Minister of Health Dr Aaron Motsoaledi. Picture: SIYABULELA DUDA
Minister of Health Dr Aaron Motsoaledi. Picture: SIYABULELA DUDA

The death toll from the listeriosis outbreak could be much higher as countries in the Southern African Development Community (Sadc) region do not have testing and monitoring to detect listeriosis cases.

The disease is not a notifiable disease across Southern African countries‚ meaning doctors are not reporting each case to a centralised authority.

On Thursday, Health Minister Aaron Motsoaledi and Sadc health ministers and ambassadors held an emergency high-level interministerial meeting in Johannesburg to discuss the world’s largest listeriosis outbreak that started in SA.

Many of the countries represented at the meeting import Tiger Brands’ Enterprise polony and cold-meat products. The Tiger Brands Polokwane factory had the ST 6 strain of listeria‚ which is responsible for 91% of all South African listeriosis patients‚ in 26 places.

There have been 967 confirmed cases and 183 deaths from listeriosis in SA. But only one patient with listeriosis has been identified in the rest of Southern Africa despite many countries importing implicated products. Namibia recorded a patient on March 12.

In the high-level meeting‚ the South African health department gave advice and scientific expertise on the disease. Motsoaledi also said he did not think there would only be one case outside of SA.

“It did arise in the meeting that countries might not be able to detect something like this,” Motsoaledi said.

He said few also had the ability to do DNA testing of listeriosis strains and SA had offered expertise if needed.

The minister said there may be multiple reasons for the lack of cases outside of SA. One was that SA had the largest HIV burden in the world and HIV may make people more susceptible to listeriosis.

The disease is particularly dangerous for pregnant women‚ elderly people and people with weakened immune systems.

“We don’t know the role and the incidence of HIV and AIDS in this whole thing,” said Motsoa-ledi. “We have the highest prevalence of HIV [in the world]. All of those things [are] still going to be discussed.”

Swaziland’s health minister‚ Sibongile Ndlela-Simelane‚ said her country had not detected cases but “appreciated the capacity of South Africa to help identify deaths and cases”. She suggested Swaziland was not able to measure cases.

Many officials had high praise for SA despite the implicated products having origina-ted in the country.

Mauritius High Commission second secretary Jevin Pillay said: “The Sadc is a big family. We have always trusted our partners. Mauritius wishes to congratulate South Africa for being so proactive on this.”

Motsoaledi said 35% of listeriosis patients were using the private sector when treated. About 65% of patients were seen in public hospitals and he was exceptionally pleased that it was public sector hospital doctors who had picked up cases in the middle of 2017 and then notified the National Institute for Communicable Diseases about a possible outbreak.

He also said although the Constitution gave municipalities the power to carry out health inspections of food processing factories‚ many were not sophisticated enough to challenge large corporations.

The minister said small municipalities were not matched to the “firepower of well-advanced factories”.

Motsoaledi wants the nat-ional health department to employ health inspectors‚ known as environmental health practitioners.

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