Johannesburg - According to the National Institute for Communicable Diseases (NICD), the Gauteng province has six confirmed cholera cases, including one death.
All of the cases are adults, with ages ranging from 19 to 44 years. No confirmed cases have been reported in other provinces.
According to the NICD, the first three cases were imported or import-related cases following travel to Malawi. Cases four and five contracted the infection locally; they had not travelled, had no connections to imported cases or each other, and did not live or work in the same area.
"By definition, the detection of locally acquired indigenous cholera cases is a confirmed cholera outbreak. The source(s) of infection in these cases is not known at present," read an NICD statement.
The institute further said that while there is an ongoing risk for imported cases following travel from other African countries currently experiencing cholera outbreaks (especially Malawi, Mozambique, Zambia, and Zimbabwe), the detection of locally acquired cases is critical to guide public health investigations and timely interventions that effectively interrupt cholera transmission in affected communities.
"Healthcare workers and laboratorians countrywide have been urged to consider and test for cholera in persons with acute watery diarrhoea," added the NCID.
The City of Johannesburg has indicated that as of January 31, 2023, three countries in the southern African region (Malawi, Mozambique, and Zambia) reported ongoing cholera outbreaks.
"The City of Johannesburg can confirm that since the recent reports of the cholera outbreak in our neighbouring countries, five cases have been confirmed in South Africa, of which four cases were reported in the City of Johannesburg."
"The cases are of two sisters who had recently travelled to Malawi for a funeral and developed symptoms on their return to Johannesburg. The third case is a contact to the sisters, and the fourth case is a man from Alexandra Township," said a city statement.
MMC Health and Social Development Ennie Makhafola urged members of the public and healthcare professionals to exercise caution and report any suspicions of cholera for further investigation.
Makhafola encouraged individuals to practice good hand hygiene, which includes washing their hands with water and soap, both before and after using the restroom or the toilet and before preparing or eating food.
Some facts about cholera provided by the City of Johannesburg include:
What is cholera?
Cholera is a diarrheal disease caused by a bacterium called Vibrio cholerae. Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1–10 days after infection and are shed back into the environment, potentially infecting other people.
To whom does cholera pose a threat?
It can affect all ages, mostly individuals who lack access to adequate sanitation and piped, safe water.
How is cholera spread?
- A person may get cholera by drinking water or eating food that is contaminated with the cholera bacterium.
- Unclean hands can contaminate food and water.
- In an outbreak, the source of the contamination is usually the faeces of an infected person.
- The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water. The disease is not likely to spread directly from one person to another; therefore, casual contact with an infected person is not a risk for becoming ill.
- An infected person ‘’carrier’ ’who does not have symptoms can also transfer the bacteria during food preparation.
When cholera is severe, it often manifests as follows:
- Severe diarrhoea (rice water stools) and dehydration (caused by loss of body water).
- Vomiting may occur.
- Children may develop fever.
- If left untreated, cholera can be fatal in a matter of hours, even in previously healthy people.
What safety measures are recommended?
- Hand washing with water and soap before and after using the bathroom/toilet and preparing or eating food.
- Use only clean, treated or boiled water.
- Wash all raw food with clean, treated or boiled water
- Wash food utensils in clean, treated or boiled water
- Protect food from fly contamination and prevent fly contamination in your homes
- Do not allow children to play in dirty pools, rivers or storm water outlets
- Do not contaminate rivers or leave sewage where it can be washed into a river by rain.
- Safe disposal of human excrement and nappies is recommended.
How does cholera get treated?
- Cholera can be successfully treated if the patient visits the clinic or hospital as soon as symptoms start.
- Immediate replacement of the fluid and salts lost through diarrhoea is important.
- Patients can be treated with oral rehydration solution, a pre-packaged mixture of sugar and salts to be mixed with water and drunk in large amounts.
- This solution is used throughout the world to treat diarrhoea.
- Severe cases also require intravenous fluid replacement.
Cholera outbreaks usually occur in settings with inadequate sanitation and insufficient access to safe drinking water. Currently, cholera is not endemic in South Africa, and the last outbreak was in 2008/9.
The Star