Update on Cholera Outbreak in Gauteng and Free State Provinces - May 24, 2023
National Institute for Communicable Diseases confirmed a Cholera outbreak in Gauteng and Free State Provinces. A total of 53 cases have been confirmed, with 9 in Free State and 44 in Gauteng. Updates on cases, testing, and hospital admissions provided. Stay informed about the current situation.
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UPDATE ON CHOLERA OUTBREAK PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH DR SSS BUTHELEZI DIRECTOR-GENERAL: HEALTH 24 May 2023 1
BACKGROUND The National Institute for Communicable Diseases (NICD) notified the Department about cases and deaths in a suspected diarrhoeal disease and confirmed Cholera outbreak in Gauteng and Free State Provinces. As of 19:00 on 23 May 2023, a total of 53 cases of cholera have been confirmed by NICD. Gauteng and Free State are the only provinces with confirmed cases to date.
FREE STATE PROVINCE Total of 9 confirmed cases; 3 new cases confirmed at NICD on 23 May 2023 Seven faecal specimens collected from patients at Parys Hospital (Fezile Dabi District) were referred to the NICD and tested on 23 May 2023. 3 of the 7 specimens tested positive on PCR for Vibrio cholerae and for the cholera toxin gene target. No further information is available for these cases as yet. All confirmed cases are from the Vredefort-Parys area
GAUTENG PROVINCE Total of 44 confirmed cases; 18 new cases confirmed at NICD over the past 24 hours Of the 44 cases, 11 are the cases confirmed in February and March from City of Joburg Metro and Ekurhuleni Metro, and 33 are from the Hammanskraal area. All 18 new cases are from the Hammanskraal area, diagnosed at Jubilee Hospital. A total of 67 patients with diarrhoea are still admitted in Jubilee Hospital; 15 of these 67 patients are confirmed to have cholera. In total, 157 patients with diarrhoea have been seen at Jubilee Hospital.
SUMMARY REPORT AS OF 23 MAY 2023 Source: NICD
EPIDEMIOLOGICAL OVERVIEW 3 3 3 8 Cumulatively, 44 cases reported including five (05) deaths (one in EKU & four in TSH) Eight (8) in Johannesburg, three (3) in Ekurhuleni and thirty- three (33) Tshwane
GAUTENG CHOLERA CASES Total number of cholera cases 44 Tshwane 33 Johannesburg 8 Ekurhuleni 3 Jubilee 29 Med forum 1 SAPS 3
CHOLERA CASES BY AGE AND GENDER, GAUTENG Female Male 4.5 4 4 4 4 No. of cholera cases 3.5 3 3 2.5 2 2 2 2 2 2 1.5 1 1 1 1 1 1 1 1 1 1 1 1 1 0.5 0 0-4 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 5-9 60-64 65+ Age-group Of 44 cases reported, 45% (20/44) were Females & 55% (24/44) were Males with a median age of 38 years
JUBILEE HOSPITAL DIARRHOEA CASES 23 May 2023 18h00 Total number of patients seen with diarrhoea 165 Total confirmed cases 29 Patients transferred out 18 Total cases still admitted 67 (15 with positive results) Deaths 17 Source: GP DoH
HAMMANSKRAAL SAP COLLEGE 3 Confirmed cases in SAPS officials 5 admitted and discharged Outbreak Response Team (ORT) collected samples from all SAPS attendees with gastrointestinal complaints at the college 71samples tested and 2 positive Environmental Health officials conducted inspections: 7-day compliance notification was issued due to non-compliance found on premises (kitchen, cold chain management, cleanliness) Investigation continue to determine the cause of the outbreak through collaboration of multisectoral departments
VISIT TO HAMMANSKRAAL BY DEPUTY MINISTERS Deputy Ministers of Health, Water Affairs and Sanitation, and Social Development accompanied by the MEC for Health and MMC of Tshwane Metropolitan Municipality visited Hammanskraal Following this visit a Technical Committee of DGs and HODs was formed and tasked to directly manage all the interventions in the area under the leadership of the Director- General of Health Technical DGs meeting with various Departments (GP Department of Health, Department of Water and Sanitation and Department of Social development) together with Tshwane Metropolitan Municipality was held. Work is still underway and some information still needed to be sourced and verified. There will be constant engagement to monitor progress on their roles and responsibilities.
TSHWANE METROPOLITAN MUNICIPALITY: WATER PROVISION Deployment of water tankers to informal settlements Hammanskraal: 44 water tankers are deployed in wards 08, 13, 49, 73, 74, 75,76, and 95 The water used to fill the trucks are sourced from hydrants supplied by Rand Water, Magalies Water, Stinkwater and Pyramid at Roowaal
TSHWANE METROPOLITAN MUNICIPALITY: WATER QUALITY ANALYSIS Water samples were routinely taken and analysed in fulfilment of the SANS 241: 2015 standard Sampling is intensified to include more sampling points Some of the points sampled in the last 3 days include: Temba Water Treatment Plant Eersterus hydrant (supplied by rand water) Magalies hydrant SAPS College Kanana Water Tanker All points tested negative for E.coli and faecal contamination
TSHWANE METROPOLITAN MUNICIPALITY : PUBLIC HEALTH AND ENVIRONMENTAL HEALTH Outbreak Response Team activated Support provided to health facilities Regular Risk Communication and Community Engagement with the public Preventive measures communicated communities Food samples taken at various points including restaurants and food vendors Food safety educational measures were emphasized Health education on safe burials to be implemented 11 schools were visited and water samples were collected with affected
DEPARTMENT OF WATER AND SANITATION Water samples were taken and results are still pending, feedback will be provided as soon as the results are received DWS and Tshwane Metropolitan Municipality will compare water quality test results to identify affected sources The Department continues to work with the Municipality
DEPARTMENT OF SOCIAL DEVELOPMENT Accessed list of deceased from Jubilee Hospital to provide support to families Working with local councilors Providing psycho-social support to affected families
INTERVENTIONS BY NDOH AND SUPPORT FROM OTHER STAKEHOLDERS The Department sent a team to Free State Province to provide support to the province on the ground. The team comprises of the core national outbreak response team (Communicable Disease Control, Environmental Health and Health Promotion), the National Institute of Communicable Disease Control (NICD) Outbreak Response Unit (ORU) and WHO. Surveillance and Epidemiology, The team travelled on Monday, 22 May 2023 and started field work on Tuesday, 23 May 2023. Technical support has been received from WHO with one official supporting NDOH and others supporting Gauteng and Free State Provinces
OTHER UPDATES A webinar with the objective to give an update on the Cholera outbreak and the steps to be taken in response to the outbreak was held on the Tuesday, 24 May 2023 with a total of above 750 participants attending. Key Speakers were from the Department of Health, NICD and WHO.
CONCLUSION Task Team at DG level will continue to engage and guide all the interventions Water quality sampling will continue and be intensified especially in affected Provinces Collaboration with all key stakeholders to manage the outbreak DoH, DSD, DWS, Tshwane Municipality to work together on public communications Outbreak Response Teams in all Provinces are on the alert
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