South Africa has recorded additional cases of human rabies after two children from KwaZulu-Natal died from the virus recently.
According to the National Institute for Communicable Diseases of South Africa (NICD), the first case involved a two-year-old child from Umlazi, Durban, who was admitted in hospital with muscle fatigue, hyper-salivation and paralysis.
“It was reported that he had been bitten on his face two or three months before his illness. He had been bitten by a neighbour’s dog, which was killed, but not investigated for rabies,” said the NICD, adding that the child did not receive rabies post-exposure prophylaxis (PEP).
On 31 August 2020, the child tested positive for human rabies after three saliva samples were collected and the toddler passed away shortly after hospital admission.
The second case involved a four-year-old child who was reportedly attacked by a dog in Marianhill, eThekwini, in April 2020.
“Investigations found that the dog in question was still alive and vaccinated for rabies in 2017. Either the evidence is incorrect or the child acquired rabies from a different source,” the institute explained.
“Following the injury, the child was taken to a healthcare facility, but no reports for the provision of rabies PEP was available. The child fell ill in August 2020 with symptoms including vomiting, weak appetite, headache and dysphagia.”
The four-year-old was hospitalised and also passed away shortly after admission on 25 August.
“Post-mortem investigation on brain and skin samples confirmed the clinical diagnosis of rabies.”
This brings the total number of human cases of rabies reported in South Africa to seven this year.
Three cases each were recorded in KwaZulu-Natal and the Eastern Cape and one in Limpopo.
“Probable cases are those that presented with a clinical history and outcome, and epidemiological history compatible with a diagnosis of rabies, but laboratory confirmation was not possible.”
The NICD said rabies is a fatal, untreatable disease.
However, it can be prevented firstly by vaccination of companion animals, most importantly domestic dogs and cats.
The institute said domestic dogs are linked to the majority of human rabies cases in the country.
“When possible exposures do occur, rabies virus infection can then be prevented by prompt application of rabies PEP.”
This includes thorough wound washing and treatment, provision of rabies vaccination and in cases where the exposure involved the breach of skin and contact with mucous membranes, the administration of rabies immunoglobulin.
NICD said rabies PEP is a “lifesaving emergency medicine”.