KZN reports more human rabies cases after two children die

According to the National Institute for Communicable Diseases, eight confirmed human rabies cases have been recorded in South Africa, since the start of 2023. These have been reported in KwaZulu-Natal (4), Eastern Cape (3) and Limpopo (1). File Picture: Shelley Kjonstad/African News Agency (ANA)

According to the National Institute for Communicable Diseases, eight confirmed human rabies cases have been recorded in South Africa, since the start of 2023. These have been reported in KwaZulu-Natal (4), Eastern Cape (3) and Limpopo (1). File Picture: Shelley Kjonstad/African News Agency (ANA)

Published Sep 8, 2023

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Durban — Two children from KwaZulu-Natal are the latest confirmed human rabies cases in South Africa.

In its August communiqué, the National Institute for Communicable Diseases (NICD) said that in August, two human rabies cases were reported from Zululand and eThekwini, respectively.

The NICD said that regarding the first case, a child was bitten by a dog in the Emadwaleni area in Nongoma in May.

“He reportedly did not receive any rabies post-exposure prophylaxis (PEP). He was only brought to a neighbouring clinic when he started to feel lethargic, itchy and experienced a loss of appetite.

“He started to develop further symptoms of clinically suspected rabies, including hypersalivating, irregular jerky movements, anxiety, and hyperactivity.

“He was eventually taken to a hospital in the uMkhanyakude District in northern KwaZulu-Natal,” the NICD said.

“By performing an RT-PCR test on a nuchal sample taken from the medulla at the base of the brain, this diagnosis of rabies was laboratory-confirmed after the child died.”

The NICD said that the second case was a child from the Ntinyane area in Umbumbulu.

It said that the source of the exposure in this case is unclear, but rabies in dogs has been reported from the area.

“The child was diagnosed with clinically suspected rabies after she was hospitalised with symptoms of malaise, anxiety, aerophobia, anorexia, and hydrophobia.

“The rabies virus was also detected in ante-mortem saliva and cerebrospinal fluid samples taken before the child died on August 10, 2023,” the NICD said.

The institute said that as of August 23, eight confirmed human rabies cases have been recorded in South Africa, since the start of the year.

“Cases, including those described here, were identified in the provinces of KwaZulu-Natal (4), Eastern Cape (3) and Limpopo (1),” the NICD said.

The NICD said that for the same period in 2022, 10 human rabies cases were confirmed, with just two from KZN, five from the Eastern Cape and three from Limpopo. There were also an additional five probable cases identified from the Eastern Cape last year.

It said that only these three provinces — KZN, the Eastern Cape and Limpopo — have documented human cases in recent years.

The NICD said that due to a lack of public awareness of the disease, low dog vaccination rates, and sometimes inadequate PEP given to bite victims, rabies deaths continue to occur in South Africa.

Despite the fact that once symptoms manifest, rabies is invariably fatal, it is completely preventable after contact with rabid animals.

“To prevent rabies, thorough wound cleaning is followed by a dose of rabies immunoglobulin (RIG) and rabies vaccine given on the day of exposure for category 3 wounds (breach of skin, any bleeding, contact with mucosal membranes, or broken skin).

“The remainder of the vaccine doses are then given on days 3, 7, and between 14 and 28. Successful community rabies prevention depends on rabies risk education, community engagement, vaccination of dogs and cats, appropriate wound care, and prompt PEP intervention,” the NICD stated.

Visit www.nicd.ac.za for additional information and full PEP guidelines.

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