A grandmother who tragically died from rabies four months after being scratched by a stray puppy during a holiday in Morocco was only correctly diagnosed when doctors initially believed she was suffering a severe mental health crisis, a coroner's inquest has heard.
Initial Symptoms and Hospital Admission
Company director Yvonne Ford, 59, from Barnsley, first raised concerns with her family in May last year when she began experiencing persistent headaches and heightened anxiety. Her condition deteriorated significantly, leading to her initial admission to Barnsley Hospital on June 2.
The inquest at Sheffield Coroners Court heard how Mrs. Ford's symptoms rapidly progressed to include nausea, vivid hallucinations, severe agitation, panic attacks, difficulty eating, and hydrophobia – an intense fear of water that caused her to spit and left her unable to drink.
Mental Health Misdiagnosis
Medical staff struggled to identify the cause of her distressing symptoms and initially considered a psychiatric origin. Consequently, she was referred to psychiatrist Dr. Alexander Burns just four days after her hospital admission.
Dr. Burns, concerned she might have Lyme disease from a tick bite, inquired about recent foreign travel. The family mentioned a trip to Florida but confirmed no insect bites had occurred.
By this stage, Mrs. Ford had been told she was suffering from delirium, but she expressed doubts, asking her family if she was developing dementia and insisting she felt there was more to her condition.
Crucial Revelation About Dog Scratch
The breakthrough came when Mrs. Ford's husband, Ron, informed Dr. Burns that during their holiday in Morocco the previous February, his wife had been scratched on the leg by a stray puppy they startled on a beach. The scratch had pierced the skin, though it seemed so minor at the time that she treated it with a wet wipe.
Mr. Ford confirmed his wife had not received a rabies vaccination before traveling to Morocco, information that other doctors had reportedly been unaware of previously.
Rabies Diagnosis and Fatal Outcome
Dr. Burns immediately grew concerned about rabies given the dog scratch and her symptoms, describing finding her "wide-eyed and perplexed and spitting into a bowl." He swiftly referred her to the specialist infectious diseases team at Royal Hallamshire Hospital in Sheffield.
Tragically, Mrs. Ford's condition continued to deteriorate, and she died on June 11. Dr. Burns later explained that after researching rabies symptoms, it became clear all of her symptoms could be explained by that diagnosis.
Extreme Rarity of Rabies in the UK
The inquest heard from Dr. Katharine Cartwright, a consultant in infectious diseases at Sheffield Teaching Hospitals NHS Foundation Trust, who emphasized that rabies "has the highest mortality rate of any infection in the world" and is 100% fatal once symptoms appear, with no known cure.
Dr. Cartwright noted there have been only 26 reported rabies cases in the UK since 1946, and in the US, only half of approximately 100 cases were correctly diagnosed before death. She stated that rabies is "so unusual, so out of everyone's experience" that it's not surprising it wasn't considered immediately.
Family's Anguish and Calls for Awareness
Mr. Ford told the inquest the family was "panicking like hell" as his wife's condition worsened, feeling insufficient action was being taken. Mrs. Ford's daughter, Robyn Thomson, a 32-year-old neonatal nurse, has called for greater public awareness about rabies risks.
The inquest also revealed that Mrs. Ford visited her GP in March and April with headaches and what was diagnosed as hives from an insect bite reaction – symptoms Dr. Cartwright confirmed were unrelated to rabies, which typically has an incubation period of one to three months but can be longer.
Rabies Risk in Popular Tourist Destinations
The UK has been rabies-free since 1922, with the last death from rabies in a non-bat animal occurring in 1902, thanks to measures like dog licensing, stray dog euthanasia, and quarantine protocols.
While Western Europe is considered low risk by the World Health Organization, many popular tourist destinations including Morocco, Egypt, Tunisia, and Turkey carry high risks of dogs transmitting rabies to humans.
The inquest, being held before a jury due to involving a death from a notifiable disease, continues as the family seeks answers about this rare and tragic case.
