Cape Town: The National Institute for Communicable Diseases (NICD) have confirmed an outbreak of enteric fever (commonly known as typhoid fever) in the Western Cape and North West provinces.
The NICD said it was working with provincial authorities to track and contain the outbreak.
Typhoid fever is endemic to South Africa and is caused by Salmonella Typhi.
Prevalence of the disease is lower than most other countries in sub-Saharan Africa. While it is a notifiable medical condition in South Africa, reported cases significantly underrepresented the true number of cases.
Children are at a higher risk of contracting typhoid fever.
The head of the centre for enteric diseases, Dr Juno Thomas, said that diagnosing typhoid fever was generally difficult as the person doesn’t present with anything typical.
“It can be more like a flu-like illness, fever, fatigue, headache, nausea. Some people may also have abdominal symptoms like pain, constipation or diarrhoea.”
She said that even when the symptoms seemed to go away, people could become carriers and spread it to others through their faeces. Contaminated food and water supply could also be a source of transmission.
“In the last few years, there has been an extremely drug-resistant typhoid fever strain and that makes it very difficult to treat these patients. It can be diagnosed in a blood culture,” Thomas said.
South Africa usually saw fewer than 150 cases of typhoid fever annually.
However, Thomas said the number of cases had been increasing, especially in the affected provinces with cases dating from 2020.
The last time the country had a big outbreak of typhoid fever was in 2005, in Delmas, Mpumalanga, where almost 3 000 cases were recorded. The outbreak was caused by contaminated water.
Yhe Western Cape has reported 64 cases in three separate outbreaks in the Cape Town Metro health district, the Cape Winelands and the Garden Route. The North West has reported 18 cases in the Dr Kenneth Kaunda district.
The NICD is using genome sequencing, similar to one used in 2017/2018 during the listeriosis outbreak, to investigate all cases. This is said to assist investigators in tracing the clusters of infections and the common source of the infection.