South Africa government gives update on Listeriosis outbreak

SOUTH AFRICA – South Africa’s Minister of Health Dr Aaron Motsoaledi has given a statement regarding the outbreak of Listeriosis in the country.

According to the Minister, 727 laboratory-confirmed cases had occurred between January 2017 and 5 January 2018, an increase from 527 cases reported as of 29 November 2017.

However, authorities were fiding it difficult and tedious to find the actual patient from the health facility that had sent the specimen following a positive test in a particular laboratory.

“Now out of the total of 727 laboratory-confirmed cases which we know about, we were only able to trace 134 actual patients, 134/727 is only 18%.

This means that we still have a very long way to go in searching. Out of the 134 traced patients, 61 had passed on.

Of the new cases, i.e. of the 119 new cases found since 5 December 2017, we were only able to trace 5 and 3 of these have passed on.

These 3 are already counted in the total of the 61 deceased,” said Dr. Mtsoaledi said.

The public sector reported highest occurrence of the disease at 65% while the private sector reported 35%, with Gauteng region hit most, followed by Western Cape and KwaZulu Natal regions.

Rapid spread and unusual/unexpected behaviour characteristics of Listeriosis prompted the Department of Health to make an amendment since 5 December 2017 to include Listeriosis among the notifiable diseases.

To trace the source of the outbreak of Listeria monocytogenes, NCID carried a whole genome sequencing (WGS) analysis using clinical, food and environmental isolates.

As of 3 January 2018, 337 isolates had been sequenced and the research from the clinical isolates concluded that the outbreak was as a result of a single strain of Listeria monocytogenes, ST6.

“This ST6 strain has been identified in isolates from all 9 provinces, and this finding supports the current working hypothesis, of a single source of food contamination causing the outbreak, i.e a single widely consumed food product or multiple food products produced at a single facility.

We cannot yet link the clinical isolates obtained from patients to a particular foodstuff or a particular food production site environment,” said the Minister.

According to research carried out by Environmental Health Practitioners on the source of Listeria outbreak on a Tshwane patient hospitalised with Listeriosis in December 2017, they concluded that the abattoir run by Sovereign Foods had Listeria, which could cause illness though not the source of the outbreak.

The abattoir has since been cleared to resume operations.

The abattoir had been closed 2 months earlier by DAFF following concerns of unhygienic conditions and practices.

According to the Minister, efforts to mitigate Listeriosis outbreak include inspection of all food premises within the province, detailed submission on Listeria-positive food items, environmental swabs and Listeria isolates to the NICD by food industry stakeholders.

The minister urged South Africans to practice basic food hygiene principles as outlined in the World Health Organization’s ‘Five Keys to Safer Food’ programme.

He raised concerns that young people are most vulnerable to Listeria accounting for 40% of the cases.

Their mothers likely infect them at birth since 96% of neonates affected had early onset disease.

He made a special appeal to health workers and the public to pay special attention to all pregnant women.

Listeriosis is caused by the bacterium, Listeria monocytogenes widely distributed in nature and can be found in soil, water, vegetation and the faeces of some animals.

It can also be caused by contaminated animal products (including meat, meat products, dairy products), seafood and fresh produce such as fruits and vegetables.

Listeria monocytogenes though treatable, is regarded a virulent organism, especially to young kids, with a reported high mortality rate (sometimes higher than 30%) in the world.

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