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 to assess her symptoms, an inquest has heard.
Yvonne Ford, 59, died in Barnsley hospital on June 11, 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 told on Tuesday that Ford, originally from Barnsley, had decided not to seek medical treatment because she believed it was a minor injury and had simply cleaned the wound with a wet wipe.
Only when Ford and her family returned to England did she begin to exhibit symptoms, which were diagnosed as rabies only after she was referred to Barnsley Hospital’s mental health centre.
Alexander Burns, the psychiatrist who evaluated Ford, told the jury that he had been asked to see her because his colleagues at the hospital had had difficulty diagnosing her and believed her symptoms might suggest a mental health problem.
Rabies, a virus transmitted through saliva that causes brain inflammation, can cause symptoms such as extreme anxiety, hallucinations and dizziness, as well as fatigue, problems drinking water and a shutdown of the central nervous system.
Burns said she had initially suspected Ford had Lyme disease, caused by tick bites, before her husband told her about the dog scratch in Morocco. He also said the short stay unit that had been caring for Ford had not noticed the scratch.
After learning about the scratch, Burns began “worrying that the diagnosis might be rabies, in the context of…the various neurological symptoms” and sought more knowledge about the disease, having never encountered it before in his career.
In 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 the infectious diseases unit at Sheffield Royal Hallamshire Hospital, where she died days later.
Katharine Cartwright, an infectious diseases expert at Sheffield University Hospitals, told the jury that there had only been 26 confirmed cases of rabies in the UK since 1946, but that the disease had a 100% mortality rate once symptoms began to appear.
However, he said post-exposure vaccines could help if given before symptoms occur, and that vaccinating dogs and other animals that could transmit rabies had been incredibly effective in eradicating the disease from the UK.
Since Ford’s death, his family has attempted to raise awareness about the prevalence of rabies around the world. His daughter, Robyn Thomson, has joined the charity Mission Rabies to immunize dogs in countries including Cambodia and Malawi.
Speaking to The Guardian in January, Thomson said she and her family were shocked by her mother’s diagnosis and had decided to help people in Ford’s memory, saying: “I want to turn what happened into something positive and I want to help people like mum.”
