HomeArticlesMpumalanga reports its first cholera case — and death

Mpumalanga reports its first cholera case — and death

  • A 73-year old Mpumalanga woman has died of cholera. It’s the province’s first cholera case, increasing the number of provinces in South Africa with confirmed cholera infections to four (Gauteng, Free State, Limpopo and Mpumalanga). Twenty six people in South Africa have so far died of cholera.
  • But Health Minister Joe Phaahla says South Africa’s cholera cases have decreased significantly over the past week, particularly in Hammanskraal near Tshwane, where 23 people have died of cholera.
  • Between 17 and 23 May 163 patients with cholera-like symptoms such as diarrhoea, vomiting and abdominal pain, were seen by health workers at Jubilee Hospital in Hammanskraal, and 17 people died. That number has now decreased to 30 such patients between 24 and 30 May with two people dying.
  • In the Free State, where nine cholera cases have been confirmed, no new cases were reported since 23 May.
  • Tshwane has 99 cholera-confirmed cases (some of them laboratory-confirmed, some of them confirmed without testing, based on symptoms patients have). Seven new cases were confirmed in the city between 30 May and 31 May (these cases include the cases from Hammanskraal): three at Jubilee Hospital, one at 1 Military Hospital, one at Eugene Marais Life Hospital, one at Netcare Montana Hospital and one at Odi Hospital.

A Mpumalanga woman, 73, has died of cholera, the health department announced on 1 June, making it the province’s first confirmed cholera infection. The woman died in Mmametlhake Hospital, about 60kms from Hammanskraal in Gauteng, where 23 people have died of cholera. This brings the cholera death toll in South Africa to 26; one person has also died in Ekurhuleni in Gauteng and another in Parys in the Free State.

Cholera has now spread to four provinces — the Free State, Gauteng, Limpopo and Mpumalanga, bringing the number of laboratory and clinically confirmed cases to 121. Laboratory-confirmed cases are verified with a test and clinical cases on the basis of the symptoms a patient has. 

The source of the Mpumalanga infection has not been confirmed.

The country’s first two cholera cases were confirmed on 5 February and imported from Malawi after two sisters from Diepsloot in Johannesburg attended a funeral there and tested positive on their return. 

Malawi is having its worst cholera outbreak ever and the disease has spread to all 29 districts in the country. Between March 2022 and April 2023, the country recorded close to 60 000 cases and about 1 800 deaths.

The World Health Organisation says 13 countries in Africa are experiencing cholera outbreaks and this poses a risk for cross-border infection, as happened in regard to South Africa’s initial infections. Phaahla, however, says South Africa won’t impose travel restrictions on countries with cholera outbreaks. 

Cholera is caused by a germ, Vibrio cholerae, which normally hitches a ride from one person to another through an infected person’s faeces. The bacterium spreads when contaminated sewage isn’t disposed of properly, and then comes into contact with water or food that others consume.

About one in 10 people will have severe symptoms such as watery diarrhoea (the colour of water after you cooked rice in it), thirst and vomiting.

Phaahla says other than routine customs forms, which include questions about whether someone has experienced diarrhoea or stomach aches, no specific measures to detect cholera at border posts have been put in place to prevent people with cholera from entering the country. “We have to rely on people to be honest when they fill out those forms,” he says. 

Eight new cholera cases were confirmed between 30 and 31 May — seven of them in Tshwane: three at Jubilee Hospital in Hammanskraal, one at 1 Military Hospital, one at Eugene Marais Life Hospital, one at Netcare Montana Hospital and one at Odi Hospital. The other case is the Mpumalanga case that the health department announced on 1 June.

But Phaahla says far fewer patients now come to health facilities with cholera symptoms than two weeks ago. For instance, in Hammanskraal near Pretoria, an average of 23 patients per day were seen at Jubilee Hospital between 17 and 23 May, but in the subsequent seven days (24-30 May) that number decreased to four patients per day. Twenty-three people have died of cholera in Hammanskraal. 

In the Free State, where nine cholera cases have been confirmed, no new cases were reported since 23 May.

[ICYMI] Watch the health department’s cholera briefing on 30 May

Some background and our previous coverage

Are you a health worker and would like to know how to spot and treat cholera? Find out from our story on 23 May that breaks it down

How do people get cholera and why is it spreading in South Africa? Dylan Bush and Jesse Copelyn explain the cause of cholera and how it spreads.

[WATCH] How does cholera spread?

But what makes the cholera germ travel fast in South Africa? In our newsletter last week, Mia Malan and Joan van Dyk looked at the role that unfit municipalities — which have failed to provide clean, running water and adequate toilets to several communities — play. 

Recently, cholera was detected in a part of the Vaal River. The department of water and sanitation says the ”original source of the cholera infection” has not been found yet, but it’s likely that the cholera outbreak in Hammanskraal in Tshwane is related to the pollution of water sources in the area from the City’s Rooiwal Waste Water (sewage) Treatment Works upstream of Hammanskraal. The facility hasn’t been well-maintained for many years. 

But the department says tap water in Ngwathe Local Municipality (the municipality for the area of the Vaal River where cholera has been found) in the Free State is safe to drink. It says it has conducted water quality tests on all the sources of drinking water in the area and tests showed that treated tap water doesn’t contain cholera.

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Mia Malan is the founder and editor-in-chief of Bhekisisa. She has worked in newsrooms in Johannesburg, Nairobi and Washington, DC, winning more than 30 awards for her radio, print and television work.

Joan van Dyk was a health journalist, senior health journalist and news editor at Bhekisisa between 2017 and 2023.