This is what makes prevention and treatment so vital. After seven laboratory-confirmed human rabies cases were reported in 2020, the surge to 19 cases in 2021 is a serious cause for concern.
Medical Chronicle’s Nicky Belseck spoke to Medical Scientist at NICD, Dr Jacqueline Weyer and technical lead for rabies in Sub-Saharan Africa for the Global Alliance for Rabies Control (GARC), Dr Andre Coetzer to get a clearer picture of the situation. “Human rabies cases are nearly always linked to dog rabies,” said Dr Weyer. “When there is an increase in dog rabies the risk for human rabies also increases.” Dr Coetzer agreed. “Outbreaks of rabies in dogs were observed in new locations in the Eastern Cape province, with human rabies cases occurring as a result. As such the persistence of dog rabies in areas previously considered controlled, resulted in a significant increase in human rabies cases.”
With the first laboratory-confirmed human rabies case already confirmed for 2022 in the Eastern Cape, both doctors agree the key to prevent the number from skyrocketing this year relies on the control and elimination of rabies from the cohabiting dog populations. “This has been proven across the world in areas where dog-transmitted human rabies has been eliminated,” said Dr Coetzer. “Therefore, well planned and executed mass vaccination of dogs in the affected areas are needed to bring the existing outbreaks under control, said Dr Weyer.
Dr Coetzer expressed a concern that doctors appear to be under the mistaken belief that rabies is not something that still occurs in SA. “Doctors think rabies is a small problem in a few parts of the country. In fact, we now see what can happen in metropolitan cities,” he said. According to Dr Weyer, “Currently Buffalo City in the Eastern Cape and eThekwini in KwaZulu-Natal are severely affected. The country is endemic for rabies, so where we find enough susceptible (unvaccinated) dogs, the risk for rabies virus transmission exists as the virus can be spread from one area to the next by a single infected animal. From time to time, we see rabies spreading to areas where it was not a problem or well controlled before, for example Soweto in 2010 and Cape Town in 2021. “When exposures to potentially rabid dogs (or other animals) take place, an individual can be protected from infection with the virus through rabies post-exposure prophylaxis. This entails proper washing, cleaning, and management of wounds (even if they are small), rabies vaccination, and the administration of rabies antibodies,” said Dr Weyer. “Any patient that has been exposed to a suspected or unvaccinated animal should immediately wash the wound with soap and running water for at least 15 minutes before going to the doctor for further treatment,” elaborated Dr Coetzer.
“Rabies in humans is rare, but one case is one case too many. This is a fatal disease that can be prevented. Rabies vaccination of dogs should not only be seen as the crucial measure to bring rabies outbreaks under control, but it should also be used to prevent outbreaks from occurring in the first place,” Dr Weyer concluded.