The South African government says that it is conducting a review of food safety legislation in a bid to prevent another deadly outbreak of listeriosis. Polity reports that the National Institute for Communicable Diseases (NICD) said that the death toll from what the World Health Organisation (WHO) deems the world’s worst-ever listeria outbreak in South Africa has risen to over 200. But government said the number of cases of listeria have declined drastically cases since identification of the source of the food-borne bacteria and the recall of implicated products.
Government said that factories that have produced implicated products ceased production in March and have been inspected by a team of national, provincial, district officials and WHO food safety experts, adding that imported meat and all imported products of animal origin would be monitored.
“Risk profiling of food processing premises is underway and preparations have been made for a programme of inspections and laboratory testing of high risk processing facilities of food that may be at risk for Listeria contamination. A review of food safety legislation is being conducted,” it said.
Health Minister Aaron Motsoaledi, on Saturday addressed ministers of the African Regions World Health Assembly about the South African situation.
Since January 2017, at least 204 people are now known to have died from listeria, up from 183 reported two months ago, Business Day reports the NICD has announced. While the number of cases diagnosed each week has decreased, a total of 1,033 people have contracted listeriosis – a disease caused by bacteria from soil, water, vegetation and animal faeces which can contaminate fresh food, notably meat.
Health officials announced in March that they had traced the outbreak to an Enterprise Foods plant in Polokwane and immediately ordered a nationwide recall of the affected products.
According to the report, the government said “since identification of the source of the outbreak and recall of implicated products, the number of cases of listeria has declined drastically”.
A number of African countries have imposed a ban on imports of chilled meat from South Africa.
The infection mainly affects children and has an incubation period of up to 70 days, making it difficult to track.
More than two months have passed since consumers in the country were cautioned about the dangers of consuming contaminated products. Subsequently, the Department of Health urged consumers to destroy and refrain from consuming a number of processed meat products and large-scale recalls of affected products were also initiated across the country.
However, since then, and despite the various efforts, Marlene Louw and Melissa van der Merwe, at the University of Pretoria’s agricultural economics, extension and rural development department write in a Business Day report, that the death toll and infections increased to about 200 confirmed deaths and more than 1,000 infections.
They write: “This raises a number of questions: did these messages reach consumers in a timely manner? Did consumers understand them? And did the messages change the consumers’ behaviour?
“These questions become even more critical when considering low(er)-income consumers. These consumers rely heavily on the implicated products and are therefore comparatively more exposed to the food safety issues associated with the listeriosis outbreak in South Africa.”
Louw and van der Merwe write that this notion is supported by national income and expenditure data from 2010, which indicate that South African consumers, on average, allocate 8% of their spending on meat to processed products. For low(er)-income households, this share increases to about 15%. With consumption trends associated with convenience and urbanisation gaining momentum, this share is expected to keep increasing.
They write: “It further seems that the above effect is amplified, as lower-income consumers only have limited access to official messages from the department. From a sample of 110 destitute and unemployed food consumers in townships around Johannesburg, it was found that only 44% answered ‘Yes’ to the question ‘Do you know what listeriosis is?’, in the week directly after the department’s announcement.
“These consumers were also able to identify, on average, only two out of seven key symptoms associated with listeriosis. Follow-up questions related to products and brands associated with listeriosis revealed that 75% knew polony and viennas should be avoided, but only 52% of the respondents were able to attach a brand to the infected products.
“The results of the study suggest there is a significant income difference between the groups that indicated they were familiar with the term ‘listeriosis’ and the group that did not. Income differences were also apparent in knowledge associated with products and brands.
“Here, income level could serve as a proxy for asset endowment, which includes technologies that allow easy access to information. These include radios, smartphones and televisions.
“These results seem to support the notion that low(er)-income consumers are more exposed to food safety issues due to their limited access to these technologies and, ultimately, the information shared on these platforms.
“It’s been well established that the technical capacity to monitor and enforce food safety standards in South Africa is lacking. Unfortunately, as is evident by the rising death toll, it also seems the channels being used to spread information to mitigate the effects of a food safety incident are also inadequate.
“Our research found that the main channels through which these consumers received messages related to listeriosis were radio (42%), television news (17%) and word of mouth (12%). However, these channels seemed to be mostly inadequate in conveying the full and correct message in a timely fashion, with 56% of the respondents indicating that they first heard about listeriosis around 4 March or later. Preventative messaging, before the sources of the disease were identified, were therefore lacking.
“Incomplete information has far-reaching implications. From an economic perspective, inaccurate or incomplete information can cause economic harm beyond implicated brands and could even be detrimental to food vendors in informal economies in terms of sales and losses. The listeriosis outbreak in South Africa, and the rising death toll, should serve as a learning experience on how destitute consumers can be better and more timeously reached with accurate food safety messages.
“This will require tailor-made messages through non-traditional media channels, specifically aimed at vulnerable groups in terms of income level, language and employment dynamics.
“If this is not done, we are selectively protecting consumers against food-borne illnesses. This is ultimately adding to the stark inequalities already prevalent between South Africa’s consumers.”
The listeriosis epidemic is under control now that meat products from Enterprise and Rainbow Chickens have been recalled. Health24 reports that this is according to Motsoaledi who said during his budget vote in Parliament: “Since the recall, we have had fewer than five cases a week in the past five weeks compared to 40 a week before the recall.”
Meanwhile, government aims to test 14m people over the next two years, hunting for new HIV, tuberculosis, diabetes and hypertension patients – despite the fact that health facilities are “overburdened” and unlikely to cope with additional patients.
Motsoaledi said that private doctors would be brought in to treat the additional patients.
The massive testing campaign – to be called “Surge” – will be launched next month by President Cyril Ramaphosa. It aims to identify 2m new HIV-positive people, 80 000 people with TB and “thousands and thousands” of diabetes cases over the next two years.
“I am sure none of you will ever suggest that we cannot treat more people simply because the system is overburdened,” said Motsoaledi. “This is where the (National Health Insurance) comes in. The essence of NHI is to make sure that both public health facilities and skills and the private sector facilities and skills are available to all the citizens of our country.”
The report says although the R4.2bn allocated by Treasury for the NHI is lower than the department hoped, most of this money will be used to screen people, particularly school kids, for diseases and buy the time of private sector health workers to treat patients.
Over the next two years, the treatment of HIV-positive patients will be “decanted” to 250 private doctors. In addition, 52 private psychiatrists and 71 psychologists are going to be brought in to address the backlog of 1,431 awaiting-trial prisoners referred to the state for mental evaluation. This backlog is “clogging up the criminal justice system and worsening the congestion in mental health facilities”, said Motsoaledi.
Government is also planning a “massive” cancer campaign, said Motsoaledi. It has allocated R100m to oncology services in KwaZulu and Gauteng to address radiation backlogs.
Government will also “uncompromisingly target tobacco smoking and unnecessary sugar intake” – both of which cause cancer. “Please do not allow yourselves to be rented by tobacco and sugar companies to become their spokespersons here in Parliament and in communities,” Motsoaledi warned MPs.