The first cholera death in South Africa in over a decade has the health authorities on high alert.

Health Minister Dr Joe Phaahla this afternoon confirmed the first death linked to the recent cases of cholera. The number of laboratory-confirmed cases has risen to five.

Phaahla said the 24-year-old man lived in the Emandleni informal settlement in Wattville near Benoni in Ekurhuleni. He had no prior local or international travel history.

The patient presented with profuse watery diarrhoea, said Phaahla, and was admitted to the Tambo Memorial Hospital. Tests confirmed his cholera diagnosis. “Sadly, he passed away a few days later,” Phaahla said.

One of the man’s contacts is still in hospital and further investigations are being conducted.

According to the department, the deceased’s body will be transported to KZN for burial and health officials will advise the bereaved family and undertakers of the precautions needed to prevent the spread of the disease.

Fourth case

The fourth case was recorded in a 28-year-old man from Alexandra township in Johannesburg, who also has no travel history.

“The patient presented himself at the Edenvale Hospital Emergency Centre with a four-day history of diarrhoea, vomiting and body weakness.”

A specimen was collected for testing, but the patient was not admitted to hospital. The health department says he was managed as an outpatient, given treatment to take home, and requested to return for his results, which came back positive.

The department said the outbreak response team conducted a case investigation and visited the patient’s residence and workplace the following day.

What is cholera?

Cholera mainly spreads through contaminated or polluted water and the department notes that people can be infected directly through drinking contaminated water or indirectly, through eating contaminated food.

Symptoms include diarrhoea dehydration, vomiting and body weakness.

Members of the public are reminded to maintain hand hygiene to prevent possible transmission.

All people who experience cholera-like symptoms, with or without local or international travel history, are encouraged to immediately visit their nearest health facility for screening and testing to ensure early detection and successful treatment, should they test positive, urges the authorities.

Initial cases

The first laboratory-confirmed infections, detected on February 5, were identified in two sisters who travelled from Johannesburg to Malawi to attend a funeral.

“Both patients had developed symptoms on their return to Johannesburg. One patient presented to a local clinic and was then admitted to hospital. During the case investigation and follow-up of close contacts, the sister reported that she also developed diarrhoea while travelling back from Malawi, but it resolved within a day and she did not seek healthcare.

“A close contact (household family member) of one of the patients was admitted to hospital with diarrhoea and dehydration, and is considered a possible case. Laboratory test results are pending and follow-up of close contacts is ongoing,” the department said in a statement at the time.

The department previously noted that it was working closely with the affected province, the National Institute for Communicable Diseases (NICD) and the World Health Organisation to monitor the situation.

Cholera outbreaks

The NICD says that since January last year, more than 14 African countries have reported cholera outbreaks.

“As of January 31, three countries in the southern African region (Malawi, Mozambique and Zambia) reported ongoing outbreaks. The outbreaks in Mozambique and Zambia are likely linked to the outbreak in Malawi, which has been ongoing since March 2022,” a statement by them reads.

Cholera is not endemic in South Africa. The health department said the country’s last outbreak was in 2008/2009, when about 12 000 cases were reported following an outbreak in neighbouring Zimbabwe.