A woman from Norway has died from rabies after a puppy bit her while she was on holiday in the Philippines.
Birgitte Kallestad died last week, more than two months after coming in contact with the young dog.
It is the first rabies-related human death in Norway for more than 200 years, according to the Norwegian Institute of Public Health.
According to a statement put out by her family, Kallestad and her friends were riding mopeds when they found the puppy.
The group of friends brought it to the resort in which they were staying and bathed, cared for and played with it.
All of them sustained minor bites and scratches, which they sterilised and washed soon after. The scrapes had been so small that nobody gave them a second thought.
Kallestad had posted updates from her vacation in the Philippines on Instagram.
It was only weeks after Kallestad returned that she began to feel unwell.
Rabies is transferred from an animal's saliva. Initial symptoms could be confused for the flu — fever, fatigue and headaches. But as the virus spreads, it can cause inflammation of the brain and hallucinations. Doctors say that it is almost always fatal once symptoms start showing.
Doctors in Norway did not connect Kallestad's symptoms to rabies, and so, she spent several days in and out of Førde hospital, where she worked. She had been admitted for a week before she died. The rabies diagnosis came three days earlier.
Kallestad's family is now urging Norwegian authorities to include the rabies vaccine in the inoculation programme for the Philippines and other places where rabies can be contracted from animals.
"Our dear Birgitte loved animals," her family said in the statement. "Our fear is that this will happen to others who have a warm heart like her. We want this vaccine to be included in the programme for places where it can be rabies and that people become aware of the dangers."
The World Health Organization estimates that over 55,000 people die of rabies every year. More than 99% of the victims are in Asia, Africa and South America. Dogs are the main cause of rabies-related deaths.
Rabies in humans is 100% preventable through prompt appropriate medical care.