How can One Health surveillance reveal hidden trends in human and animal cases?
Rabies, endemic in South Africa, is a fatal viral infection affecting livestock, wildlife, domestic animals, and humans through direct zoonotic exposure. Although rabies has been reported in numerous mammalian species, most human infections are associated with contact with rabid domestic dogs. Traditional surveillance systems that rely on sector-specific reporting may underestimate the true burden and distribution of disease, particularly where animal and human data are reviewed separately.
A One Health surveillance approach provides an integrated framework to address these challenges by combining human and animal health data. In South Africa, human rabies is classified as a Category 1 Notifiable Medical Condition requiring immediate public health action, while animal rabies is designated a controlled animal disease under national legislation, with mandatory reporting and vaccination of domestic dogs and cats. Laboratory confirmation of cases is conducted through established national reference and veterinary laboratory networks, enabling systematic data collection across sectors.
This report presents an integrated One Health surveillance overview of rabies in South Africa for the period 1 January 2021 to 31 December 2023, combining human and animal data to describe national trends and support rabies prevention and control efforts.
Materials and Methods
A retrospective review of documents was carried out using data collected during routine rabies surveillance in SA. Descriptive epidemiology was applied to characterise the occurrence of rabies in humans and animals in SA during the study period.
For human rabies cases, data were extracted from the Notifiable Medical Conditions Surveillance System (NMCSS) and compared with data available from a database curated at the NICD.
The latter database was compiled through data collected from test requests and submission forms, case investigation forms, and field investigation reports by provincial Department of Health (DoH) Communicable Disease Clusters (CDC) and SA Field Epidemiology Training Programme (FETP).
Results
A total of 54 human rabies cases were reported, comprising 44 laboratory-confirmed cases and 10 probable cases. These cases were reported from 17 municipalities in three provinces, namely the Eastern Cape (EC,n=27), KZN (n=18), and Limpopo (LP, n=9). Eighty-three per cent (n=45) of the cases were aged under 16 years, and 64.8% (n=35) were male.
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