Cholera outbreak in South Africa: Everything you need to know

South Africa is on high alert after two cases of cholera have been reported in Limpopo. File picture: Pexels

South Africa is on high alert after two cases of cholera have been reported in Limpopo. File picture: Pexels

Published Jan 17, 2024


South Africa is on high alert after two cases of cholera were reported in Limpopo.

Two new cholera cases have been reported in Limpopo and it appears it may be imported cholera.

It is believed that they are two Zimbabwean men.

South Africa has been on the lookout for cases after a state of emergency was declared in Zimbabwe, with around 250 suspected cholera deaths reported last year.

When asked to confirm if it was indeed imported cases, the Limpopo Department of Health spokesperson, Neil Shikwambana told eNCA: “Part of the investigation revealed that two Zimbabwean men who were living and working in South Africa, travelled home for festive season so in the absence of other cases, it was concluded that these could be imported cases.”

Shikwambana said the department was on “high alert” and in talks with stakeholders. There would also be an investigation into water cleanliness.

“Cholera is purely a water-borne disease so if you get your water quality, sanitation and infrastructure correct then you are likely going to avert this kind of challenge,” said Shikwambana.

Vaccines, Treatments, and Symptoms

Cholera, caused by the bacterium Vibrio cholerae, can prove fatal within hours if left untreated. Researchers estimate that annually, there are 1.3 to four million cases of cholera, resulting in 21,000 to 143,000 deaths globally.

However, most infected individuals display either no symptoms or mild ones and can be effectively treated with oral rehydration solutions.

Severe cases often require immediate attention. They involve rapid treatment with intravenous fluids and antibiotics.

Symptoms include severe acute watery diarrhoea, with the potential to cause death if untreated.

The majority of infected individuals exhibit mild or moderate symptoms, typically appearing 12 hours to five days after infection. In a minority of cases, acute watery diarrhoea with severe dehydration can lead to fatal outcomes

Combining oral cholera vaccines with enhanced water and sanitation infrastructure is recommended for controlling outbreaks and preventing the disease in high-risk areas.

Prevention and Control Strategies

A multifaceted approach is essential to control cholera effectively. This includes surveillance, water and sanitation interventions, community engagement, and treatment.

Surveillance involves rapid detection through clinical suspicion and diagnostic tests, while strengthening the capacity to detect and monitor occurrences is crucial for effective control measures.

Water and sanitation interventions, aligned with Sustainable Development Goals, offer a long-term solution to cholera control. Treatment involves prompt administration of oral rehydration solution (ORS) and, in severe cases, intravenous fluids and antibiotics. Mass administration of antibiotics is not recommended due to concerns about antimicrobial resistance.

Community engagement is pivotal, integrating local culture, practices, and beliefs into programs promoting good hygiene practices, safe food preparation, and proper disposal of faeces.

Additionally, oral cholera vaccines, currently consisting of three World Health Organization pre-qualified options, play a vital role in controlling cholera in endemic areas, humanitarian crises, and outbreaks.

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