Business Day

More disease deaths likely in region

- Katharine Child /TimesLIVE

The death toll from the listeriosi­s outbreak could be much higher as countries in the Southern African Developmen­t Community (Sadc) region do not have testing and monitoring to detect listeriosi­s cases.

The disease is not a notifiable disease across Southern African countries‚ meaning doctors are not reporting each case to a centralise­d authority.

On Thursday, Health Minister Aaron Motsoaledi and Sadc health ministers and ambassador­s held an emergency highlevel interminis­terial meeting in Johannesbu­rg to discuss the world’s largest listeriosi­s outbreak that started in SA.

Many of the countries represente­d at the meeting import Tiger Brands’ Enterprise polony and cold-meat products. The Tiger Brands Polokwane factory had the ST 6 strain of listeria‚ which is responsibl­e for 91% of all South African listeriosi­s patients‚ in 26 places.

There have been 967 confirmed cases and 183 deaths from listeriosi­s in SA. But only one patient with listeriosi­s has been identified in the rest of Southern Africa despite many countries importing implicated products. Namibia recorded a patient on March 12.

In the high-level meeting‚ the South African health department gave advice and scientific expertise on the disease. Motsoaledi also said he did not think there would only be one case outside of SA.

“It did arise in the meeting that countries might not be able to detect something like this,” Motsoaledi said.

He said few also had the ability to do DNA testing of listeriosi­s strains and SA had offered expertise if needed.

The minister said there may be multiple reasons for the lack of cases outside of SA. One was that SA had the largest HIV burden in the world and HIV may make people more susceptibl­e to listeriosi­s.

The disease is particular­ly dangerous for pregnant women‚ elderly people and people with weakened immune systems.

“We don’t know the role and the incidence of HIV and AIDS in this whole thing,” said Motsoaledi. “We have the highest prevalence of HIV [in the world]. All of those things [are] still going to be discussed.”

Swaziland’s health minister‚ Sibongile Ndlela-Simelane‚ said her country had not detected cases but “appreciate­d the capacity of South Africa to help identify deaths and cases”. She suggested Swaziland was not able to measure cases.

Many officials had high praise for SA despite the implicated products having originated in the country.

Mauritius High Commission second secretary Jevin Pillay said: “The Sadc is a big family. We have always trusted our partners. Mauritius wishes to congratula­te South Africa for being so proactive on this.”

Motsoaledi said 35% of listeriosi­s patients were using the private sector when treated. About 65% of patients were seen in public hospitals and he was exceptiona­lly pleased that it was public sector hospital doctors who had picked up cases in the middle of 2017 and then notified the National Institute for Communicab­le Diseases about a possible outbreak.

He also said although the Constituti­on gave municipali­ties the power to carry out health inspection­s of food processing factories‚ many were not sophistica­ted enough to challenge large corporatio­ns.

The minister said small municipali­ties were not matched to the “firepower of well-advanced factories”.

Motsoaledi wants the national health department to employ health inspectors‚ known as environmen­tal health practition­ers.

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