Meeting the rabies control challenge in South Africa

Abstract

Although rabies is well controlled in many areas of the world, the disease remains endemic in some animal populations and still causes more than 50,000 fatal human cases per year. According to the World Health Organization (WHO), more than 2.5 billion people are at risk in more than 100 countries. Rabies has the 10th-highest mortality of all infectious diseases worldwide. Developing countries account for almost all the reported human deaths, and the tropical and subtropical regions in Africa, Asia, and South America are most affected. In Africa rabies is underreported, in part because it is easily misdiagnosed as other fatal encephalitides, such as cerebral malaria. Infected dogs are the major source of rabies in South Africa and much of the developing world. This pattern contrasts with that in the United States and Europe, where most concern rests with wild species that are infected with the rabies virus. For instance, rabies is epizootic in U.S. raccoons and skunks along the Atlantic coast, and also occurs in coyotes and foxes in the southwest as well as in foxes in Alaska. In Europe, foxes are the major source of rabies. Bats also carry lyssaviruses (Microbe, Nov. 2008, p. 521), and many recent cases of rabies in North America are associated with bat bites. The goal of eliminating human rabies in South Africa — and potentially many other areas of the continent — is realistic and will depend on effectively controlling this disease in domestic dogs. Achieving this goal will depend on implementing a vigorous and sustained campaign throughout the country. With luck, the lessons learned from current efforts within the country will serve as a model for combating this disease in other areas of southern Africa and beyond.