Officials tracing three cluster outbreaks of typhoid fever across Western Cape
Health officials are investigating four outbreaks of typhoid fever in South Africa in order to track down the potential sources of infection. The National Institute for Communicable Diseases (NICD) has reported three outbreaks in the Western Cape and one in the North West. Dr Juno Thomas from the NICD says although typhoid fever is common in South Africa; there has been a notable increase in transmission in some areas. Typhoid fever, also called enteric fever, is a bacterial infection that is caused by a bacterium called Salmonella typhi. It is spread by drinking contaminated water or eating contaminated food.
Experts have detected three different cluster outbreaks in the Western Cape; in the City of Cape Town, the Cape Winelands and the Garden Route.
Dr Thomas says cases have increased in the Western Cape in the past two years. In 2020, she says there were a total of 31 cases across the province. Last year, the number of cases rose to 48. This year, there are currently 64 cases. “There is this ongoing but low-level transmission because the number of cases overall for the Western Cape have not been huge.”
According to Dr Thomas, people who live in areas without proper water supply and sanitation infrastructure are at a greater risk.
The last major outbreak of typhoid fever in South Africa was in Delmas, Mpumalanga in 2005. It was caused by human waste in one of the boreholes.
"It's not a dramatic outbreak like what we saw in Delmas but it does show us that there is some transmission happening within those communities that we've got the potential to investigate and perhaps address whatever sources there are for transmission", Thomas added.
She says officials can only monitor the ongoing transmission of typhoid fever by conducting blood culture tests on patients who are admitted to healthcare facilities where there is access to the necessary lab testing facilities.
Because many patients often present with flu-like symptoms, Thomas says that cases are going undiagnosed and healthcare professionals are not testing for it.
As a result, she believes that the number of reported cases does not accurately reflect the number of actual cases in the country. “If you aren't testing and you aren't diagnosing the cases, it means that it results in ongoing transmission.”
She added, “It's nothing new in the country. Like many other lower-middle-income countries, we have typhoid all-year-round across the country but every now and then we also get what we get clusters of diseases where there are perhaps more cases than we expected in a particular area amongst particular communities.”