27 September 2010
Rabies was confirmed as the cause of death in the 2 year child who died in a Johannesburg Hospital recently, one month after being scratched by an unvaccinated domestic puppy in Soweto. Laboratory tests were conducted at the National Institute for Communicable Diseases and the Dept of Anatomical Pathology, National Health Laboratory Service on post-mortem brain samples. This is the first confirmed human case of rabies resulting from an animal exposure in the Johannesburg Metropolitan. This human rabies case coincides with a serious outbreak of rabies in dogs in Johannesburg. Until this outbreak, the risk of rabies in JHB was very low, and therefore there is limited awareness about what should be done to prevent rabies disease in humans. It is critically that all dog and cat owners ensure that their animals have been vaccinated against rabies within the past 3 years in order to protect their pets, themselves and their children against this uniform ally fatal disease. The first animal vaccine is given at three months of age with a booster within the following nine months.
Human rabies can be prevented in almost 100% of cases if correct post-exposure preventative treatment is given timorously following exposure to suspected rabid animals. The rabies virus is transmitted from infected animals to humans through scratches, bites or licks on mucous membranes of the lips or eyes. The virus cannot be transmitted through intact skin, so touching, petting or being close to the animals is not a risk. Preventative measures include the following: Washing of the wound very well for at least 10 minutes with water or soap and water to wash out the virus, and a course of rabies vaccinations into the arm so that the person can make antibodies against the rabies virus. If there is a scratch with blood or a bite the addition of concentrated rabies antibodies into the wound is important to immediately ‘neutralize’ the virus.
Rabies has been confirmed in 6 domestic dogs in the greater Johannesburg area in the past 4 weeks. The affected areas to date include Sophiatown, Bushkoppies (Eldorado Estates), Meredale, Kibler Park and Dobsonville in Soweto. These animals were pets that had not been vaccinated against rabies and the source of exposure of these animals is unclear. It is likely that other dogs in surrounding areas could also be infected. The isolates were characterized and shown to be of the dog strain (canid biotype) originating from KwaZulu-Natal Province. Cases of rabid domestic dogs were also confirmed in May 2010 in Witpoortjie (Roodepoort), and in Linden in 2009.
While dog bites are very common in Johannesburg, clearly not every bite poses a risk of rabies, but a bite or scratch from a stray animal or an animal that is sick or behaving strangely or an unprovoked attack would suggest a rabies risk. Dogs are the commonest source of rabies for humans, but cats, cattle, and mongoose are all important in transmission. People should avoid handling any stray animals.
Issued by The national Institute for Communicable Disease a division of the National Health Laboratory Service
For more information contact Nombuso Shabalala on 011 555 0545 or 082 886 4238
