5 cases of human rabies — NICD warns on animal vaccination

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The National Institute for Communicable Diseases (NICD) has warned animal owners to vaccinate their pets after at least five cases of human rabies were reported around the country. The Times reports that a sixth fatal “probable case of rabies” reported in the Free State claimed the life of a person who had been exposed to a domestic cat.

“These cases were recorded in patients from Limpopo‚ Mpumalanga‚ KwaZulu-Natal (two cases) and the Eastern Cape. Another probable case of rabies was reported from the Free State in December 2017‚ involving a patient that presented and died with the clinical diagnosis of rabies and suffered an exposure to a domestic cat before falling ill‚” said the NICD.

In the case of the fatality‚ “laboratory confirmation was not possible due to the lack of appropriate specimens”. Three of the cases involved exposure to dogs and the remainder were cats.

The report says rabies is present in the saliva of an infected animal and is transferred to humans through biting‚ scratching or wounds that come into contact with the animal’s saliva.

The institute said rabies was preventable through post-exposure treatment. “When a possible exposure occurs‚ it is important to wash the wound thoroughly with soap and water and present to a health care facility for rabies risk assessment as soon as possible. The rabies specific preventative treatment includes a series of rabies vaccinations and the administration of rabies immunoglobulin. Wound treatment including washing and disinfection of the wounds‚ tetanus booster vaccination and possibly antibiotic treatment (depending on the nature of the exposure) will also be provided at the health care facility.”

The report says the first line of defence against rabies is to ensure that pets are vaccinated.

In humans‚ rabies presents in the form or “furious” rabies or “dumb” rabies. Initial symptoms can include general weakness‚ discomfort‚ fever or headache. Tingling at the bite site may be noted. The disease progresses rapidly to “furious” rabies‚ which presents as anxiety‚ confusion and agitation. As the disease progresses‚ the patient becomes delirious‚ behaves abnormally‚ hallucinates and may have a variety of psychiatric symptoms before becoming comatose.

The “paralytic” or “dumb” form of rabies is clinically similar to poliomyelitis‚ but presents with descending paralysis‚ coma and death. The acute period of disease typically lasts 2 to 10 days.

The Times report
NICD Rabies report

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