The KwaZulu-Natal Department of Agriculture is on high alert for human rabies in the province following the death of four people between May and June who died after failing to seek treatment for dog bites.Last year, eight people died of rabies in KZN, with the total number of rabies in animals reaching 203.According to the department, they anticipate a possible increase in both human rabies and rabid dogs in the near future.The problem is twofold: people who have been bitten do not always seek preventative rabies treatment after being bitten by an animal, and animals are not being vaccinated.“Human deaths are perfectly aligned with the disease in dogs, which are the main source of rabies,” said department spokesperson Mac Makhathini.He said the prevalence of rabies in dogs is dependant on the vaccination coverage. He added that the province has experienced a decline in vaccinations being done due to inadequate support given to veterinary staff. He blamed the lack of adequate support on a number of factors such as limited funding for basic requirements like loudhailers, and “a lack of key posts being filled in management and field staff”.Another factor that is affecting the vaccination programme is the hijackings or attempted hijacking of state vehicles, which limits access to some areas. Makhathini said there has been a decline in public awareness since 2014, when the disease was almost eliminated, and he said the public then became “lax”. Other problems he highlighted are a “lack of high-level political support and procurement problems and long delays”.According to Makhathini, key areas of concern include the Ugu District, eThekwini, iLembe, and Zululand, but he said they are continually campaigning there. He said that many people don’t vaccinate their pets because of the costs at private vets or they have transport problems. “The state is making vaccines available to certain private vets to assist with free vaccinations, but this is area dependant,” he said.According to Makhathini, people are not always aware that they should immediately seek treatment for bites and said the responsibility to raise awareness lies with the Department of Health. He said his department does not have issues with getting the vaccine but said there are reports of the private sector finding it difficult to get the vaccine.“Post-exposure rabies treatment is available free of charge from most government hospitals and larger clinics. “Private veterinary practices have been extremely active in assisting with vaccinations, especially around urban areas, and are contributing significantly to control and surveillance of the disease,” he added. “Special mention must be made of the SPCA and other welfare groups who also contribute a massive proportion of the surveillance samples in the province, as well as vaccinations.”Underberg farmer and top canoeist Graeme Anderson (29) died in 2012 after contracting rabies through a dog’s saliva.Animal lover and well-known canoeist Graeme Anderson died in 2012 after contracting rabies from a dog he had picked up that looked “hungry and sick”. The dog in the photograph is not the rabid dog. Anderson contracted rabies after the stray licked him. Anderson then wiped his eye and the saliva containing the virus entered his body.Anderson’s mother, Trish Anderson, is urging people to get vaccinated, even if they just come into contact with a strange animal.“My son was driving and saw a little dog. “It just looked sick and hungry.“A few years ago, rabies had been almost eradicated so we didn’t even think about it. It was the last thing on our minds, we didn’t even consider it. “If we had, he would have sought treatment.”Trish said her son had just arrived back from a holiday in Mozambique when he complained of a sore back.“The next morning, when I called, he told [me] he was battling to breathe.” She said he was admitted to hospital that day and the next morning Anderson phoned her to say he thought he might have rabies. “He called a farmer friend because he could not drink water. The friend suggested he try to take a shower and he just couldn’t do it.” She said he told the doctors but that they did not expect rabies to be the issue. “The night after he told me he thought he had rabies, the hospital called to say he was hallucinating and that he might have rabies.” The doctors put him into a medically induced coma to try the Milwaukee protocol. This is when the patient is put into a coma and then given antiviral drugs. Anesthetics are then reduced if the body shows signs of fighting the virus off. The method worked for a 15-year-old Wisconsin girl Jeanna Giese, however, it is not a certain cure for the virus and more often than not, does not work.Trish said her son was the first person in South Africa to have the treatment, however, after being in a coma for five weeks and showing no sign of brain function, the family and doctors decided to take him off life support.Trish said it had been an extremely difficult time for them, and said she would never want another family to go through the same thing. “Just do it. Vaccinate your dogs and cats and get vaccinated if you come into contact with strange animals. My son contracted the virus after the dog he picked up licked his hand. He then rubbed his eye and the saliva entered his system. It’s not just a dog or cat bite or scratch that can infect a person. People need to be more aware and seek treatment when these things happen.”WHAT IS BEING DONE?The department said mass campaigns are under way to raise awareness.Additional people have been trained to do vaccinations with animal welfare and private vets adding support to the limited staff of state veterinary services. The Health Department is also training clinic staff. Makhathini added that 22 vehicles have been sent to key offices in the coastal areas and plans have been drawn for mass intervention, however, “key equipment still needs to be sourced”. He said 500 health practitioners from private and government hospitals have been trained in disease recognition and treatment protocols and additional training events have been hosted by the private sector. “Over 300 community caregivers have been trained in iLembe for awareness and mobilisation while four groups of vaccinators have been trained around the province to help veterinary services in vaccinations of dogs.”CATS AND RABIES:• 55 cats tested positive for rabies in the province during the last 20 years.• Each year a small number of cats (average 2-3) are diagnosed with rabies in KZN.• Cats do not have a natural immunity to rabies and must be vaccinated as with dogs. • Cats become very aggressive when rabid and often attack without provocation. • Human deaths from cat bites are common globally.• Cats can carry more than one rabies virus in KZN. A retrospective study of positive cat samples found eight percent died from a rabies virus called Mokola virus. Mokola is a rabies-related virus that produces the identical disease. While its origins are unknown it is thought it could be from rodents. It is also genetically distant from dog rabies and so less is known about how effective treatment will be for humans, but it will kill.• All cat scratches and bites must be attended to as dog bites, and possibly with greater urgency.Chase Valley vet Dr Estee Van Aardt said they had not had problems procuring any rabies vaccinations.She said there was an issue when it came to wild animals and domestic animals as it is difficult to pick up on rabid wild animals.She said Pietermaritzburg was well-vaccinated and private veterinary clinics often give the shot for free to domestic animals. At the state veterinary clinics or mobile clinics, it is free.Hayfields veterinary nurse Sister Leslie Shooter said they had seen an increase in people bringing their pets for vaccinations.She added that there seemed to be more awareness about the virus in Pietermaritzburg.WHAT IS RABIES AND HOW CAN IT BE IDENTIFIED IN AN ANIMAL?Makathini said rabies is a fatal viral encephalitis, and is the most fatal disease known to man.It is transmitted via the bite of an infected animal, usually dogs, with virus laden saliva entering the wound and attaching to nerve cells. “Once this attachment has occurred death is 100% certain. However, if the wound is immediately washed with soap and placed under running water for 10-15 minutes, disinfectant applied and correct treatment is sought immediately it is also 100% preventable,” he said.Rabies has also been known to incubate in a person for as long as two years but generally it is between one and two months. THE SYMPTOMS:• Changes in animal behaviour.• Agitation as the dog does not know what is happening.• Strange vocalisations — howling, barking.• Salivation, difficulty swallowing.• Loss of co-ordination. • Dehydration (rabid dogs are not generally scared of water) as they cannot drink because their throat is paralysed.• Chewing strange objects.• Biting at the air as if there are flies around it.• Aggression — biting often occurs when stimulated by sound, touch or movement.• Paralysis of back legs.• Depression — sickly looking• Death usually occurs within three days of the first signs.While the disease is mainly found in dogs, it can affect all mammals, and all have the potential to transmit the disease.