The South African government has encountered difficulties in determining the source of the cholera epidemic, which has led to the unfortunate demise of 24 individuals. However, the health minister has stated that it is premature to attribute culpability to the water quality supplied by Tshwane municipality in Hammanskraal for the outbreak of cholera.

By Mbali Mthembu

According to the minister of health Dr Joe Phaahla, it is too early to hold the water quality provided by Tshwane municipality in Hammanskraal responsible for the cholera outbreak that has caused over 24 deaths in the community over the last 14 days.

In contrast, the disease may have been brought into the country by two sisters from Johannesburg who were possibly infected in Malawi. According to the minister, these were the first two cases reported in Gauteng at the beginning of February. In January, the two Diepsloot, Johannesburg-based sisters travelled to Malawi by bus, according to him.

In February, they tested positive for cholera. Nine additional cases were confirmed, some of which were linked to the sister’s relatives, others to Ekurhuleni, and one to a child who tragically succumbed to the disease.

“Cholera is endemic in Malawi,” Phaahla told reporters.

In other cases, the source of the disease remains unknown. Without conclusive evidence, the minister has cautioned against identifying the Hammanskraal water supply as the cause of the outbreak in the region.

“Because of the fact that for many years, Hammanskraal has had issues with the supply of water, it is very easy for us to say the water supply is the source of cholera. At this stage, we still have our work cut out in terms of digging deeper into where is the origin of cholera there,” Phaahla said.

Tshwane is regarded as the epicentre of the cholera outbreak, but Phaahla reported that the city’s first reported case was traced to a 56-year-old police officer from Giyani, Limpopo. The officer was enrolled in a South African Police Service (SAPS) course at Hammanskraal and tested positive for cholera in early May.

Following this incident, eight other police officers were hospitalised with the same symptoms.

The outbreak was largely “limited to specific areas.” Within days the cases had a rapid increase, Phaahla said this was “when the outbreak team was called to assist in hospitals.” However, during that period, 17 patients died.

Phaahla confirmed that the majority of the 24 lives lost to the disease thus far have occurred in northern Pretoria. In addition, he confirmed that 99 patients were being treated for the illness, and he noted that the disease’s severity has significantly diminished.

“In terms of those confirmed, even those with diarrhoea, in terms of serious illness, there is a very significant decline. People are coming early even those with symptoms, and they are treated, and we are not having any in the hospital even as we speak. There are no seriously ill patients,” said Phaahla.

Turning his attention to the hospital care, he said they were elated that there were no cholera-related deaths over the past seven days and that the Jubilee Hospital now has cholera-specific wards.

 “We have also appointed a gastroenterologist, and we have a field hospital in Kanana and deployed additional staff.”

He said the National health department is working with various other departments, such as the Social Development Department, Water and Sanitation, and the Presidency and that Doctors Without Borders were also assisting to curb the outbreak.

He called on all South Africans to practice good hygiene, especially when preparing food. And when using sanitation facilities. “When you do your number 2, you must wash your hands with not only water, but you must use soap,” said Phaahla.

It remains unclear how many cholera cases there are nationally, but Hammanskraal is the hardest-hit area by far to date.  

Cholera can cause acute diarrhoea, vomiting and weakness and is mainly spread by contaminated food or water. It can kill within hours if untreated.

South Africa last experienced the worst cholera outbreak in 2009, when more than 12,000 cases were reported. The outbreak was reportedly traced back to neighbouring Zimbabwe.