Suspected rabies outbreak investigation in Kafue District, Zambia, 2023

Introduction Zambia has experienced fluctuating numbers of dog bites. On September 4th, 2023, the District Health Office was notified of a suspected rabies case in a patient who had been bitten by a stray dog two weeks prior. The patient exhibited neurological symptoms consistent with rabies. The objective was to describe the suspected rabies outbreak. Methods An outbreak investigation was done that involved a multisectoral team , which included the Ministry of health, Provincial Health Office, District Health Office, veterinary Department, the Council, Local government and Police. The data was collected through interviews using structured questionnaire and records. Malaria and syphilis tests were carried out. The investigation was done and patient was managed. Mass dog vaccination and registration, including Health Care Risk assessment and scheduled Incident Management System (IMS) meetings were planned. Results The patient was a 31-year-old male who presented with anxiety, agitation, disorientation, headache, hydrophobia, hyperactivity, insomnia, and itchiness at a recent dog bite site. The patient exhibited symptoms of psychosis, including flight of ideas and hallucinations, and was admitted for psychiatric evaluation. Malaria and syphilis test were negative and medication prescribed (artane, B complex, cloxacillin, haloperidol, paracetamol, and the anti-rabies vaccine). Patient escaped during the observation but was later located. The symptoms had resolved 10 days from the date onset. A total of 2060 dog vaccinations was done out of the 2360 set target. Dog registration was achieved and IMS meetings were held as scheduled. Conclusion The investigation highlighted the importance of careful rabies outbreak management, integrated Bite Case Management (IBCM), and continued community education about rabies to prevent fatal outcomes and achieve consistent case management.