In May 2003 the Nkomazi Muncipal area in Mupumalanga had a cholera outbreak.
The first case was admitted at the Tonga hospital, 26 April 2003 however the National Outbreak response Team was never informed.
The province reported 75 cases 8 May 2003 at Tonga hospital, 19 tested positive for vibrio cholera.
The affected area was the Nkomazi Muncipal area, Ehlanzeni District, Tonga sub-district. Three fatalities were reported the one confirmed death was a two year old.
Upon investigation it was discovered that a stream from the Nkomazi River that flows through the area could have been the source of the outbreak as it was heavily contaminated with faecal coliforms.
The cases were managed according to the national cholera guidelines for cholera control. The cases were managed at a clinic in Tonga and at Tonga hospital. Patients were treated on an out-patient basis, oral rehydration and intravenous rehydration for severely dehydrated patients.
Surveillance measures were established within the communities. An early warning system for formidable disease of outbreak potential was set up. Clinics and patients were closely monitored. Microbial tests to confirm cholera cases were sent to the national health laboratory services. Furthermore cholera cases were listed according to the notification system.
Community health education is an on going process. Educational material such as pamphlets and posters were distributed as well as an information slot on the radio within the area. Community leaders further set up educational talks on personal and environmental hygiene, water safety and chlorination and hygienic handling of food.
With regards to water and sanitation the Department of Water Affairs and Forestry provides the affected area with water. About 20% of the affected households were estimated to be without proper sanitation facilities. Message boards were set up at sources of unsafe water.
(Source: Department of Health)