Quarterly Update for Rabies (January to April 2024)

Rabies is a fatal but preventable and controllable viral zoonosis (see rabies). Rabies remains a persistent health concern in South Africa, with dogs being the primary source of exposure for human infections. The disease is endemic across the country, with cases reported in both domesticated and wild species. Rabies in domestic dogs is especially prevalent in certain parts of the provinces of KwaZulu-Natal (KZN), Eastern Cape (EC), Mpumalanga, and Limpopo (LPP). Through the multi-sectoral strategy for rabies control in South Africa, the goal is to eliminate dog-transmitted human rabies by 2030. The challenge remains the delivery of dog rabies vaccination at a level sufficient to interrupt onward transmission of the virus.

During the first quarter of 2024 (1 January to 30 April), 3 cases of human rabies were reported in South Africa. These cases were reported from the eThekwini Municipality, KZN (n=1) and the Ngqushwa Municipality, Amathole district, EC (n=1) (Figure 1). A case involving a patient who was hospitalized in the Gauteng province, acquired the disease in Zimbabwe following an exposure in December 2023 (Figure 1). All cases involved children, aged 2, 5 and 7 years respectively. For two cases reportedly no medical intervention was sought post-exposure, whilst the one case received incomplete regimen of rabies post-exposure prophylaxis. For the latter case, it is reported that rabies immunoglobulin and one dose of vaccine was administered following the exposure, but the vaccine course was not completed. In 2023, 12 cases of human rabies were laboratory-confirmed in South Africa (KZN=6, EC=5, LPP=1), with five (KZN=2, EC=2, LPP=1) occurring during the first quarter.


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