'We are looking everywhere': Phaahla on trigger for cholera outbreak

Health minister Dr Joe Phaahla says though the direct source of the Hammanskraal cholera outbreak is yet to be established, the search is being widened to check if transmission was caused by travel.

“At this stage, we are saying we are looking everywhere. It's still not a certainty, we are looking also into whether it is transmission by travelling. We must get deeper into that. At this stage, our colleagues in the water sector want to do further investigations,” he said.

Phaahla said the City of Tshwane and the department of water & sanitation continue to check water sources for contamination.

He was giving an update on the cholera outbreak on Wednesday.

He said recent cholera incidents could be traced from the cases of two sisters from Diepsloot, Johannesburg, who had travelled together by bus to Malawi in January and returned on January 30. The cases were reported by provincial authorities on February 5.

“A husband of one of the women also subsequently tested positive for cholera after developing symptoms. Subsequently, eight more cases were confirmed, six more in Johannesburg, mainly in Diepsloot and two cases in Ekurhuleni. The last public statement regarding those early cases was by us on March 29,” he said.

Phaahla said these cases were linked to travel to an endemic country, but the two in Ekurhuleni could not be directly linked.

Looking at Gauteng, and Tshwane in particular, Phaahla said the first reported case was a 56-year-old male originally from Giyani, Limpopo, who resides in Musina.

The police officer was enrolled for a three-week course at the SAPS college in Hammanskraal, which started on May 8.

He complained of diarrhoea and vomiting on May 12  and was taken by ambulance to Muelmed Hospital in Pretoria on May 15.

“Laboratory tests confirmed cholera on May 15 and further confirmed by the National Institute for Communicable Diseases (NICD) on May 18. The patient is still in ICU in a stable condition receiving treatment,” he said.

Phaahla said a follow-up by the outbreak response team revealed that students were complaining of gastrointestinal symptoms, with 33 of them seen at various health facilities resulting in eight admissions. All are in a stable condition.

The national health department and Gauteng health outbreak response team were called to Jubilee District Hospital on May 19 and informed about a large number of patients who had arrived with gastrointestinal symptoms since May 15, when the police officer was admitted to Muelmed Hospital.

“We need to just also check as to whether there might have been some contact with people travelling before he came to Hammanskraal. Because of the fact that for many years, the area of Hammanskraal has been known to have challenges with the quality of water, it's very easy for us to take the easy route to think that the source is in the water,” he said.

Phaahla stressed that he was not linking the man to the other cases, but was merely looking at the trends.

“It is possible the gentlemen might have come carrying it from Musina. It is also possible that he might have come to Hammanskraal without it and contracted it there.”

There were no linked cases from Musina, where the policeman lived, he said.

“We are confident that it will be contained,” said Phaahla, adding that no health workers  had become ill due to the outbreak.

Highlighting some of the outbreak interventions, he said a field hospital had been set up in Kanana.

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