The death toll from an outbreak of the food-borne disease listeriosis in South Africa has more than doubled from previous numbers given in January, to 176 deaths. According to the National Institute of Communicable Diseases (NICD) said 945 cases of the disease have been confirmed since January last year, up from the previous figures given last month of 61 deaths and 720 confirmed outbreaks.
The NICD report says South Africa’s most densely populated province Gauteng accounts for 59% of reported cases, followed by the Western Cape with 12% and KwaZulu-Natal with 7%.
Outcome at the end of hospitalisation is known for an additional 18 cases, bringing the total with known outcome to 635/945 (67%) of patients. 176 (19%)
of patients are known to have died
At present, the source of the outbreak is not known, although progress is being made in each area of the investigations.
The public are advised that processed, ready-to-eat meat products, soft cheeses, and unpasteurised milk and dairy products should be avoided by persons who are at risk of listeriosis. In addition, processed, ready-
to-eat meat products include viennas, polonies, russians, ham, other ‘cold’ meats, sausages, various corned meats, salami, pepperoni and similar products typically found in the processed meat sections of food retailers and butcheries should be avoided, or thoroughly cooked in boiling water or heated at high temperatures of 70°C or higher before eating
The listeriosis outbreaks have caused panic among South Africans but health experts have said that there is no need to panic. According to a Weekend Argus report, Dr Kgomotso Mogapi, from Kwamqemane Lifestyle and Wellness Centre in Pietermaritzburg, said only 10% of the world’s population has listeria in the gut and most were not ill from it.
Western Cape Health Department spokesperson Mark van der Heever said while the disease, which can be contracted via milk, meat and vegetables, is a serious disease, it can be prevented. The infection with listeria usually results in gastroenteritis with diarrhoea, vomiting and fever, and symptoms can range from mild to severe.
National Department of Health spokesperson Popo Maja said the first documented outbreak was recorded between August 1977 and April 1978 when 14 cases from Joburg were reported. Since then, sporadic cases have occurred throughout South Africa over the years.
Between January and September 2015, seven cases were reported in the Western Cape even though no common source of exposure was found in these cases. In July 2017, however, panic erupted when doctors from neo-natal units at the Chris Hani Baragwanath and Steve Biko Academic hospitals alerted the NICD about unusually high numbers of babies with listeriosis. This triggered a review of all cases diagnosed in both public and private hospitals. According to the department, so far 872 laboratory cases of listeriosis have been confirmed across the country.
Mogapi said listeria thrives in cold temperatures, including in fridges. So what happens when someone eats contaminated food?
There is, meanwhile, a need for proper communication on the disease. A Daily Maverick report says this is according to the chair of Parliament’s portfolio committee on health, Lindelwa Dunjwa who told the committee that she had convened the meeting “so that we could go into our constituencies and tell our communities to understand simple hygiene habits”.
Health Minister Aaron Motsoaledi said although listeriosis has been identified in the country since 1977, this was the first time the disease had become “notifiable to the public”. According to Motsoaledi, this particular strain of listeriosis identified by laboratory testing has seen a rapid spread and has seen unusual behaviour – which prompted the department to notify the public.
Motsoaledi pointed out that like many other infections, listeriosis is widely distributed in nature. It is found in soil, water and vegetation. Contamination of food can occur through not rinsing or cooking food thoroughly.
The report says Motsoaledi told the committee he was particularly worried about the spread of the disease because the incubation period is between two and 70 days. This poses difficulties in trying to find the source of infection among neo-natals (babies between 0 and 28 days old). “The reason they get it is because they get it directly from their mothers,” said Motsoaledi.
The report says during the meeting, MPs expressed concerns about whether communities were receiving adequate communication about the dangers of the disease and how they could prevent it. “We need more environmental health-workers in our communities,” said Democratic Alliance (DA) MP Lungiswa James, who asked: “Why didn’t people know about this (listeriosis)?”
ANC MP Claudia Ncube-Ndaba questioned how people could be well-informed when messages and rumour were being spread on social media – for instance, stories circulating that chickens from popular fast food outlets were being infected. She didn’t know whether these reports were true or not.
“Do we really have the capacity to inform citizens?” asked Patricia Kopane, DA shadow minister for health, who asked if hospitals and clinics were capable enough to inform citizens about listeriosis.
The report says Motsoaledi was quick to allay fears about the capabilities of health facilities, saying, “We can’t underestimate our clinics. They’ve dealt with cholera and other communicable diseases.” Clinics know about the importance of hand-washing and keeping hygienic habits, especially when preparing food, said Motsoaledi.
National Freedom Party MP Ahmed Shaik Emam asked what measures were being taken to monitor standards for food sold on streets, especially food that is exposed for the entire day. Motsoaledi admitted, “We do have a problem here, I must confess.”
According to Motsoaledi, health inspectors were moved from the department of health in 1996. They now fell under municipal control. “Imagine a small rural municipality, which is struggling to provide water to remove refuse, having to put money aside for what they believe is a function of health – they just ignored it,” he is quoted in the report as saying.
Motsoaledi said there were plans to hold a press conference updating the country on the outbreak since the last update on 8 January. This would be done once the Multisectoral National Outbreak Response Team, which was tasked to investigate the source of the disease, had met.
He said he had given the directive to provincial ministers to spread information about listeriosis, using interviews and handing out pamphlets to the public about the disease, as part of the department’s national campaign. “I have asked MECs to give interviews locally, to the local radio stations. We are trying, and we’re also using community health-workers (to spread information),” Motsoaledi is quoted in the report as saying.