Human Rabies: A tragedy that must be prevented

Human rabies is endemic throughout South Africa and every year a number of deaths occur, mainly in children largely due to bites from infected dogs, coupled to incorrect management after the exposure.The encephalomyelitis that follows central nervous system invasion bythe rabies lyssavirus is invariably fatal. However modern vaccines and immunoglobulin registered for use in South Africa are safe and very effective in preventing rabies when administered correctly before and after exposure. Unfortunately the prohibitive cost of rabies vaccine does not allow for prophylactic routine immunisation of all children or indeed for the immunisation of all animal bke victims in South Africa.This article reviews current best practice in determining which persons should receive pre-exposure vaccination and post-exposure treatment. lt updates and expands the clinical guidelines for rabies management prepared by the South Africa Department of Health, briefly discussing specific principles of management. In addition, the confirmation of diagnosis and approach to patient care are described.