Typhoid alert after outbreak in Western Cape and North West
District and sub-district services also conducts health promotion activities that includes general hygiene and hand-washing.”
CAPE TOWN - Health-care professionals have been encouraged to be alert for possible cases of Typhoid following outbreaks in the Western Cape and North West provinces.
During a briefing on Wednesday, the National Institute for Communicable Diseases (NICD) Centre for Enteric Diseases head, Dr Juno Thomas, said outbreak investigations were ongoing in the two provinces.
In 2020 and 2021, the Western Cape recorded 64 cases of typhoid in three separate outbreaks. Gauteng has recorded 45 cases while 18 cases have been detected in North West.
The potentially life-threatening infection caused by the bacterium Salmonella typhi is usually spread through contaminated food or water.
While measures to control outbreaks and prevent further transmission are known, some are challenging to implement, with multiple stakeholders involved and financial constraints a reality, Thomas said.
There was also an important need to raise awareness among healthcare workers to detect cases, she said.
“We know we are under-detecting (cases), so we might be missing other outbreaks as well,” Thomas said.
Western Cape Health Department spokesperson Mark van der Heever confirmed the number of laboratory-confirmed enteric fever cases detected in the province during 2021/22 was higher than in previous years, with the Cape Town Metro, Cape Winelands and Garden Route districts reporting more cases than expected.
“Whole-genome sequencing of enteric fever isolates has identified specific ‘strains’ responsible for separate clusters in these districts, confirming that in those districts cases are linked and there is ongoing local transmission,” Van der Heever said.
The identification and investigation of enteric fever cases, like typhoid, and clusters involves ongoing surveillance and line listing, thorough case management, contact tracing, environmental investigations and health promotion.
“All recent single cases and clusters are under investigation by the districts, sub-districts and local authorities. Health-care professionals are encouraged to be alert for possible cases and have a low threshold for collecting blood cultures when investigating cases of acute febrile illness,” Van der Heever said.
District Municipality Environmental Health Services officials are part of the response teams to address sanitation and water safety-related issues, he added.
“They are responsible for the routine monitoring of municipal water supply to communities which involves routine sampling for indicator organisms. In areas where water samples were collected and tested at specific laboratories as part of the investigations, typhoid fever could not be isolated. District and sub-district services also conduct health promotion activities that includes general hygiene and hand-washing.”
Cape Times