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Cholera: UFS experts provide prevention and treatment tips

28 June 2023 Photo Supplied

Opinion article by Ms Akani Baloyi; Dr Olivia Kunguma, Disaster Management Training and Education Centre for Africa (DiMTEC) at the University of the Free State; and Dr Arishka Kalicharan, Department of Basic Medical Sciences, Faculty of Health Sciences, University of the Free State.

Since the 1800s, many countries globally have had a long history of cholera outbreaks, with several countries experiencing periodic outbreaks and the disease remaining a public health concern. In Africa, countries like Senegal, Malawi, Zimbabwe, the Democratic Republic of Congo, Tanzania and many more have suffered greatly from this water-borne plague.

South Africa is among these countries – one of its major outbreaks, in 2008, killed more than 65 people, with more than 12 000 cases reported. The outbreak spread from Musina in Limpopo to the other provinces. The spread of cholera from Musina was attributed to a 2008/2009 outbreak in Zimbabwe, which affected more than 98 000 people; this was a case of disease contagion.

The 2008/2009 Zimbabwe outbreak was rated the country and the world’s largest ever recorded. Due to its political and economic crises, thousands of Zimbabweans migrated to South Africa. The movement of people from Zimbabwe helped spread the disease, as it is highly contagious. Because South Africa also had its own political and economic issues, cholera started spreading like wildfire. Similarly to Zimbabwe, South Africa is struggling with service delivery by local authorities due to poor governance and corruption.

In an effort to improve Zimbabwe’s health system after that outbreak, the United Nations donated almost $5 million. Despite such a big cash injection, the country’s health system is still not of a standard that can help mitigate and prevent cholera. The country still finds itself losing people due to cholera outbreaks.

The challenge in Africa is that decision-makers suffer from ‘reactive syndrome’, i.e. they wait for an outbreak before intiating activities like surveillance, health promotion, encouraging of laboratory testing, assessing and maintaining boreholes/ municipal water plants, and providing temporary emergency water, sanitation and hygiene. Only when an outbreak is already under way do they remember the existence of emergency and response plans, and then start updating them.

A recent cholera outbreak in Hammanskraal, north of Tshwane in Gauteng, South Africa, had claimed 23 lives by 28 May after residents were diagnosed with diarrhoeal disease due to cholera. In the neighbouring Free State, two deaths had been reported by 9 June.

It has become common knowledge that the main source of cholera infection is poor sanitation, lack of clean water, and contaminated food. But it is important to also know that most people exposed to the cholera bacterium do not get sick. They are unaware they have been infected, unless they start displaying symptoms such as diarrhoea, vomiting, and muscle cramps. Excessive diarrhoea can lead to dehydration, making it difficult for the body to perform basic functions. If left untreated, diarrhoea can be fatal.

The root causes are exacerbated by poor investment in public health and an unsettled political environment, in particular governance of municipalities and neglect of water treatment plants. The prevalence of this preventable infectious disease demands immediate attention from policymakers, health organisations, and society in general. Addressing the root causes, boosting preventative measures, and ensuring access to clean water and adequate healthcare services to eradicate cholera in South Africa is crucial.

How can we mitigate and prevent the spread of cholera?

While we lobby for policymakers or people who hold political power to be called to account and advocate for large-scale investment in establishing and maintaining water and sanitation facilities and the strengthening of public health community engagement, we need to consider some methods the public can explore.

Most infected people will have few to mild symptoms, which can be successfully treated with an oral rehydration solution. This solution replenishes the body’s fluid levels and can treat mild dehydration caused by diarrhoea, vomiting, or other medical conditions. Oral rehydration solutions can be made at home with the following ingredients:

1 litre of preboiled water (an effective way to disinfect the water)
6 level teaspoons of sugar (improves the absorption of electrolytes and water)
½ teaspoon of salt (promotes water absorption, since there is significant fluid loss due to diarrhoea)
1 tablespoon (or a palatable amount) of white vinegar (contains antimicrobial properties for preventing and treating infections)

This solution should be consumed after every loose stool, or as often as possible. If a child has been infected with the disease, in addition to the oral solution, give the child 20 mg (over 6 months of age) or 10 mg (under 6 months of age) zinc per day (tablet or syrup).

We should also always adhere to cost-effective habits such as routinely washing our hands and consuming preboiled water.

There are also three World Health Organisation (WHO) pre-approved oral cholera vaccines, namely Dukoral, Shanchol, and Euvichol-Plus. They all require two doses for full protection. These vaccines are available at the nearest clinic or hospital, and are relatively cost-effective.

Cholera and several other public health crises should not exist in the modern economy we are living in. Africa has the resources needed, including several medical interventions. Africa must address its issue regarding political leadership, which is its biggest challenge. There is an urgent need for proactiveness among our political leaders and government authorities which should see them take the lead in continuous multi-sectoral collaboration. They should invest in preparedness programmes that include training health workers and surveillance. And lastly, there is an urgent need for an accountability system for all the funds donated and invested towards improving a country’s healthcare system.

News Archive

UFS to investigate implementation of quality-monitoring system for SA food industry

2006-02-07

Some of the guests who attended the workshop were from the left Prof James du Preez (Chairperson: Department of Biotechnology at the UFS); Prof Lodewyk Kock (Head: South African Fryer Oil Initiative (SAFOI) at the UFS)); Mrs Ina Wilken (Chairperson: South African National Consumer Union (SANCU)); Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences at the UFS) and Mr Joe Hanekom (Managing Director of Agri Inspec).
Photo: Stephen Collet

UFS to investigate implementation of quality-monitoring system for SA food industry

The University of the Free State (UFS) will be investigating the implementation of a quality-monitoring service for the South African food industry.

This was decided during a workshop to discuss the external quality monitoring in the edible oil industry of South Africa, which was recently held at the UFS.

Major role players in the fast-food sector like Nando's, Spur, Captain
Dorego's, King Pie Holdings, Black Steer Holdings, etc and various oil
distributors like Felda Bridge Africa, Refill Oils, PSS Oils and Ilanga Oils attended
the workshop. Also present was Mrs Ina Wilken, Chairperson of the South African National Consumer Union (SANCU) and key-note speaker of this workshop. She represented the consumer.

These role players all pledged their support to the implementation of this quality- monitoring system for the whole food industry.

The decision to implement this system follows the various malpractices reported in the press and on TV concerning food adulteration (eg the recent Sudan Red Scare), misrepresentation (eg olive oil scandal exposed in 2001) and the misuse of edible frying oils by the fast-food sector.

“One of the basic rights of consumers is the right to safe food. Consumers must be protected against foods and food production processes which are hazardous to their health. Sufficient guarantee of the safety of all food products and food production processes should be implemented. It does not help to have adequate food standards and legislation and there is no manpower to do the necessary investigation or monitoring,” said Mrs Wilken.

The South African Fryer Oil Initiative (SAFOI), under the auspices of the UFS Department of Microbial, Biochemical and Food Biotechnology, currently monitors edible oils in the food industry and makes a seal of quality available to food distributors.

“Last week’s decision to implement the quality-monitoring system implies that we will now be involving also other departments in the UFS Faculty of Natural and Agricultural Sciences who are involved in various aspects of the food chain in an endeavor to implement this quality monitoring system,” said Prof Herman van Schalkwyk, Dean: Faculty of Natural and Agricultural Sciences at the UFS and one of the main speakers at the workshop.

Prof van Schalkwyk said that the main aim of such a system will be to improve the competitiveness of the South African food industry. “It is clear that the role players attending the workshop are serious about consumer service and that they agree that fraudulent practice should be monitored and corrected as far as possible. Although some of the food outlets have the capacity to monitor the quality of their food, it may not seem to the consumer that this is an objective process. The proposed external monitoring system would counteract this perception amongst consumers,” said Prof van Schalkwyk.

The workshop was also attended by representatives from SAFOI and Agri Inspec, a forensic investigation company collaborating with inter-state and government structures to combat fraud and international trade irregularities.

Agri Inspec has been working closely with SAFOI for a number of years to test the content of edible oils and fats. “Extensive monitoring and control actions have been executed in the edible oil industry during the past four years to ensure that the content and labeling of oil products are correct. Four years ago almost 90% of the samples taken indicated that the content differed from what is indicated on the label. This has changed and the test results currently show that 90% of the products tested are in order. However, to maintain this quality standard, it is necessary that quality monitoring and educational campaigns are continuously performed,” said Mr Joe Hanekom, Managing Director of Agri Inspec.

“The seal of quality presented by SAFOI should also be extended to include all the smaller oil containers used by households,” Mrs Wilken said.

The SAFOI seal of quality is currently displayed mainly on some oil brands packed in bigger 20 liter containers, which include sunflower oil, cottonseed oil, palm oil etc which are used by restaurants and fast food outlets. “Any oil type is eligible to display the seal when meeting certain standards of authenticity. In order to display the seal, the distributor must send a sample of each oil batch they receive from the manufacturer to SAFOI for testing for authenticity, ie that the container’s content matches the oil type described on the label. This is again double checked by Agri Inspec, which also draws samples countrywide from these certified brands from the end-user (restaurant or fast food outlets). If in breach, the seal must be removed from the faulty containers,” said Prof Lodewyk Kock, Head of SAFOI.

“It should however be taken into account that oils without a seal of quality from the UFS can still be of high quality and authentic. Other external laboratories equipped to perform effective authenticity tests may also be used in this respect,” said Prof Kock.

“It is also important to realise that any oil type of quality such as sunflower oil, cottonseed oil, palm oil etc can be used with great success in well controlled frying processes,” he said.

Further discussions will also be held with the Department of Health, the SA National Consumer Union and Agri Inspec to determine priority areas and to develop the most effective low-cost monitoring system.

More information on the UFS oil seal of quality and oil use can be obtained at www.uovs.ac.za/myoilguide

Media release
Issued by: Lacea Loader
Media Representative
Tel: (051) 401-2584
Cell: 083 645 2454
E-mail: loaderl.stg@mail.uovs.ac.za
6 February 2006

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