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In a follow-up on the human rabies situation in South Africa in 2023, the National Institute for Communicable Diseases (NICD) reports three cases of human rabies were confirmed from KwaZulu-Natal (KZN) and Eastern Cape (EC) provinces collectively from March 25 to April 24, 2023.

This brings the total cases in 2023 to date to five confirmed.

These cases were reported form EC (n=2), KZN (n=2) and Limpopo (LPP) (n=1). This compares with the seven human rabies cases (EC=5, KZN=1, LPP=1) that were reported for the same time period last year from the same provinces.

The case reports on the most recent cases are as follows:

For the first case, a family-owned dog bit the wrist of a 28-year old man from Malinda, East London (Buffalo City district, EC) in December 2022. The dog’s owner had tied it up for the SPCA to take it away because it had been behaving strangely when the bite event happened. The dog tested positive for rabies.
Reportedly the bite victim only received a single dose of rabies vaccine. The diagnosis of rabies was confirmed through RT PCR testing of two ante-mortem collected saliva samples.

The second case involved a 46-year-old man from Cliffdale (eThekwini district, KZN) who suffered a dog bite to his leg in February 2023. The dog was put down and no laboratory testing was conducted. The rabies vaccination status of the animal could not be confirmed. Reportedly the bite victim did receive rabies post-exposure prophylaxis (PEP) but this could not be confirmed. The clinical diagnosis of rabies was confirmed through RT-PCR testing of an ante-mortem collected saliva sample.

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The third case a 14-year-old female, who was bitten and suffered many injuries to her neck and face on 17 February 2023. The same dog attacked several children and an adult in the same week at Mjobeni, Libode (OR Tambo district EC), but because it was a stray, veterinary officials who were later called to the scene were unable to locate it for collection and testing. Following the biting events, all of the children received medical attention and reportedly rabies PEP was initiated although rabies immunoglobulin was not provided/not available at the time. A post-mortem brain sample tested positive for rabies following a direct rabies antigen test.