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Updated 28 June 2018

No cholera outbreak in Tshwane, but investigation continues

The National Institute for Communicable Diseases (NICD) says that despite widespread reports of diarrhoea-related illnesses in Tshwane, there is no cholera outbreak.

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There have been several reports of a possible cholera outbreak in Hammanskraal and other areas in the City of Tshwane, but the National Institute for Communicable Diseases (NICD) said initial testing shows that there are no signs of cholera.

In a statement, the NICD said that it is assisting the Department of Health as it continues to investigate reports of increased cases of diarrhoeal disease – possibly linked to unsafe water in Region 2, City of Tshwane.

Stool samples collected

Public sector healthcare facilities in the area have not noted an increase in diarrhoeal disease, and review of available data confirms this. Four stool samples collected from people with diarrhoea have been sent to the NICD so far.

No bacteria – specifically, no Vibrio cholerae which causes cholera – or viruses were detected in the stool samples. The NICD therefore confirmed that there is no evidence of an outbreak at present. 

Dr Juno Thomas, Head of the Centre for Enteric Diseases at the NICD, told Health24 that there definitely isn't a cholera outbreak and the country hasn't seen one since February 2018.

Notifiable Medical Conditions

The Institute also said that testing of potable water is underway to assess water safety, and the NICD will continue testing stool samples.

The NICD has a specific system for tracking and monitoring illnesses throughout the country. The organisation has various categories for what they call Notifiable Medical Conditions.

Category 1 Notifiable Medical Conditions (NMC) requires urgent response and the NICD classes cholera as a Category 1 NMC. Other diseases and illnesses which fall into the same category are listeriosis, plague, malaria and human rift valley fever.

"The reporting of priority communicable diseases is detailed in the National Department of Health's Notifiable Medical Conditions regulations. there are certain diseases which need to be reported immediately to the Department of Health authorities, as soon as a healthcare worker or laboratorian suspects or confirms the diagnosis.

"Cholera is one of these high priority diseases that are immediately notifiable. For diseases of major epidemic potential, in most instances a single case is treated as an outbreak. Cholera falls into this category — so, a single case of suspected or confirmed cholera must be notified immediately and an outbreak response is activated on receipt of the notification," added Thomas.

City of Tshwane agrees

The City of Tshwane expects the results from tests run on water in Hammanskraal and other areas on Thursday, but the City agrees that there is indeed no cholera.

Spokesperson for the City of Tshwane, Selby Bokaba, told Health24 that someone tipped them off and said that it may be cholera.

"We can't simply fold our arms and not do anything, so we provided water tankers and ran tests on the water in these areas. We now know for a fact that there is no cholera, because people would have been really sick, hospitals and clinics would be flooded if there was an outbreak. We don't know why this person said it could be cholera.

"We had to err on the side of caution, because we need to satisfy all important stakeholders and the people in these communities. We expect the results from the water tests in the near future," said Bokaba.

Image credit: iStock

 
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