Cholera source still in question

WHILE health stakeholders have noted a downward trend in new cholera cases across the country in recent days, the “elephant in the room” regarding the source of the outbreak remains “in question”.

This was according to Health Minister Dr Joe Phaahla during an update yesterday on the outbreak of cholera in different parts of the country.

Phaahla, speaking at the briefing in Hatfield, Pretoria, said at this stage, the outbreak of the disease could be defined as being limited to very specific areas in the country.

He credited the “hopeful” turnaround in the past seven days as being due to the collaborative efforts of the provincial Health Department, working with the City of Tshwane municipality and other entities such as the World Health Organization.

The minister said although there was a promising trend of fewer infections, with them being optimistic that the situation could be contained sooner rather than later, the “elephant in the room” remained the source of the outbreak.

With regards to the earlier outbreak recorded in Johannesburg and Ekurhuleni around February and March, he said the only link that could be established was between the cases of two sisters reported to have travelled to Malawi for a funeral and back to Johannesburg in February.

In the Fezile Dabi district in the Free State, Phaahla said that at this stage, health officials had not been able to find the source of the outbreak.

“According to a report from the Free State, the water sources were tested, but the tests were deemed non-compliant because of the high nitrate content, which is apparently due to too much chloroform.”

He said they did not have a clear pattern and needed to “drill deeper” in places such as Tshwane, as the first case originated from someone from Musina, near the Beitbridge border.

As a result, health officials still needed to determine whether the first case reported of a 56-year-old police officer, who initially complained of symptoms on May 12 during his stay at the SAPS College in Hammanskraal – and confirmed it on May 15 – had any contact with travellers before he arrived in the area.

The minister said the total number of cases stood at under 300, and while tracing has been ongoing, stakeholders need to determine the source.

With water supply in Hammanskraal having been an issue for years before the outbreak, Phaahla said the easy route would be to think the source of the outbreak was the water, but reports presented no such indication.

“We still have our work cut out in terms of the origin of the outbreak. From a public health point of view, we have to continue educating people in terms of basic and individual public hygiene standards and stressing the importance of washing hands once they have done number two and to use soap and water.

“What we are happy about is that there have been no new reported cases in the past seven days since May 23, and we are hopeful that we will locate the source soon.”

Health officials said that from May 17 to May 23, 163 patients presented at Jubilee Hospital with diarrhoea and vomiting, an average of 23 a day.

The number of deaths was 17 over seven days; however, in the subsequent seven days from May 24 to May 30, that had reduced to 30 patients, with an average of four patients a day and a total of two deaths.

“The key message is that at this stage the outbreak of cholera is limited to a small area in the Free State, Ngwathe municipality, with no reported new cases since May 23. In the case of Tshwane, we have 99 confirmed cases, 7 in the last 24 hours.”