Human rabies associated with domestic cat exposures in South Africa, 1983–2018

Abstract

Rabies is a fatal encephalitic disease caused by lyssaviruses belonging to the family Rhabdoviridae. At the time of this report, a total of 16 species of lyssaviruses, which included the prototype rabies virus (RABV), and 2 related but unclassified bat lyssaviruses, Taiwan and Kothalati, had been recognised by the International Committee on Taxonomy of Viruses (ICTV 2019). Globally RABV, also referred to as ‘classic rabies’, circulates in natural transmission cycles involving domestic dogs and various wildlife species. In the Americas, RABV is found in certain insectivorous and haematophagous bat species (Banyard et al. 2013). The public health burden of rabies is, however, very closely related to the occurrence of the disease in domestic dogs; thus, human cases of rabies are mostly reported from areas where dog rabies is uncontrolled (Hampson et al. 2015). An annual estimation of 59 000 human deaths occur worldwide with 95% of rabies cases occurring in Africa and Asia (Hampson et al. 2015). In South Africa, RABV circulates both in domestic animals and wildlife cycles, involving the canid and mongoose variants of the virus (Nel, Thomson & Von Teichman 1993). The urban cycle involves domestic dogs reported from various locations in the country, but particularly from the KwaZulu-Natal, Eastern Cape, Limpopo and Mpumalanga provinces (Cohen et al. 2007; Zulu, Sabeta & Nel 2009). Sylvatic cycles of the canid variant RABV in bat-eared foxes and black-backed jackal (Zulu et al. 2009) and the mongoose variant RABV in certain species of mongoose occur in South Africa (Van Zyl, Markotter & Nel 2010). Apart from the reservoir species, canid and mongoose RABV infections are reported in an array of domestic and wildlife species in the country, with these animals primarily serving as dead-end hosts (Sabeta et al. 2018). Laboratory-confirmed human rabies cases in South Africa are predominantly dogmediated, and seven cases of rabies linked to other domestic species and wildlife have been reported (Weyer et al. 2011).