Public Notice: Public Health Response to the Confirmation of Rabies in Cape Fur Seals

Environmental Health Practitioners (EHPs) from Garden Route District Municipality (GRDM), together with Western Cape Veterinary Services, the Department of Forestry, Fisheries and Environment (DFFE), City of Cape Town Coastal Management, and other partners are working closely to establish the extent and timeline of the outbreak through further sampling and testing.

Circular H80/2024, which is aligned to Circular H19/2022: Rabies: Updated Draft National Human Rabies Prophylaxis Guideline and the Prevention of Human Rabies Cases:

This serves as an alert to inform healthcare providers and workers of the necessary public health response following a confirmed rabies case in a wild Cape Fur Seal from Big Bay, Blouberg, Cape Town.

The sample was taken from the seal in question on 22 May 2024 and was confirmed to be infected with rabies by the Western Cape Department of Agriculture on 7 June 2024.

Rabies has never been detected in seals in Southern Africa before, and this is one of the very few detections in seals worldwide.

Information on various seal bite incidents has been received by the Western Cape Department of Health and Wellness from the City of Cape Town Coastal Management, Oudekraal, Kommetjie, Muizenberg, Blouberg in Cape Town, and Plettenberg Bay.

Rabies in unvaccinated animals can lead to the spread of the disease and can be fatal to humans. Therefore, with the confirmed rabies case in Cape Town, the public needs to be advised of the following:

All human and animal contact should be avoided as far as possible.

1. Anyone bitten by a seal from December 2023 should seek medical attention and after risk assessment, be given PEP (Post Exposure Prophylaxis) if necessary.
2. Anyone with an animal bitten by a seal from December 2023 should consult a local state vet.
3. Owners to ensure that their animal’s Rabies vaccination is up to date.

Public Health Response and Measures Following the Confirmed Rabies Case in Cape Fur Seals:

1. Ensure all persons who have sustained seal bites since December 2023 access medical advice for a risk assessment to determine the need for PEP (Post-Exposure Prophylaxis).
2. All new seal bites should be managed and treated as animal bites.
3. PrEP (Pre-Exposure Prophylaxis) should be recommended for persons at high risk or those directly and continually exposed to animals, such as veterinarians.
4. Healthcare facilities and medical professionals should record any seal bite cases that have occurred within the last six months using the Western Cape Animal Bite Incident Form.
5. Ensure the availability of an adequate supply of rabies immunoglobulin and rabies vaccine.
6. Implement risk communication strategies.

BACKGROUND ON RABIES

Rabies is a zoonotic, fatal, vaccine-preventable viral disease which is spread through the bite of an infected animal. It is endemic in South Africa with an average of 10 laboratory confirmed cases of human rabies confirmed annually.

Signs of Rabies in animals

• Abnormal behaviour.
• Domestic animals show aggression, disorientation and paralysis. They may foam at the mouth and bite people without provocation.
• It is important to note that animals are infectious before they develop any signs of unusual behaviour.

Signs and symptoms of Rabies in humans

• Discomfort and pain at the site of the wound.
• Fever, headache, nausea and vomiting and this progresses to signs of neurological dysfunction and death.

Transmission from animals to humans

• The rabies virus is present in the saliva of infected animals and is transmitted by a bite or scratch, a lick on broken skin and a lick on mucous membrane (eyes or mouth).

Human to human transmission

• It has been infrequently reported and has been limited to a few cases involving organ and graft transplantation from donors who have died of undiagnosed rabies.
• Although rabid patients may inflict bites and scratches on health care workers, no secondary cases of human rabies have been confirmed or reported following such exposures.

 Preventative measures

• Vaccinate animals. By law, all dogs and cats in South Africa must be vaccinated against Rabies and re-vaccinated every 1-3 years.
• Rabies infection in humans can be prevented by prompt administration of rabies PEP (Post-Exposure Prophylaxis) following exposure to rabid or suspected Rabies-infected animals.
• All animal bites should be assessed for potential rabies virus exposure.
• All wounds must be immediately washed for 5 – 10 minutes with water.

For any additional information regarding this article please or to report any incidents please contact:

Mr Johan Compion
Manager: Municipal Health & Environmental Services
E-mail: info@gardenroute.gov.za
Tel: 044 803 1300 / Cell: 082 803 5161