Epidemiology of human rabies in South Africa, 1983–2007

Rabies remains a global public health problem but increasingly so in the developing world. Given a lack of awareness, priority and diagnostic capability, very few developing countries, especially in Africa, report on laboratory confirmed human rabies cases. Here we present a retrospective study on the epidemiology of human rabies in Republic of South Africa for a 25-year period, 1983–2007, based on laboratory confirmed cases. The study highlights the role of the domestic dog as a reservoir and vector of rabies and contrasts this to the almost negligible contribution of wildlife vectors to the overall burden of human rabies in dog rabies endemic areas. From the collective data set, epidemiological aspects that include various features of these human rabies cases as well as failures in or towards the treatment of exposures are reported.Molecular analysis of virus isolates did not identify any additional cases of rabies attributed to infection with the Duvenhage, Lagos bat or Mokola or any other rabies-related viruses.

Research highlights▶ Domestic dog is the most important vector of rabies to human population in South Africa despite prevalence in several wildlife species. ▶ Molecular phylogeny of human rabies cases reflect endemic animal rabies cycles. ▶ No evidence for additional human rabies cases associated with infection rabies-related viruses in South Africa.