In a follow-up on the rabies situation in South Africa, the National Institute for Communicable Diseases (NICD) reports a total of six laboratory confirmed human cases of rabies in South Africa for 2018 to date.
Four of these cases were reported from KwaZulu Natal Province where a resurgence of rabies has been reported. The remaining cases were reported from the Easter Cape Province.
Another probable case of rabies was reported from the Eastern Cape, but samples for laboratory investigation for rabies was not available. The case did however present with a clinical disease compatible with a diagnosis of rabies and had a history of exposure to a potentially rabid dog before falling ill.
For all of the cases, exposures to either rabid domestic dogs or cats were reported.
Rabies in humans can be prevented through post exposure prophylaxis. When a possible exposure occurs it is important to wash the wound thoroughly with soap and water and visit a health care facility, where the risk for rabies will be assessed. If the animal exposure posed a risk for rabies virus transmission, rabies specific preventative treatment are provided to prevent the infection. This includes a series of rabies vaccination and the administration of rabies immunoglobulin. Wound treatment including washing and disinfection of the wounds, tetanus booster vaccination and possibly antibiotic treatment (depending on the nature of the exposure) will also be provided at the health care facility. Other animals may also become infected with rabies virus and transmit the virus to humans, but such reports are less common. The rabies virus is present in the saliva of the affected animal and may be transmitted to humans through bites, scratches or other wounds that break the skin and allow the infected saliva to enter the body.
Rabies can also be controlled in animals through rabies vaccination. As humans become infected after contact with rabid dogs and cats, the first line of defense against the infection is to ensure that these animals are protected against the infection and cannot transmit the virus. Rabies vaccination of domestic dogs and cats are mandatory by law in South Africa and the onus is on pet owners to ensure that their pets are vaccinated on schedule.