Conference Abstract | Volume 9 (ConfPro8): Abstract 15 | Published: 05 Oct 2026
Hope Chisanga1,2,3,4,&, William Nsemani1,2,4, Cheepa Haabeenzu1,2,4, Mwatisausa Zulu1,5, Moboola Habwanda5, Gocho Kapoba5, Brian Habasimbi4, Callistus Kaayunga4, Dabwitso Banda1,2, Nyambe Sinyange1,2
1Zambia National Public Health Institute, Lusaka, Zambia; 2Zambia Field Epidemiology and Training Program, Lusaka, Zambia; 3University of Zambia, Lusaka, Zambia; 4Southern Provincial Health Office, Choma, Zambia; 5Monze District Health Office, Monze, Zambia
&Corresponding author: Hope Chisanga, Institutional affiliation: Zambia National Public Health Institute, Lusaka, Zambia, Email: hopechisanga5@gmail.com, ORCID: https://orcid.org/0009-0000-5166-5350
Received: 11 Mar 2026, Accepted: 28 Aug 2026, Published: 05 Oct 2026
Domain: Infectious Disease Epidemiology
Keywords: Rabies; post-exposure prophylaxis, One Health, 7-1-7 framework, Zambia
©Hope Chisangaet al., Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Hope Chisanga et al., Human rabies following failure to access post-exposure prophylaxis: An outbreak investigation in Monze District, Zambia, 2025. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfPro8):15. https://doi.org/10.37432/JIEPH-CONFPRO8-0015
Dog-mediated rabies causes an estimated 59,000 deaths annually, with sub-Saharan Africa bearing the heaviest burden. Post-exposure prophylaxis (PEP) prevents death if given promptly. Despite the availability of effective PEP, human rabies deaths continue to occur due to delayed care-seeking, vaccine shortages, and weak One Health coordination. We investigated a laboratory-confirmed human rabies death in Monze District to describe the case, assess 7-1-7 compliance, evaluate dog vaccination coverage, and identify barriers to PEP access.
A 15-year-old male was bitten by an unidentified stray dog on 27 November 2025 and presented to Makonka Rural Health Centre that day. The patient did not receive wound cleansing or PEP because of district-wide vaccine stock-outs despite presenting to a health facility on the day of exposure. The family applied traditional remedies for 18 days. He was admitted to hospital with encephalitis on 21 December and died on 30 December 2025, 33 days after the bite. Detection was 24 days after exposure, notification was outside the 1-day target and response actions were initiated within five days. Only 662 of an estimated 20,000 dogs (3.3%) had been vaccinated, substantially below the WHO target of 70%. The District Anti-Rabies Task Force constituted in November 2025 had not convened by April 2026.
This preventable rabies death resulted from missed opportunities for wound management, lack of PEP availability, and weak implementation of district-level One Health response mechanisms. Three priority actions may prevent further rabies deaths: stocking PEP at rural health centres, conducting emergency ring dog vaccination within 5 km of confirmed exposures, and convening the multisectoral anti-rabies task force under district-level One Health leadership.
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