During the past month, South African health officials have reported four additional cholera cases, bring the total to 10 since early February.
All new cases were detected in Gauteng Province over the last week, and have been classified as indigenous cases.
Three of the new cases are in the City of Johannesburg and are adults who participated in the same traditional healing ritual. One case is in Ekhurhuleni: a 10-year-old child with no history of travel and no apparent links to other cases. All new cases are recovering.
All cases are in Gauteng Province; no confirmed cases have been reported in other provinces. The cases range in age from 10 to 50 years. In eight cases, Vibrio cholerae was isolated from stool or rectal swab specimens in and further characterised as toxigenic Vibrio cholerae O1 serotype Ogawa; two cases were negative on culture and diagnosed by PCR tests. All isolates have tested susceptible to ciprofloxacin and azithromycin.
The first three cases in this outbreak were imported or import-related cases following travel to Malawi. All subsequent cases acquired infection locally and are classified as indigenous cases.
Some cases reported exposure to, or consumption of, untreated water from the Jukskei and Klip rivers and these are being investigated as possible sources of infection.
While there is an ongoing risk for imported cases following travel from other African countries currently experiencing cholera outbreaks (especially Malawi, Mozambique, Zambia and Zimbabwe), the increasing number of locally-acquired indigenous cases is very concerning.
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