11 March 2021 - NW407
Hlengwa, Ms MD to ask the Minister of Health
Whether there are any plans in place to combat the spike in cases of rabies in the Republic which have led to some fatalities; if not, why not; if so, what are the full, relevant details?
In 2020, a total of seven cases of human rabies was laboratory confirmed in South Africa, six of which originated in eThekwini District, KwaZulu-Natal (KZN) Province and one in Limpopo (LPP) Province. This compares to 10 laboratory-confirmed human cases in 2019.
In addition, three children were identified in 2020 who had dog bites/exposure and died of clinically compatible rabies disease. These cases could not be confirmed in the laboratory and were classified as probable cases in the provinces of KZN (n=1), LPP (n=1) and Eastern Cape (n=1).
To date, for 2021, 1 case of human rabies was reported from eThekwini, KZN.
The provinces that reported rabies cases during 2020 and 2021 have put in place prevention activities and plans. KwaZulu-Natal, Eastern Cape and Limpopo have put the following measures in place:
Actions taken in KZN
- A circular informing all districts was released;
- There are On-going health education and awareness campaigns, which is being among the affected communities;
- There is ongoing training of Health Care Workers;
- Rabies meetings were held by eThekwini District with role players;
- A One health approach is in place, in collaboration with Department of Agriculture, Land Reform and Rural Development (DALRRD);
- Alerts were sent out by DALRRD with real time surveillance maps and
- Animal rabies vaccination campaigns were completed in the affected areas.
Challenges identified by eThekwini District
- Patients presented late to health care facilities for medical help.
- Cultural beliefs resulted in delayed health seeking behavior by patients.
- Patients did not complete their vaccines according to the schedule given.
- There were delays in reporting on the notifiable medical conditions (NMC) system by health practitioners.
The DALRRD is responsible for controlling rabies in animals; most human rabies cases were as a result of dog bites. The DALRRD have also been experiencing challenges such as:
- too many stray dogs were roaming in the community;
- dog owners were not vaccinating their dogs on time;
- there was a need for further rabies education in the community and
- a high number of government vehicles were hijacked while rendering animal health services, including dog vaccinations.
Eastern Cape noted that despite the Covid-19 response having priority, the following were conducted:
- Routine surveillance of animal bites in humans were conducted (which was a proxy for suspected human rabies);
- Healthcare workers at the facility level were trained on case management;
- Treatment protocols were developed and distributed to health facilities;
- routine surveillance of rabies among animals by Veterinary Services are ongoing.
- Health promotion activities were conducted in high risk areas, especially when there were animal cases reported by Veterinary Services.
Rabies control in Limpopo are as follows:
- Health talks for the communities were conducted in collaboration with DALRRD.
- The DALRRD also vaccinated dogs; this is ongoing.
- Annual rabies awareness days were celebrated every year jointly with DALRRD.
- Politicians were engaged in promoting rabies prevention messages in the community.
- The province ensured that rabies post exposure prophylaxis was available in facilities.
- Refresher training for health workers were conducted and is ongoing.
- Health education on rabies were conducted for traditional healers.