The Public Health Bulletin of South Africa (PHBSA) has laid bare the scale and severity of a foodborne disease (FBD) outbreak at a Cape Town restaurant earlier this year. It also highlights broader cracks in South Africa’s food safety surveillance system.

FBDs can stem from various hazards, including microbiological agents (such as bacteria, viruses, and parasites) and chemicals (like environmental pollutants, natural toxins, and food allergens). These hazards can lead to over 200 diseases, ranging from acute gastroenteritis to chronic illnesses, cancer, permanent disability, and even death.

The bulletin detailed the outbreak investigation and public health response after a clinician alerted the National Institute for Communicable Diseases (NICD) to several gastroenteritis cases, all traced back to the same restaurant.

The suspected FBD outbreak was swiftly escalated, prompting action from the Communicable Disease Control unit in the Western Cape.

According to the PHBSA report, 46 individuals were identified as symptomatic. All had either eaten at or worked at the restaurant. Rectal swabs or stool samples were collected from 49 individuals, and lab testing revealed that 33 were positive for Shigella spp. or Enteroinvasive Escherichia coli (EIEC). This included six patrons and 27 staff members.

Shigella and EIEC are closely related gram-negative bacteria known to cause gastroenteritis in humans. Both are among the “big six” foodborne pathogens flagged by the U.S. Centers for Disease Control and Prevention (CDC) and are commonly transmitted through infected food handlers or contaminated food.

While the outbreak’s definitive source could not be identified, which is a frustratingly common outcome in FBD cases, investigators explored multiple plausible pathways. These included contaminated food, infected staff, and surface transmission.

The bulletin also highlights the extent to which FBD outbreaks are under-investigated nationally. Between March 2018 and August 2020, South Africa recorded 337 FBD outbreaks. Only 129 (38%) were actively investigated. Of these, just 14 (11%) underwent comprehensive analysis combining lab, environmental, and epidemiological data.

The Bulletin reminded the public that foodborne diseases aren’t limited to short-term stomach bugs. They can stem from a wide range of hazards including bacteria, viruses, parasites, chemicals, toxins, and allergens. These can lead to more than 200 acute and chronic conditions, including cancer, lifelong disability, and death.

With an estimated 91 million FBD cases and 137,000 related deaths per year in Africa alone, the stakes are high. The gaps in South Africa’s response infrastructure are cause for concern.

Provincial Field Epidemiologist in the Western Cape and the National Institute for Communicable Diseases, Janine Bezuidenhoudt, who is also the lead author of the study “Investigation of a foodborne disease outbreak linked to a restaurant, City of Cape Town Metropolitan, Western Cape Province, South Africa, February 2024,” said documenting this outbreak thoroughly was critical to strengthening future investigations.

“We need national Shigella guidelines to guide outbreaks caused by Shigella,” she said. “It is important for individuals with a foodborne disease to access healthcare for proper clinical management and that specimens are collected. Clinical specimens are needed to identify the causative organism and to enable the implementation of appropriate public health measures.”

tracy-lynn.ruiters@inl.co.za

Weekend Argus 

Source link