Only 6 cases of listeriosis reported in NC
WHILE only six cases of listeriosis have been reported in the Northern Cape, nationally the death toll stands at 82 and the National Institute for Communicable Diseases (NICD) has warned that the outbreak is continuing.
Northern Cape Department of Health spokesperson, Lulu Mxekezo, said this week that six cases had been treated in the Province.
The two most recent cases were treated this year at the Kimberley Hospital and Dr Harry Surtie Hospital. “These patients have been discharged and are recovering well at home,” Mxekezo said.
At least three people are known to have died from listeriosis in the Northern Cape last year, one an immunosuppressed patient, who was admitted to Kimberley’s Lenmed hospital, and two patients from Danielskuil who died in the Kimberley Hospital.
Both Mediclinic Kimberley and Lenmed confirmed earlier that no new or suspected cases had been admitted to either of the hospitals.
According to the NICD, a total of 820 laboratory-confirmed listeriosis cases have been reported nationally to the NICD since January 1, 2017. Most cases have been reported from Gauteng (59 percent or a total of 486) followed by the Western Cape (13 percent or 105 cases) and KwaZuluNatal (seven percent or 59 cases).
Eight-two people have died.
NICD official Dr Juno Thomas warned, however, that as more cases are tracked and the outcomes of patients recorded the “death toll will become higher”.
So far only 238 cases have had a definite outcome where the NICD was able to confirm if the patient has been cured or died from the food-borne disease.
According to the World Health Organisation (WHO), listeriosis infection, thought to be dangerous but preventable, is caused by the bacterium Listeria monocytogenes which is transmitted through contaminated food and causes symptoms like fever, muscle aches, nausea and diarrhoea.
The source of the outbreak is yet to be confirmed but many people have since been hospitalised with the infection.
“To date 34 percent of cases have come from the private sector and 66 percent from the public and when you think that less than 20 percent of the population relies on private health services it certainly is a signal that the risk is not limited to those living in poor socio-economic conditions,” Thomas said.
“The sense we’re getting is that the source is a single contaminated food commodity or small group of commodities from the same facility, that is or are very popular and accessible to all South Africans across the board.”
Thomas also pointed out that a wide-range of people affected showed that the contaminated food source was unlikely to be a “luxury product” like soft cheeses or seafood but rather widely-consumed processed meats and dairy products.
She said the NICD could, however, not rule out the possibility of fresh and frozen fruit or vegetables as being the culprit.
The bacteria Listeriosis is killed by heat so experts suspect the source to be food products that do not require to be cooked and are bought ready-to-eat such as polony or sausages.
Thomas further highlighted that the NICD and Department of Health (DoH) were doing “everything possible” to locate the source including visiting homes of each patient with confirmed listeriosis infection and testing “everything and anything” in their fridges, freezers and cupboards.
According to the NICD, Municipal Environmental Health Practitioners in all provinces have embarked on systematic inspection and sampling of meat and poultry production, processing, and packaging facilities.
“Cases of listeriosis will continue to be investigated, with traceback and further investigation of any positive food/environmental samples.”
Minister Motsoaledi’s office has since facilitated inspections of production, processing and packaging facilities involved in meat and poultry, as most patients have reported consuming these products.
“This testing is happening in all nine provinces and the dairy and fresh and frozen produce industries will be inspected next,” Thomas said.
Professor Laetitia Rispel from the University of the Witwatersrand’s School of Public Health said while deadlier outbreaks have occurred in other countries, South Africa’s “relatively sophisticated laboratory and diagnostic infrastructure” has allowed the local epidemic to be meticulously tracked and placed it on record as the worst in world history.
“The reason it is proving so difficult to locate the source is that it has affected people across the entire country and you can just imagine the massive number of outlets involved in food production and processing that need to be tested,” Rispel said, adding that the time and resources needed for such an investigation are extensive.
She highlighted that the situation is often compounded by the fact that listeriosis infection was relatively rare with an average of 60 to 80 annual cases and as a result, many clinicians are not well-versed in suspecting this particular bacterium.
Listeriosis is both treatable, taking between two and six weeks to treat, and preventable through safe preparation of food. But many healthy individuals experience mild symptoms or none at all. Newborn babies, pregnant women and people with compromised immune systems are most at risk of becoming sick or dying.
Thomas said that almost half (42 percent) of the deaths have occurred in infants under one month of age who contract the infection from their mothers while in the womb.
“Even if we haven’t confirmed the source with absolute certainty but have a high suspicion of what it could be, we will inform the public immediately – this is our obligation,” she said.
“In the meantime, we are cautioning high-risk groups like pregnant women and people living with HIV to be cautious of ready-to-eat products like processed meats and to heat food thoroughly before eating.”