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Volume 13, Number 12—December 2007

Research

Epidemiology and Molecular Virus Characterization of Reemerging Rabies, South Africa

Cheryl Cohen*†Comments to Author , Benn Sartorius*†, Claude Sabeta‡§, Gugulethu Zulu‡§, Janusz Paweska*†, Mamokete Mogoswane¶, Chris Sutton#, Louis H. Nel§, Robert Swanepoel*†, Patricia A. Leman*, Antoinette A. Grobbelaar*, Edwin Dyason**, and Lucille Blumberg*†
Author affiliations: *National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; †University of the Witwatersrand, Johannesburg, South Africa; ‡Onderstepoort Veterinary Institute, Pretoria, South Africa; §University of Pretoria, Pretoria, South Africa; ¶Limpopo Department of Health and Social Development, Polokwane, South Africa; #University of Limpopo, Polokwane, South Africa; **Limpopo Department of Agriculture, Polokwane, South Africa;

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Table

Clinical and laboratory features of confirmed, probable, and possible human rabies cases, Limpopo Province, South Africa, 2005–2006

Characteristic No. confirmed cases/total (%) No. probable cases/total (%) No. possible cases/total (%) Total
Clinical features
Hypersalivation 19/21 (90) 4/4 (100) 1/2 (50) 24/27 (88)
Agitation 14/21 (67) 2/4 (50) 0/2 (0) 16/27 (59)
Weakness or paralysis 14/21 (67) 3/4 (75) 2/2 (100) 19/27 (70)
Fever 14/21 (67) 1/4 (25) 1/2 (50) 16/27 (59)
Hallucinations 11/21 (52) 4/4 (100) 1/2 (50) 16/27 (59)
Confusion 12/21 (57) 0/4 (0) 1/2 (50) 13/27 (48)
Hydrophobia 8/21 (38) 1/4 (25) 0/2 (0) 9/27 (33)
Alternating lucidity and confusion 8/21 (38) 0/4 (0) 1/2 (50) 9/27 (33)
Aggression 6/21 (29) 1/4 (25) 0/2 (0) 7/27 (26)
Vomiting 6/21 (29) 1/4 (25) 1/2 (50) 8/27 (30)
Spasms 5/21 (24) 0/4 (0) 0/2 (0) 5/27 (19)
Convulsions 5/21 (24) 0/4 (0) 1/2 (50) 6/27 (22)
Abdominal distension 4/21 (19) 1/4 (25) 0/2 (0) 5/27 (19)
Pain at the bite site 4/21 (19) 0/4 (0) 1/2 (50) 5/27 (19)
Diarrhea 2/21 (10) 1/4 (25) 0/2 (0) 3/27 (11)
Insomnia
2/21 (10)
1/4 (25)
0/2 (0)
3/27 (11)
Laboratory results
Elevated leukocyte count (>10 x 109 cells/L) 9/19 (47) 4/4 (100) 0/2 (0) 13/25 (50)
Elevated urea (>7 mmol/L) 11/19 (61) 2/4 (50) 0/2 (0) 13/25 (50)
Elevated creatinine (>100 μmol/L) 1/19 (5) 1/4 (25) 0/2 (0) 2/25 (1)
Elevated total bilirubin (>21 μmol/L) 0/5 (0) 0/4 (0) 0/1 (0) 0/10 (0)
Elevated conjugated bilirubin (>6 μmol/L) 0/5 (0) 0/4 (0) 0/1 (0) 0/10 (0)
Elevated alkaline phosphatase (>120 IU/L) 3/5 (60) 3/4 (75) 1/1 (100) 7/10 (70)
Elevated gamma glucosyl transferase (>35 IU/L) 2/5 (40) 0/4 (0) 0/1 (0) 2/10 (20)
Elevated alanine transaminase (>40 IU/L) 1/5 (20) 2/4 (50) 0/1 (0) 3/10 (30)
Elevated aspartate transaminase (>40 IU/L) 2/5 (40) 2/4 (50) 0/1 (0) 4/10 (40)

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