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09/01/18: Death toll from South Africa’s listeriosis outbreak doubles in a month

unnamedThe origin of the outbreak remains a mystery, but a Sovereign Foods abattoir has been closed after listeria bacteria were found there.

The death toll from the listeriosis outbreak plaguing SA has nearly doubled in the past month, to 61 from 36, as SA grapples with an outbreak that experts say is the worst on record, worldwide.

The origin of the outbreak remains a mystery, though researchers have confirmed it probably has a single source.

Nonetheless, a Sovereign Foods abattoir has been closed, after listeria bacteria were found there.

Sovereign Foods, which is based in the Eastern Cape‚ is one of the major poultry producers in Africa. The company delisted from the JSE on November 22, concluding a management buyout funded by private equity firm Capital works.

But Health Minister Aaron Motsoaledi said the strain found at the abattoir was not the ST6 strain responsible for the deadly outbreak.

He told a briefing in Pretoria on Monday that a chicken sample collected from the fridge at a patient’s home tested positive for Listeria monocytogenes.

This chicken was traced back to the store and then traced back to the abattoir. It was sourced from Sovereign Foods‚ he said.

However‚ all samples collected from the abattoir have so far failed to pick up the ST6 strain of the outbreak that the country is experiencing.

As a consequence‚ authorities cannot yet link clinical isolates obtained from patients to particular foodstuffs or a food production site.

As a precaution‚ the abattoir was served with a prohibition notice pending further investigations.

“At this juncture, we cannot conclude that the abattoir called Sovereign Foods is the source of the present outbreak. But we can conclude that it has listeria, which can cause illness, and hence it was in the best interest of public health that the abattoir was prohibited from further preparing food pending the cleaning of the environment and meeting certain conditions given to them,” he said.

He said that the number of cases of listeriosis confirmed via lab testing had increased from 557 in early December to 727 at the latest count.

Food scientists are now calling it the worst documented listeriosis outbreak in global history.

Motsoaledi told reporters that even though more cases were confirmed in laboratories, the department was still a long way from tracing all patients as well as the source of the outbreak.

“Now out of the total of 727 laboratory confirmed cases which we know about, we are only able to trace 134 actual patients, which is only 18%. This means that we still have a long way to go in searching. Out of the 134 traced patients, 61 had passed on,” said Motsoaledi.

He said the department had taken a number of measures to fight the outbreak, including declaring listeriosis a notifiable condition for the first time in history; conducting genome sequencing analysis on samples; and checking with potential source areas that hygiene guidelines were being followed.

The minister said 91% of the isolates were ST6 type isolates, a finding that supported the hypothesis that a single source of food contamination may have caused the outbreak from one or more food products at a single facility.

However, he said such a food product or facility had not yet been found definitively.

Rufaro Chatora, the country representative of the World Health Organisation, said SA had done well to declare the listeriosis as a notifiable condition. He said while the condition had been found in France, the US and Denmark, SA’s latest outbreak were one of the longest.

Acting director-general of the Department of Agriculture, Forestry and Fisheries Markets Ramasodi said the department was compiling a list of countries, including Brazil, where it was considering a precautionary and temporary ban on the import of foods that could have been contaminated through unhygienic practices.

He said the department was not aware of any country which intended to ban South African goods as a result of the latest outbreak.

Listeriosis has a relatively high mortality rate — 20%-25% — compared with illnesses caused by most other food-borne pathogens. Less than 1% of people who get Salmonella or E. coli O157 die as a result.

Neonates — babies younger than 28 days old — remain the most affected by listeriosis.

Also at great risk of contracting it are pregnant women — 20 times more at risk than other healthy adults — along with those over 65 and people who have weakened immune systems‚ due to HIV/AIDS‚ diabetes‚ cancer or organ transplants.

The outbreak is across all nine provinces and clinical tests have revealed that the listeria originates from a single source — “most likely a food product on the market or a series of food products produced in the same manufacturing environment”, says Dr Lucia Anelich‚ a prominent South African food microbiologist and food safety expert.

“I concur with my colleagues from business‚ academia and governments‚ in Europe‚ Australia‚ Canada and the US‚ that this is the worst documented listeriosis outbreak in global history,” she said.

Foods that have caused outbreaks are typically contaminated by the environment during manufacturing‚ processing or packing.

“Avoiding cross-contamination from raw to cooked foods is of immense value in preventing food-borne disease in general in the home‚ in restaurant environments and in the manufacturing sector, and is thus just as applicable to listeriosis,” Anelich said.

Foods most often implicated in foodborne outbreaks globally are deli meats (polony‚ ham etc) and hot dogs; refrigerated pâtés or meat spreads; unpasteurised (raw) milk and dairy products; soft cheese made with unpasteurised milk‚ such as feta‚ brie and camembert; refrigerated smoked seafood; and raw sprouts and pre-packaged salads.

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