Date: Fri 31 May 2019 08:04 ICT
Source: The Phnom Penh Post [edited]
A 50-year-old man from Svay Rieng province died on Tuesday night [28 May 2019], 19 days after being bitten by a dog in Trapaing Trav village in Kampong Ro district's Nhor commune.
The wife of the bitten man told The Post that before the incident, while she was at home, her husband went to a paddy field with their 5-year-old niece and sheltered in a hut where he always rests on sunny days.
When they arrived at the hut, they saw a dog asleep on the ground. The dog woke up and bit [the man's] niece, causing a minor skin injury with no bleeding, [the wife] said.
[The man] went to help her, but the dog suddenly jumped up and bit him on the right forearm, this time inflicting more serious injuries. "The dog bit my niece and he helped her. He said the dog had seemed gentle. "They chased the dog to hit it, but it lunged back from about 5 metres away and bit my husband," [the wife] said.
She said that after being bitten, [her husband] sought treatment from a traditional Khmer physician but did not go to a doctor for an injection.
"After leaving the traditional physician, he didn't get any more treatment. Our children told him to see a doctor for injections, but he didn't go."
"As days went by, he was busy growing rice, spraying rice fertilizer, and pumping water. He kept putting off going to see a doctor until he was in serious danger," she said.
She said her husband became feverish and was unable to drink water, and developed a fear of water, fire, and the wind.
At this point, she sent her husband to the Svay Teap Referral Hospital where he was injected with a serum and sent to the provincial hospital. That hospital, in turn, sent him on to the capital's Pasteur Institute in Cambodia.
Because the gate was not yet open, she finally sent her husband to Calmette Hospital next door. When they arrived at Calmette Hospital, doctors told [the wife] that her husband was in a critical condition and they could not save his life.
She then took her husband back home, arriving there on Tuesday morning
[28 May 2019]. [He] died that same night.
[She] said the dog was probably carrying rabies. She didn't know where it came from and it was sleeping in the paddy fields.
Ly Sowath, a doctor at the Pasteur Institute in Cambodia's Epidemiology and Public Health Unit, could not be reached for comment.
Sowath told The Post in February  that the vaccine against rabies is effective if received before being bitten or in the 1st 24 to 48 hours afterwards [see comment].
Doctors ask people to observe the health of the animal that bites them. If the dog does not get sick or die within 10 days, it is a sign that it was not carrying rabies. But anyone suspecting any irregularity should get vaccinated as soon as possible.
According to the Pasteur Institute of Cambodia, the disease is 100 per cent preventable through post-exposure vaccination if provided in time, but it is [almost] 100 per cent fatal once symptoms develop. [Byline: Ry Sochan]
[The last comment by Cambodia's Pasteur Institute deserves to be listened to and memorized. The appearance of clinical rabies signs indicates the termination of the incubation period; at this stage, attempts to save the life of the victim are doomed to fail.
On the other hand, we have reservations concerning the cited Cambodian Pasteur Institute's advice of February 2019, in which it was allegedly stated that "the vaccine against rabies is effective if received before being bitten or in the 1st 24 to 48 hours afterwards." Such information may leave exposed people's life seriously threatened in case they have missed seeking medical help during the 1st 48 hours after being exposed.
Hopefully, the family of the victim's niece, who was exposed to the same dog, has already sought medical advice. - ProMED Mod.AS]
[HealthMap/ProMED-mail map of Cambodia: