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The City of Cape Town’s Health Department remains on high alert as concurrent disease outbreaks run their course. This summer, health officials are not only contending with the annual diarrhoea season, but also face an increase in cases of other communicable diseases including pertussis and typhoid. Read more below:

Summer in Cape Town often sees a surge in diarrhoea cases which affect children under five years of age most severely.

‘Due to increased efforts and the diligence of health practitioners, we have in recent years noted a decline in the number of diarrhoea-related deaths, and diarrheoa with dehydration during the season. Sadly, this drop in diarrhea cases was followed by an increase in pneumonia in this age group over the same period. Health officials now call this period the surge season,’ said the City of Cape Town’s Mayoral Committee Member for Safety and Security; and Social Services, Alderman JP Smith.

Health officials remain vigilant as the City faces a number of other concurrent disease outbreaks.

‘In August 2017 we saw diphtheria and measles cases occurring and by now we have all heard about the national listeria outbreak. In addition to these, we have also had an increasing number of cases of pertussis and typhoid reported.

‘These diseases present a significant and costly challenge to the City. Not only are staff and resources under pressure, but the outbreak of any disease also puts lives and livelihoods at risk,’ said Alderman Smith.The diseases that City health officials are currently keeping track of are listed below.

Typhoid

In 2017, 26 cases of typhoid fever were reported in the City. Typhoid is caused by the bacterium Salmonella typhi. Individuals infected with the bacteria can spread it through contaminated food or drink. Water which has been exposed to sewerage containing the bacteria can also spread the disease. Typhoid presents with fever, stomach pains and sometimes a rash. Prevention of typhoid centres around good hand hygiene and safe food preparation.

City clinics have regular health talks about the prevention of water- and food-borne diseases and diarrheoa danger signs. Healthcare facilities ensure that individuals who are sick and dehydrated (especially children) are fast-tracked to prevent disease progression.

Diphtheria and pertussis – vaccine preventable diseases

A cluster of three diphtheria cases was reported in August 2017 and was successfully contained. Diphtheria is spread from person to person through ‘droplet spread’ of an infected person. Patients have flu-like symptoms, a sore throat and/or swollen neck. Swallowing and breathing may also be obstructed.

The number of pertussis cases in the city increased from 42 in 2016 to 101 in 2017. Pertussis (also known as whooping cough) is an extremely contagious respiratory illness caused by bacteria which affect the upper airways causing swelling and the distinct “whooping” cough.

Both diphtheria and pertussis can be life threatening illnesses especially to infants and those who are immune-compromised. The two can be prevented with vaccines which are included in the South African Expanded Programme on Immunisation (EPI) and are available to all children, at no cost, at their nearest healthcare facility.

‘With advancements in healthcare and the current immunization programme, the seriousness of these illnesses has dropped out of public memory and there is a growing trend to not immunize. The rise in these two diseases can be, in part, attributed to this. When immunization coverage drops below a certain level in a community, the number of individuals who are susceptible to these forgotten diseases increases to the point of sustaining an outbreak. I encourage parents and caregivers to be vigilant and ensure that all children who require immunizations receive them. The City will continue to promote childhood vaccinations at all its healthcare facilities,’ said Alderman Smith.

In addition, the City of Cape Town’s environmental health practitioners identify hotspots and drive prevention activities in the communities which are most affected. Prevention activities include educating communities through public events, distributing posters, training residents on maintaining good hand washing practices without wasting water, oral rehydration solution recipes and the five key food safety tips, which are particularly relevant to the listeria outbreak.

Listeria

Listeria is a food-borne disease caused by the bacteria listeria monocytogenes. It is spread through the consumption of contaminated food. The most common foods it can be found in are vegetables, raw or unpasteurized milk and soft cheeses, processed foods and smoked fish.

‘Listeria crosses income and race boundaries. It can be present in anyone’s fridge. As a caring City, we are doing what we can to identify the source of contamination and ensure food safety across Cape Town, both at formal and informal food vendors. Listeria has been associated with certain types of foods, but it can be present in a wide range of food types. For this reason, the City’s environmental health department is sampling the entire fridge contents of persons who have contracted the disease in order to find the source. The City is now prepared to include testing for listeria in the routine checks on food samples from food retailers,’ said Alderman Smith.

As of 11 January 2018, a total of 748 cases have been identified nationally since 1 January 2017, with the majority of cases being from Gauteng (61%) and the Western Cape (13%). Thus far 67 of the reported cases have been fatal.

The City of Cape Town has seen a total of 47 cases of listeriosis since August 2017.

The five key food safety tips are:

· Wash your hands thoroughly

· Separate raw and cooked food

· Cook food thoroughly

· Keep food at safe temperatures

· Use clean water and fresh food

‘While the outbreaks are not directly related to the drought, we need to ensure that health and hygiene standards are retained through creative methods and devices such as using squeeze bottles for hand washing. Providing quality healthcare is in line with the City’s Organisational Development and Transformation Plan (ODTP). The City is committed to providing basic primary healthcare to ensure the health and well-being of all our residents,’ said Alderman Smith.

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