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Feral dog bite causing paralytic rabies: Difficult diagnosis and failure of prevention

Rabies is an acute encephalitis caused by a virus from the genus Lyssavirus (family Rhabdoviridae). It has the highest case fatality rate when compared with other infectious diseases, with over 99% of human deaths occurring in Asia and Africa. Animal-related injuries in Saudi Arabia remain a public health problem, with feral dogs accounting for the majority of bites to humans. Eradication of rabies is not achieved yet, and efforts from different parties including the Ministry of Health, the Ministry of Municipal and Rural Affairs, the Saudi Wildlife Commission, and the Preventive Medicine Department should be coordinated. Training courses for emergency physicians and campaigns to educate the general population about animal-related injuries should be conducted. In this article, we report a case of feral dog bite causing paralytic rabies in a Saudi patient. Our case is unique since the cause of death in this patient was lack of family assistance and proper follow-up of the patient to ensure completing the vaccination schedule rather than lack of treatment and resources. The involvement of infection control department should be from the 1st day of dog bite.