Rabies is a fatal viral disease that persists as a public health threat in more than 150 countries and territories across the world, resulting in an estimated 59 000 deaths annually, of which 95% occur in Africa and Asia. From 1983 to 2023, South Africa reported an average of 10 laboratory-diagnosed cases annually. Many different animals may contract and transmit the rabies virus, but domestic dogs are the most important vector of transmission to people.
During the period of 1 May to 31 July 2024, human rabies was laboratory-confirmed in two cases from the Eastern Cape and one case from KwaZulu-Natal. For the year to date, six people died of rabies in South Africa. In one case, the cause of death was probable rabies based on a history of dog bites and rabies symptoms and signs that led to death. Five of the rabies deaths were confirmed by lab testing. These cases were reported from the Eastern Cape (n=3), KwaZulu-Natal (n=2) and the province of Gauteng (n=1).
All of the cases were linked to domestic dog bites. Four of the cases involved children under the age of eight, with two cases reported in adults, a 27-year-old man and 61-year-old woman. The rabies case reported in Gauteng province was caused by a dog bite that happened in Zimbabwe, not in South Africa. Two of the victims received insufficient PEP, while four of the cases sought no medical attention at all from a nearby healthcare center. Both of the patients that got initial PEP, did not receive follow-up vaccines on days 3, 7, and 14 after the dog bite. One case received rabies immunoglobulin and one dose of the rabies vaccine, while the other case only received a single vaccine shot. In 2023, 12 cases of human rabies were laboratory-confirmed in South Africa (KZN=6, EC=5, LPP=1), with 7 (KZN=3, EC=3, LPP=1) occurring during the first two quarters and July of 2024.
