Outlining the listeriosis outbreak

Listeriosis caused panic in South Africa, as the World Health Organistion (WHO) confirmed that the country experienced the largest outbreak ever recorded. WILLIAM GEORGE spoke to the Department of Health and Bureau Veritas about precautions to take in order lower the risk of contamination and help to curb the epidemic.

Dr Aaron Motsoaledi, Minister of Health, announced in March that the source of the listeriosis outbreak was at the Tiger Brands Enterprise Foods production facility in Limpopo. Other facilities around the country were also identified as possible sources of contamination.

Since then, the Department of Health (DoH) has urged the public to remove the potentially contaminated cold meats from their homes, place them in a bag and preferably return them to the stores from which they were purchased.

By March, the investigations led by the National Institute for Communicable Diseases (NICD) uncovered 900 laboratory-confirmed cases of listeriosis, from which more than 180 people have died. New cases of infection have since also been reported.

Initially, the public was warned that the listeria bacteria can be contracted from soil, water, dairy products, meat, poultry, seafood and fresh produce.

The symptoms of listeria infection include headaches, muscle aches, fever, nausea and vomiting. If the infection spreads to the nervous system, it can cause a stiff neck, disorientation and seizures.

The world’s largest listeriosis outbreak

Previously, the largest outbreak recorded was in the United States of America in 2011. The source was from cantaloupes from Jensen Farms in Colorado. A total of 147 cases were reported and at least 33 people died.

According to the DoH, typically 60 to 80 cases of listeriosis are detected and treated annually in South African hospitals.

“Between January 1, 2017 and February 5, a total of 852 laboratory-confirmed listeriosis cases had been reported to the NICD. Most of the cases (59 percent) were reported in Gauteng, while 13 percent were reported in the Western Cape, followed by seven percent in KwaZulu-Natal.

“Sixty-six percent of the cases were diagnosed in the public healthcare sector, while the rest were diagnosed in the private sector,” the department reported.

The root of the present outbreak

In July 2017, doctors from neonatal units in the Chris Hani Baragwanath and Steve Biko Academic hospitals notified the NICD about the unusually high numbers of babies born with listeriosis.

This triggered a review of all cases diagnosed in both public and private hospitals and led to the official announcement of the outbreak in December 2017.

The NICD interviewed 109 people with the illness to obtain information about their diet in the month before falling ill.

The department confirmed that listeria can affect anybody from any socio-economic background. There are, however, certain categories of people who are particularly vulnerable. “These are the neonate, pregnant women, the elderly and people with compromised immune systems, such as those living with HIV/Aids, diabetes and chronic diseases like cancer, kidney and liver disease,” the department noted.

The recall of listeriosis-causing food

In terms of Section 60(2) of the Consumer Protection Act, the National Consumer Commission (NCC), issued manufacturers of food contaminated with listeriosis with safety recall notices. This was followed by a shutdown of the Tiger Brands factories in Polokwane and Germiston.

Food stores such as Pick n Pay and Woolworths have since recalled the products produced at the factories identified by the Department of Health.

Ongoing testing

“Bureau Veritas recently launched a food-testing laboratory in Cape Town to help to determine food-borne illness (such as listeria) up-front, to ensure safe delivery and transportation of food products,” says Joanne Barton, director of M&L Laboratory Services, a Bureau Veritas group company.

Barton says Bureau Veritas has revealed numerous listeriosis results to the NICD and the WHO.

She adds that testing turnaround time for food is critical and Bureau Veritas can offer short lead times on results to ensure quick intervention to stop releases and consumption.

“It is critical to ensure factory hygiene and also to monitor this. More importantly, the disinfectants used must be ’fit for purpose’ and rotated on a regular basis. Bacteria resistance is half of the problem, and rotation and using good disinfectants is critical,” she stresses.

The National Department of Health has tasked provincial Departments of Health to follow up on cases where outcomes are not known. This is ongoing. The NICD is assisting with this follow-up investigation where possible.

Healthcare workers caring for patients with laboratory-confirmed listeriosis are requested to complete a standardised Case Investigation Form, which includes information on the outcome of disease.

Precautionary measures for the public

The public should further note that listeriosis is found in other foods besides cold meats, including pre-prepared foods, deli foods such as cheese, milk products, fresh vegetables and fruit.

The department has urged members of the public to practice basic food-hygiene principles as outlined in the WHO’s “Five Keys to Safer Food” programme.

The core “commandments” of food hygiene include:

• Keep clean: wash hands before handling food and often during food preparation;

• Separate raw meat, poultry and seafood from other foods;

• Cook food thoroughly, especially meat, poultry, eggs and seafood;

• Keep food at safe temperatures: refrigerate and reheat foods correctly;

• Use safe water, or make it safe (by boiling);

• Choose foods processed for safety, such as pasteurised dairy products; and

• Wash fruits and vegetables thoroughly, especially if eaten raw.

Ventria aims to bring life back in the agricultural field

Like any other industry, the agricultural sector is prone to health conditions, which may result in death. Farmers are faced with risks that include sudden cardiac arrest (SCA).

SCA is caused by an acute and unexpected malfunction of the heart. The heart stops pumping blood and the person loses consciousness and stops breathing. The window to provide treatment is very small, so without early defibrillation, chances of survival are lowered significantly.

“In built up areas emergency services struggle to get there on time, this becomes more challenging in remote areas as emergency services usually arrive too late to administer life-saving interventions, so early defibrillation provided by people already at the scene can be what helps save a life,” says Blake Grace, director of Ventria, a company that supplies automated external defibrillators (AED).

Grace explains: “Ventria has chosen to market the Philips HeartStart defibrillator, which is made for people who have never used a defibrillator before. The device is easy to set up and includes automatic life guidance features – like voice prompts and cardiopulmonary resuscitation (CPR) coaching – to help guide the user through the treatment of sudden cardiac arrest.”

Since many of Ventria’s clients are in the corporate and public-services spheres, part of the company’s service offering includes management of the AEDs. The company’s managed AED services include equipment, maintenance, replenishment and post-event support.

“In order to comply with the Resuscitation Councils and British Heart Foundation, we offer a revolutionary new remote-monitoring tool called SmartLink. This automatically monitors the status of the AED every day, notifying us when an error occurs. This means we can ensure all AEDs are ready for use, anywhere in the world,” Grace adds.

“It is important for first responders to be able to rely on the device and trust that the technology will deliver what it is designed for.

“With the Philips HeartStart AED under our carefree managed AED services this will provide them with the confidence that they are adequately prepared for an SCA, anywhere and at any time,” Grace concludes.