is not the first time that dogs have arrived from Eastern Europe…We must remain vigilant, but not alarmist”.
He said that the most common way that people in France become infected by rabies is by being bitten by an infected dog when travelling abroad.
The rabies vaccine is no longer mandatory for domestic pets in France, but it is still highly recommended, and required for pets when travelling to and from outside of France. The majority of rabies vaccines in France are valid for one year.
“An unvaccinated pet poses a huge risk to all surrounding animals and their families,” the Institut Pasteur states.
