Minister Aaron Motsoaledi on outbreak of food borne disease in South Africa

Media statement by the Minister of Health Dr Aaron Motsoaledi on the outbreak of a food borne disease in South Africa

Good morning ladies and gentlemen.

Let me take this opportunity to thank you for joining us this morning

Firstly let me introduce Dr Juno Thomas, Head of the Centre for Enteric Diseases at the National Institute for Communicable Diseases (NICD), Dr Rufaro Chatora Country Representative from World Health Organisation (WHO), Mr Mooketsa Ramasodi Acting Director General for the Department of Agriculture, Forestry and Fisheries (DAFF), Mr Lionel October Director General for the Department of Trade and Industry (DTI) and Ms P Matsoso Director-General of Health Department.

This press conference is about outbreak of listeriosis.

Listeriosis is a serious, but treatable and preventable disease caused by the bacterium, Listeria monocytogenes. The bacteria is widely distributed in nature and can be found in soil, water and vegetation. Animal products and fresh produce such as fruits and vegetables can be contaminated from these sources.

Infection with listeria may result in the following three conditions:

Flu like illness with diarrhoea including fever, general body pains, vomiting and weakness

Infection of the blood stream which is called septiceamia

Meningoencephalitis (infection of the brain)

Although anyone can get Listeriosis, those at high risk of developing severe disease include newborns, the elderly, pregnant women, persons with weak immunity such as HIV, Diabetes, Cancer, Chronic liver or Kidney disease.

Listeria monocytogenes is a disease that occurs every year and is seen in our hospitals, typically 60 – 80 cases are detected and treated annually. However, in July 2017 Doctors from neonatal units in the Chris Hani Baragwanath and Steve Biko Academic hospitals alerted the NICD about unusually high numbers of babies with listeriosis. This triggered a review of all cases diagnosed in both public and private hospitals.

In October 2017 the Multisectoral National Outbreak Response Team (MNORT) was briefed on the situation in the country.

Tracing from the 1st of January 2017, as of 29 November 2017, a total of 557 laboratory-confirmed listeriosis cases have been reported from all provinces. Most cases have been reported from Gauteng Province (62%, 345/557) followed by Western Cape (13%, 71/557) and KwaZulu-Natal (7%, 37/557). As you can see the three provinces alone are responsible for 82% of the total cases. The remaining 18% is distributed in the remaining six provinces.

The age groups that are most affected are neonates, that means the first 28 of life(37%), and the age group 15 – 49 years (33%). These two groups comprise with 70% of all cases.

Of the 557 laboratory confirmed cases, 34% were from the private health facilities, and 66% were from public health facilities. Given that only 17% of South Africans use private health facilities, this proportion of cases from private health facilities is too high. This indicates that the source of the outbreak is likely to be a food product that is widely distributed and consumed by people across all socio economic groups.

Out of 557 cases, we are certain of the final outcome (discharge or death) for 70 cases. Of these 70 cases 36 persons have died.

Food safety in SA is managed intersectorally by Department of Health, Department of Agriculture, Forestry and Fisheries and the Department of Trade and Industry. Local government is responsible for municipal health services which include the enforcement of food safety legislation. The DTI looks after all aspects of fish and fishery products while DAFF manages meat safety and animal health.

There are four possible sources of listeriosis in general. These are:

Directly at origin e.g. farm

Food processing plant

Retail

Food preparation at home

But we believe for this particular outbreak the most likely possible source is contamination food at orgin e.g. farms and agriculture as well as food processing plants.

The source of this outbreak is currently being investigated, and all the stakeholders are cooperating with the investigation led by the NICD. Environmental Health Officers are following up diagnosed cases and are visiting their homes to sample food where available.

There are 23 private food tasting laboratories that are accredited by SANAS (South African National Accreditation System) which reports to the Department of Trade and Industry. This laboratories have been requested to provide data on listeria to date as well as to provide Isolates to the NICD. Thus far two have voluntarily submitted isolates from food samples. Additionally five food and laboratory associations have also been requested to provide information to their members that have been tasting for listeria. These are:

The South African Meat Processors Association (SAMPA)

South African Milk Processors Association (SAMPRO)

Milk South Africa (MILKSA)

Consumer Goods Council

National Laboratory Association

Please note that Government Laboratory Systems are also communicating their information to the NICD.

The NICD has made information available on their website regarding Listeriosis, including Frequently Asked Questions (FAQs), clinical management guidance, and laboratory testing methodology.

The Food Control Division within the National Department of Health has distributed information about the outbreak to food industry stakeholders. The MNORT is considering to include Listeriosis as a notifiable medical condition.

Whilst we continue with the investigation, the WHO has advised on five keys to food safety, which are the following:

Keep Clean. Wash your hands before handling food and often during food preparation. Please don’t get tired of washing your hands if it means washing hundred times a day, please do it!!

If you are handling or storing raw food, don’t touch already cooked food unless you have thoroughly washed your hands and food preparation utensils. In other words separate raw from cooked food.

Cook food thoroughly, never eat half cooked or uncooked food especially meat products. Food that does not usually need cooking before eating, need to be thoroughly washed with clean running water. For families with no source of clean running water need to boil their water before domestic use.

Keep food at safe temperatures. Food to be kept cold should be refrigerated and food to be served hot should be served hot.

Use safe water for domestic use at all times and use pasteurised milk products. In situations where pastueurization is not possible, for own domestic consumption, please boil the milk prior to use.

Source: Government of South Africa