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More laboratory-confirmed human rabies cases in SA with 3 fatalities

The Kloof and Highway SPCA have sent a report to the state health department after a dog was found to have rabies. Picture: Steve Smit

The Kloof and Highway SPCA have sent a report to the state health department after a dog was found to have rabies. Picture: Steve Smit

Published Apr 5, 2022

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Durban - KwaZulu-Natal is one of the three provinces that has recorded cases of laboratory-confirmed human rabies since February.

This was reported in the National Institute for Communicable Diseases (NICD) March communiqué.

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The NICD said the other provinces that reported cases were the Eastern Cape and Limpopo.

The first rabies case for 2022 in South Africa was confirmed in a 4-year-old child from the Eastern Cape.

“As of March 24, 2022, a total of four human cases of rabies in South Africa have been laboratory-confirmed,” the NICD said.

“These cases originated in Limpopo (one), EC (two), and KZN (one). In 2021, 19 cases (EC - nine; KZN - six and Limpopo - four) were confirmed in the same three provinces.”

The NICD said that in the KZN incident last month, a 24-year-old man from Folweni, south of Durban, was admitted to the hospital with confusion, hallucinations, hysteria, and hypersalivation, and died on the day of his admission.

“In December last year, while visiting a friend's home in nearby KwaMakhutha, he was scratched by a cat. The man did not seek rabies post-exposure prophylaxis (PEP), and the cat was apparently not vaccinated against rabies, behaving strangely, and died soon after the incident. Rabies was confirmed by laboratory examination of a post-mortem-collected brain sample,” the NICD said.

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The institute said the recent case from the Eastern Cape was that of a 63-year-old woman from Gqeberha in the Nelson Mandela Municipality.

“The patient presented with fever, headache, malaise, nausea, vomiting, anorexia, muscle spasm and later with seizures, anxiety, confusion, delirium, hypersalivation, hydrophobia and agitation. The woman was reportedly bitten by a dog on her arm about a month before the onset of illness. Reportedly, rabies PEP was initiated, but she only received two doses of the vaccine three weeks after the exposure. The cause of death was determined to be rabies after a laboratory examination of a brain sample,” the NICD said.

It said that the Limpopo case was of an 8-year-old child from Giyani in the Mopani district.

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“The child presented to the hospital with fever, incapacity to walk, hallucinations and self-inflicted bite wounds. The patient died following seven days of hospitalisation,” the NICD said.

“Although the child had regular interaction with a number of dogs in his surroundings, there had been no specific dog bite history that could be linked to exposure. The diagnosis of rabies was confirmed by RT-PCR on antemortem-collected saliva and skin biopsy samples.”

The NICD added that the outbreaks of rabies in domestic dogs in the eThekwini, Nelson Mandela and Buffalo City municipalities since 2021, continue.

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It said that the consequence is an increased risk of human exposure and hence an increased risk of developing rabies disease.

The pivotal intervention for rabies is the vaccination of dogs and cats and affected communities are encouraged to ensure that their pets are vaccinated against the disease. Once possible exposures occur, rabies PEP is a life-saving intervention that should be provided urgently.

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