Travellers'put at risk by lack of advice on rabies'

INFORMATION that might have prevented the death of a London waiter from rabies is virtually impossible for the public to obtain, an Evening Standard investigation has found.

At an inquest into the death of 55-year-old Hilario Laya, of St John's Wood, coroner Dr Susan Hungerford said there was a need for more people to be warned of the disease.

However, the pamphlet informing people of the dangers of rabies, known as the T6 Memorandum on Rabies Prevention and Control, was not available at several post offices, pharmacies, a doctor's surgery, or at the travel clinic of Trailfinders, one of the largest travel agents in the city.

When the Standard enquired at the Hospital of Tropical Diseases, which treated Mr Laya, we were told the pamphlet was not available there. But senior officials at the hospital, off Tottenham Court Road, later said its receptionist had made a mistake.

Dr Hungerford, assistant deputy coroner at St Pancras coroner's court, made her call for more information when she concluded her inquest into the death of Mr Laya who died on 7 May.

She said: "It is a case I shall be reporting to the Department of Health to determine if there is a need to review current guidelines as to when vaccination [against rabies] is appropriate. The case also emphasises the need for greater awareness of advice set out in T6."

Mr Laya was bitten by a rabid dog during a holiday in the Philippines, and was admitted to the Hospital for Tropical Diseases in London on 30 April.

He suffered pain in his forearm that later extended into his shoulder and neck. Soon, the sight, sound and even mention of water - the desire for which is one of rabies' most infamous symptoms - resulted in him going into violent spasms. He later suffered cardiac arrest and died after being admitted to the intensive care unit of University College Hospital.

The coroner heard that before Mr Laya went overseas he was told by his GP's nurse that he did not need a vaccination against the disease.

Mr Laya's wife, Letitia, said she was unaware of the Department of Health leaflet, which advises that only people with an "unusual risk of infection" or travelling "in remote areas where medication is unavailable" should take precautions.

However, even if the couple had known of the pamphlet's existence, the Standard's investigation has shown that they - and other Britons intending to travel abroad - would have had difficulty finding it.

Since 1946, 20 people have died in Britain from rabies that they have picked up while travelling overseas.

The disease is always fatal once it reaches a certain stage. In 50 per cent of cases, it is not even properly diagnosed before the victim dies.

Dr Tom Doherty, consultant physician at the Hospital for Tropical Diseases, told the inquest: "Prognosis is invariably fatal. There has never been a case reported in medical literature of someone who has suffered from the last stages of the disease and survived."

Dr Doherty added that he had previously treated Mr Laya in 1994 for leprosy, saying: "I find it quite extraordinary that one man could be quite so unlucky as to suffer from both these illnesses."

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