Communicable Diseases Communiqué JULY 2018, Vol. 17(7)

1 ZOONOTIC AND VECTOR-BORNE DISEASES

a An update on rabies in South Africa

A case of rabies was confirmed in an eight-year-old case definition of rabies and both cases had a boy from Canzibe, Eastern Cape Province. A history history of exposure to a likely rabid animal. of possible contact with a rabid dog, six weeks before onset of illness, was reported but the details The rise in the number of human cases reported could not be verified. The child presented to an from the Eastern Cape and KwaZulu-Natal Eastern Cape hospital with “strange violent” coincides with the outbreak of rabies in dogs (and movements, vomiting, hiccups, spasms and cats) experienced in the two provinces. Rabies can hydrophobia. A single saliva was collected for be prevented by ensuring vaccination of dogs and testing before the patient demised. The sample cats, and through prompt post-exposure tested positive for rabies by PCR and sequencing. prophylaxis following a possible exposure to a rabid animal. For more information regarding rabies post- A total of ten human rabies cases has been exposure prophylaxis, visit the NICD website: confirmed in South Africa for 2018 to date. This www.nicd.ac.za includes five cases from KwaZulu-Natal and five cases from the Eastern Cape (including the case reported here) provinces. In addition, two probable Source: Centre for Emerging Zoonotic and cases of rabies were reported from the Eastern Parasitic Diseases, NICD-NHLS; [email protected] Cape Province. These cases could not be confirmed through laboratory testing, but fulfilled the clinical

An update on human cases of Rift Valley fever on a farm in the Jacobsdal b area, Free State Province

Cases of Rift Valley fever (RVF) were reported on ed a history of a mild flu-like illness. All confirmed 16 May 2018 in 250 sheep on a farm in the Jacob- cases underwent an ophthalmic examination but sdal area of Free State Province by the Department had no signs of eye complications. The outbreak of Agriculture, Forestry and Fisheries (DAFF). The remained limited to one farm, unlike the wide- disease causes a flu-like illness in most humans, spread epidemic which occurred in southern Africa but could progress in a minority to either retinitis during 2008-2011. There is neither treatment nor with permanent blindness, or severe forms like en- vaccine for people. The farmers in the area have cephalitis or bleeding manifestations that may lead been advised by DAFF to vaccinate animals to pre- to death. Initial epidemiological investigation and vent further outbreaks in the coming 2018/19 sum- testing of humans living on the affected farm, who mer period. Individuals can prevent exposure by were involved in handling of potentially infected wearing protective clothing and equipment (aprons, animals, revealed four confirmed cases of RVF, and gloves, masks, goggles) while working with infected four probable cases, as reported in the June 2018 animals, or avoid handling of animals all together Communiqué. Further laboratory testing led to the during outbreaks. Healthcare worker guidelines and confirmation of RVF in the four probable cases. Ret- RVF case investigation forms are available from the rospective testing of whole blood revealed the pres- NICD website, www.nicd.ac.za ence of RVF viral nucleic acid in three of the initial four cases. Sequencing studies have been conclud- ed and further phylogenetic analyses are underway to determine the viral lineage responsible for the Source: Centre for Emerging Zoonotic and Parasitic 2018 outbreak. Six of the eight individuals con- Diseases, NICD-NHLS ([email protected]) firmed to have been infected with RVF virus report-

c A cluster of leptospirosis cases in Bushbuckridge, Mpumalanga Province

In 2012, a study to identify zoonotic aetiologies for three cases. All three responded well to antibiotics acute adult febrile illness in the Mnisi community of and there were no complications. All the cases live Bushbuckridge, Mpumalanga Province, was initiated in the same village in moderately close proximity to within NICD. Adults over the age of 18 years pre- each other. The sudden spike of positive cases and senting to three local community clinics with fever the geographical proximity caused concern, thus were enrolled and tested for a number of zoonotic prompting an investigation. diseases, including leptospirosis. This surveillance recently identified three cases of leptospirosis. The Leptospirosis is a zoonotic disease spread through first was identified in late April 2018, subsequently, the infected urine of animals such as rodents, cat- two more cases were identified in the month of tle, dogs and pigs (Figure 1). In areas where peo- June 2018. They presented with fever and malaise. ple and animals live in close proximity, the possibil- The diagnosis was confirmed on serology on all ity for transmission of zoonotic diseases such as

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