Since December 2017 five human cases of rabies have been confirmed in South Africa. These cases were recorded in patients from Limpopo, Mpumalanga, KwaZulu Natal (two cases) and the Eastern Cape. Another probable case of rabies was reported from the Free State in December 2017, involving a patient that presented and died with the clinical diagnosis of rabies and suffered an exposure to a domestic cat before falling ill. In this case, laboratory confirmation was not possible due to the lack of appropriate specimens to do so.
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 present to a health care facility for rabies risk assessment as soon as possible. The rabies specific preventative treatment 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. The six rabies cases mentioned here involved exposures to rabid domestic dogs (3 cases) and domestic cats (3 cases). 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. More information on rabies post exposure prophylaxis is available from the NICD website: www.nicd.ac.za.
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 defence 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. Vaccinate your pets today.