Rabies Guide 2010.pdf - the South African Veterinary Council

Table 1: Cases of rabies-related viruses in South Africa
Location Year Host Virus
Pinetown and Durban, KZN 12 1980 Fruit bats (Epomophorus wahlbergi)# Lagos bat
Stanger, KZN 13 1982 Cat Lagos bat
Durban, KZN 14 1990 Fruit bat (E. wahlbergi) Lagos bat
Durban, KZN 182 2003 Fruit bat (E. wahlbergi) Lagos bat
Richards Bay, KZN 185 2003 Canine Lagos bat
Durban, KZN 182 2004 Fruit bat (E. wahlbergi) Lagos bat
Durban, KZN 175 2004 Water mongoose Lagos bat
Durban, KZN 182 2005 Fruit bat (E. wahlbergi) Lagos bat
Durban, KZN 182 2006 Fruit bat (E. wahlbergi) Lagos bat
Durban, KZN** 2008 Fruit bat (E. wahlbergi) Lagos bat
Bela-Bela, Limpopo 15 1970 Human Duvenhage
Louis Trichardt, Limpopo 12 1981 Insectivorous bat Duvenhage
Near Rustenburg, North West 160 2006 Human Duvenhage
Umhlanga Rocks, KZN 12 1970 Cat Mokola
Mdantsane, Eastern Cape 17 1995 Cat Mokola
East London, Eastern Cape 16 1996 Cat Mokola
Yellow Sands, Eastern Cape 17 1996 Cat Mokola
Pinetown, KZN 17 1997 Cat Mokola
Pinetown, KZN 17 1997 Cat Mokola
Pietermaritzburg, KZN 17 1998 Cat Mokola
Nkomazi, Mpumalanga 171 2005 Dog Mokola
East London, Eastern Cape 171 2006 Cat Mokola
Stonehills, Eastern Cape*** 2008 Cat Mokola
* KZN = KwaZulu-Natal
** Personal communication: Dr W Markotter, University of Pretoria
*** Personal communication: Dr C Sabeta, Agriculature Research Council, Onderstepoort Veterinary Institute
# Thirteen fruit bats tested positive with the fluorescent antibody test but only three virus isolates were obtained
In February 1970, an adult male patient from Bela-
Bela (formerly Warmbaths), approximately 100 km
north of Pretoria, died after a five day illness, which was
diagnosed clinically as rabies. Infection was thought to
have taken place following a bite on the lip from a bat,
thought to be an insectivorous species. 15 This index
virus was subsequently typed as Duvenhage virus and
a further isolation has subsequently been made from a
bat in South Africa during 1981. 12 In 2006 a patient
died of rabies after an encounter with a bat in the
North West province in South Africa. The etiological
agent was confirmed to be Duvenhage virus. The
exposure occurred about 80 km from where the first
exposure occurred 36 years earlier. 160 The first reported
case of Duvenhage virus infection outside of Southern
Africa was confirmed in 2007. A Dutch tourist was
scratched by what was thought to be an insectivorous
bat at a camping site in Kenya. She developed signs of
rabies about 3 weeks after the exposure and died in a
hospital in Amsterdam 23 days later. 176
Rabies virus is antigenically most closely related to the
Australian bat Lyssavirus and most distant from Lagos
bat virus, Mokola virus and West Caucasian bat virus
(a newly described lyssavirus), in this order. 8,18,177-179 An
illustration of the distant relationship between rabies
virus and these viruses is the fact that standard rabies
vaccination as well as post-exposure prophylaxis gives
little to no protection against these viruses. 180-181 In
the absence of specific vaccines and immunoglobulins
it is reasonable that standard rabies vaccine and
immunoglobulin be used in all instances of potential
exposure to rabies-related viruses.
Over the past 20 years an important development has
been the recognition, through monoclonal antibody
and gene sequencing studies, that genotype 1 viruses
which cycle in particular host species and often
within distinct geographic regions, tend to undergo
genetic adaptation resulting in the development of
biotypes. 14,19,20 These biotypes, which have subtle