WASHINGTON (CBS19 NEWS) -- The Centers for Disease Control and Prevention has confirmed that a Virginia woman died in 2017 of rabies, which she contracted from a dog bite in India.
According to a CDC report, the Virginia Department of Health was notified on May 9, 2017 of the patient with rabies.
The 65-year-old woman had been bitten by a dog while on an extended stay in India for a yoga retreat.
She died on May 21 after her family decided to stop treatment.
The woman was the ninth U.S. resident since 2008 to die of rabies after being exposed to the disease while traveling abroad.
She began seeking treatment for problems on May 3, including multiple visits to urgent care and the emergency department of a local hospital.
It wasn't until May 8 that medical staff asked her family about potential animal exposures and her husband said she had been bitten by a puppy about six weeks before she began showing symptoms.
Rabies was confirmed on May 11 through testing of the woman's saliva and skin biopsy specimens, and health officials were able to sequence the virus, learning it was a canine variant associated with dogs in India.
Officials believe the woman became contagious about two weeks before her symptoms appeared, so around April 19.
Because she was a resident of a communal living facility, officials with the Piedmont Health District checked with other residents, of whom 13 reported close contact with the victim.
Three of those people reportedly had direct contact with her saliva and a fourth was bitten by her, so those four residents were advised to begin treatment.
The Thomas Jefferson Health District began an investigation of the case on May 9, identifying 250 health care workers who were then assessed for exposure.
Of those, 72 were advised to begin treatments of postexposure prophylaxis, or PEP. Eight workers declined treatment.
The total pharmaceutical costs for the PEP rabies immunoglobin and rabies vaccine was about $235,000, which was borne by the hospitals and the TJHD.
The CDC says the yoga retreat ran from Jan. 28 to April 5 and included people from five states and two countries as well as staff from the United States and India.
Three other members of the tour reported contact with the puppy that had bitten the woman. However, officials determined two had not been exposed to potentially infectious materials.
A North Carolina resident did report being bitten on the leg, and that person was advised to seek out treatment.
The CDC says this variant of the rabies virus was eliminated from the U.S. in 2004, but it is still endemic in 122 counties where it is the leading global cause of human deaths for a pathogen that can be transmitted from animals to people.
India has the world's largest incidence of human rabies deaths associated with dog bites, and people are advised to get pretravel rabies vaccinations if they will be involved in outdoor activities that could expose them to risk for animal bites when traveling in the country.
The local woman did not have a record for a pretravel health screening and did not get a pre-exposure vaccination before her trip. She had also never been vaccinated against rabies.
To read the full CDC report, click on the link in the Related Links box.