New rabies vaccine available in South Africa amid shortage

The National Institute for Communicable Diseases (NICD) has confirmed the availability of a new rabies vaccine Chirorab in South Africa as a response to the shortage of the commonly used Verorab vaccine.

“There is currently a shortage of Verorab rabies vaccine in South Africa. Chirorab has been identified as a suitable alternative, which the national department of health has procured through Kahma Biotech from January,” the NICD said.

Despite the change in vaccine brand, the NICD assured that Chirorab follows the same administration protocols as its predecessor.

“The dosing schedule for Chirorab remains the same as outlined in the national and World Health Organisation (WHO) guidelines for rabies pre- and post-exposure vaccination.

“Note that though the product volume per vial differs for Chirorab and Verorab, the total content of one vial constitutes a single intramuscular dose.”

The NICD advised that public sector health-care facilities in need of Chirorab should contact their provincial pharmacy depots, while private sector providers must adhere to their own procurement procedures.

Rabies remains a significant health concern in South Africa.

“Rabies is a fatal but preventable viral infection endemic in South Africa. Transmission of rabies virus to humans occurs through exposure to the saliva of an infected animal — mostly domestic dogs, but other animals may also be affected — most commonly through bites but can occur through scratches, abrasions and licks on broken skin or mucosal membranes (for example the insides of eyes, nose and mouth).”

The institute emphasised the importance of pre- and post-exposure vaccination depending on an individual's risk profile.

“Pre-exposure prophylaxis is recommended for individuals at high or continual risk of exposure to the rabies virus. This includes people who may be at risk of exposure due to their occupation (for example veterinarians and animal health technicians) or hobbies. Rabies post-exposure prophylaxis is provided when people have been potentially exposed to the virus,” said the NICD.

Rabies is a zoonotic disease (a disease which people can get from animals). It is caused by a virus which affects the brain and causes death.

In South Africa people are usually infected by dogs, but other animals such as cats, mongooses, jackals and other wild animals can also infect people.

Recently the NICD issued a notice on its website urging caution for people to be safe in proximity to seals, such as frequent swimmers, divers, surfers or people working with seals. They should consult their health-care provider and assess the need for rabies pre-exposure prophylaxis.

“Rabies in seals has historically been rare but recent reports from May 2024 have highlighted several cases of Cape fur seals testing positive for rabies along South Africa’s Western Cape and Northern Cape coastlines. While no other marine mammal species have been affected, these incidents have raised concerns about potential risks. As seals are known to travel long distances along the coast and often come into contact with humans, it’s important to understand the risks and know how to respond in case of an encounter with an aggressive seal or if you’re attacked,” it said.

The department of agriculture, land reform and rural development, on the eve of World Rabies Day in September last year, said there had been 185 laboratory-confirmed animal rabies cases in the country and seven human rabies fatalities reported for 2024.

Three human deaths had occurred in KwaZulu-Natal, three in the Eastern Cape and one in Limpopo.

On a global scale, the WHO estimates about 55,000 people die annually from rabies, with 99% of cases caused by dog bites. This equates to one death and 300 potential exposures every 15 minutes. Nearly all these fatalities occur in developing countries, with 56% reported in Asia and 44% in Africa.

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