Deadly diseases out of control

15 infants die in hospitals from illnesses that affect premature and small babies

THE GAUTENG Health Department is battling two deadly diseases that killed 15 infants in hospitals.

Apart from klebsiella pneumoniae, health officials in an unnamed provincial hospital are struggling to contain a breakout of necrotising enterocolitis (NEC), which has claimed the lives of nine babies so far.

The death rate is more than that for klebsiella pneumoniae, which has so far killed six babies at Thelle Mogoerane Hospital in Ekurhuleni.

The National Institute for Communicable Diseases (NICD) confirmed it has been fighting NEC since April, when it was first reported.

All the babies with the disease were born between March and May.

“As of August 20, 2018, a cumulative total of 42 NEC cases, including 38 premature and four full-term babies, have been reported, of which nine have died.

“Children under one month old accounted for 90.5% of the cases; 9.5% were aged between one and two months and 64% (of those) were males.

“Of the cases, 79% had a low birth weight (1 500g), 21% had a birth weight less than 1 500g and 33% were fed exclusively breast milk,” reads the latest Communicable Diseases Communiqué from August 20.

NICD spokesperson Sinenhlanhla Jimoh said they couldn’t release the name of the affected hospital. She also referred The Star to the communiqué, which indicates they are unable to pinpoint the source of the outbreak.

Jerome Loveland, a professor of paediatric surgery at Wits University and the head of paediatric surgery at Chris Hani Baragwanath Academic Hospital, said the condition predominantly affected premature and small babies.

“The common risk factors are premature birth, low birth weight and any other stressors that affect babies in the neonatal group, for example, low blood pressure, low body temperature and low blood glucose levels.”

In the May Communicable Diseases Communiqué it is indicated that in 11 cases the babies were breastfed by their mothers or received donated breast milk.

“Two women were fed both formula and breast milk while seven were formula-fed. It is unknown what feeding method was used in two cases.”

The NICD said: “The presence of Bacillus and Streptococcus species in mixed and dry powder milk formula (opened and unopened) is concerning; however, toxin production tests were not done. Heightened surveillance and strict adherence to infection prevention and control measures are highly recommended.”

The report recommends further laboratory investigation on opened and unopened milk formula to establish if it meets the international and national acceptable standards.

Loveland said NEC outbreaks happened in batches and were reliant on interpersonal contact.

“The ideal, in terms of prevention, is the babies be fed with either their mother’s breast milk or with expressed donated breast milk. That is very protective in terms of preventing NEC or any other acquired hospital condition. Patients who are formula-fed are significantly more at risk to developing NEC,” Loveland said.

He said it was difficult to prevent the outbreaks. “What hospitals need to concentrate on is optimising the use of breast milk and expressed breast milk.

“If you document a case of NEC, then that patient should ideally be isolated.”