NewsDesk  @infectiousdiseasenews

The National Institute of Communicable Diseases (NICD) two new confirmed human rabies cases from KwaZulu-Natal province since our last report, bringing the total to 19 human cases in South Africa through December 14 (Eastern Cape (n=9), KwaZuluNatal (n=6) and Limpopo (n=4) provinces).

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In addition, four probable rabies cases were reported from KwaZulu-Natal (n=3) and the Eastern Cape (n=1) provinces.

The two new confirmed cases are young boys from eThekwini. The first case involved a 10-year-old boy, reporting a dog bite on the leg in August 2021. The second case involved an 11-year-old boy. No dog bites or other animal exposures were reported in this case, but the area is amidst a marked outbreak of rabies in dogs.

Rabies is preventable in humans with prompt rabies postexposure prophylaxis (PEP). For the 23 rabies cases (19 laboratory-confirmed and 4 probable) reported in 2021 to date, several issues in the delivery of rabies PEP were noted.

For 14 cases (60.9%) apparently, no post-exposure intervention was sought. For nine cases, about a third of cases, post-exposure intervention was noted, but with deviation from recommendations: no rabies immunoglobulin (RIG) provided and series of four vaccinations not completed (n=3, 33.3%); no RIG but full course of vaccination (n=1, 11.1%); or received RIG but not full course of vaccination (n=2, 22.2%).

For three cases (33.3%) both RIG and full course of vaccination was provided; for two of these cases, facial wounds were reported. For most cases, the course on wound treatment was not available for analysis. Rabies PEP is considered a lifesaving intervention when provided appropriately and according to international guidelines.

Check out our World Rabies Day 2021 Livestream: