Bilharzia cases rising in city, report says

Nelson Mandela Bay’s ageing infrastructure is to blame for the rise in cases of bilharzia in the city.

This is according to the municipality’s environmental health deputy director, Patrick Nodwele.

While the disease is endemic to the Bay area, the National Institute for Communicable Diseases (NICD) said the number of cases reported had increased steadily over the past five years.

In what he termed an outbreak, Nodwele – in a letter to infrastructure and engineering boss Walter Shaidi – said the sewage that continuously flowed into three rivers in the Bay was a “health nuisance”.

The rivers are the Swartkops, Papenkuils and Baakens.

Nodwele wrote that sewage spills in residential areas that went unattended for days were a health risk for residents.

“Sewage spillages in residential areas were also reported to remain unattended for prolonged periods, resulting in the flow of sewage into stormwater channels and exposing [residents] to contaminated water and resulting in pollution of rivers.”

Nodwele wrote that this rendered the water unsuitable for recreational purposes and other uses. “The municipality currently battles with an outbreak of bilharzia which can be directly linked to surface waters polluted by faecal matter.

“The pollution constitutes a violation of the rights contained in Section 24 of the constitution.

“It is detrimental to human health and causes a health nuisance,” Nodwele wrote.

According to the World Health Organisation, bilharzia is a disease which is caused by parasitic worms which affect the intestines, urinary system and other parts of the body.

It is a chronic illness. NICD associate professor John Frean said while the recorded cases of bilharzia in the Bay had decreased in 2018 compared with 2017, there had been a rise in the number of cases over the past five years.

In 2018, there were 38 cases of bilharzia among Bay residents between the ages of five and 60.

Frean said the NICD had seen an increase from one case recorded in 2012 to 46 cases in 2017.

He said, however, that the cases from the government’s labs were an understatement as they excluded cases diagnosed by blood tests .

“That area [the Bay] in the Eastern Cape is a known endemic area for bilharzia,” Frean said.

“From the notifications that we get, we know that there is an ongoing transmission in the area.

“The conditions for the transmission of the disease are present.

“The infection occurs in humans and snails.

“Humans infect the water with urine and faeces and snails get infected and in turn the snails produce stages which get into humans when they come into surface water.

“When you have all the right conditions for snails and uncontrolled deposition of faeces and urine in water or on the banks and people are swimming there, you will get transmissions.”

Frean said bilharzia was common in children.

“This does not necessarily require large-scale sewage spillages.

“If you have infected people, mostly children swimming in rivers and dams, they could be a source for infecting the water as well.”

‘The outbreak can be linked to surface waters polluted by faecal matter’ Patrick Nodwele ENVIRONMENTAL HEALTH DEPUTY DIRECTOR