An outbreak of cholera has been confirmed in Harare, Zimbabwe. The World Health Organization (WHO) announced that as at 11 September 2018, almost 2 000 suspected cases including 24 deaths were reported. The outbreak is linked to inadequate supply of safe piped water and subsequent use of unsafe water supplies (including boreholes and wells). As of 13 September 2018, there are no confirmed or suspected cases of cholera in South Africa. However, there is a significant risk that travellers from the outbreak-affected area may present with cholera in South Africa. Healthcare workers countrywide, especially those in Limpopo Province, should be on high alert for suspected cholera cases.

Healthcare workers should suspect cholera in a person of any age presenting with acute onset of watery diarrhoea (with or without dehydration), especially if there is a history of recent travel to/from Zimbabwe.

Any suspected case should be immediately notified to the relevant Department of Health officials. Healthcare workers should ensure that stools or rectal swab specimens are collected from suspected cholera cases. Specimens should be sent in Cary-Blair transport medium to the laboratory with a specific request for cholera testing. Healthcare facilities and laboratories should have adequate resources for specimen collection, laboratory testing, and management of cases.   The public, especially those living in close proximity to the South African–Zimbabwe border, are encouraged to use safe water and practice good hygiene to reduce the risk of cholera and other diarrhoeal diseases.

  1. Always use safe and clean water for drinking, washing food, washing cloths and bathing. Most municipal water supplies (tap water) are safe to drink.

If you think your water may be contaminated, the following can help make it safe to drink:

  1. Boiling: Place water in a clean container and boil it for at least 5 minutes.
  2. Bleach: Add 1 teaspoon of household bleach (containing 5% chlorine) to 20-25 litres of water. Leave it to stand (in a clean, closed container) for at least half an hour before use.
  • Water purification tablets: These can be bought at your local pharmacy. Follow the instructions on the packaging.
  1. Store safe water in a clean, closed container. Use a clean cup each time to scoop water from the container, or pour water directly from the container when you need it.
  2. Always practice good hand hygiene. Wash hands with soap and water after going to the toilet, before cooking, and before eating.
  3. Use clean and safe water for cooking. Wash foods before eating. And cook foods thoroughly.
  4. Keep your household and community clean.

Additional information on cholera can be accessed on the NICD website: www.nicd.ac.za, Diseases A-Z, under ‘Cholera’