SITUATION UPDATE ON LISTERIOSIS OUTBREAK, SOUTH AFRICA

Date of issue: 25 January 2018. Issued by: Centre for Enteric Diseases and Division of Public Health Surveillance and Response

Summary
 The outbreak continues, with 53 additional cases recorded since the last update. However, 45
13 of these cases occurred during 2017 and have been retrospectively reported. 40
 Outcome data is now available for 29% (238/820) of cases, of which 34% (82/238) died. NC
35
 At present, the source of the outbreak is not known. NW
 Municipal Environmental Health Practitioners in all provinces have embarked on systematic 30
FS

Number of cases
inspection and sampling of meat & poultry production, processing, and packaging facilities. 25
LP
 Cases of listeriosis will continue to be investigated, with trace back and further investigation 20
of any positive food/environmental samples. MP
15
 EC
10
As of 23 January 2018, a total of 820 laboratory-confirmed listeriosis cases have been KZ
reported to NICD since 01 January 2017 (Figure 1). Most cases have been reported from 5
WC
Gauteng Province (59%, 486/820) followed by Western Cape (13%, 105/820) and KwaZulu- 0
GA

33

39

45

51
11
13
15
17
19
21
23
25
27
29
31

35
37

41
43

47
49
1
3
5
7
9

1
3
Natal (7%, 59/820) provinces. Cases have been diagnosed in both public (66%, 542/820) and
private (34%, 278/820) healthcare sectors. Diagnosis was based most commonly on the 2017 2018
isolation of Listeria monocytogenes in blood culture (71%, 579/820), followed by CSF (23%,
Epidemiological week
188/820). Where age was reported (n=784), ages range from birth to 93 years (median 18
years) and 42% (329/784) are neonates aged ≤28 days (Figure 2). Of neonatal cases, 96% Figure 1: Epidemic curve of laboratory-confirmed listeriosis cases by epidemiological
(317/329) had early-onset disease (birth to ≤6 days). Females account for 55% (431/783) of week and date of sample collection and province, South Africa, 01 January 2017 to
cases where gender is reported. Final outcome data is available for 29% (238/820) of cases, 23 January 2018 (n=820)
of which 34% (82/238) died.

Note: 350
 Case data is the best available at time of publication. 300
 Due to challenges with NHLS laboratory information system data (since epidemiological 250

Number of cases
week 47) and a possible lag in reporting as a result of the public holidays, case numbers are 200
likely to change and trends must be interpreted with caution.
150
100
 All healthcare workers are requested to complete case investigation forms (CIFs – available 50
on the website) for case-patients with listeriosis, and submit these to the NICD 0
(outbreak@nicd.ac.za ). Neonates (≤28 1 month - 14 15 - 49 years 50 - 64 years ≥65 years
 Clinical listeriosis management guidelines are available on the website (www.nicd.ac.za). days) years Age group
 Where clinicians suspect listeriosis but specimens (including CSF and blood) are culture
negative, a polymerase chain reaction (PCR)-based test can be performed at the NICD. PCR Figure 2: Age distribution of laboratory-confirmed listeriosis cases, South Africa,
can also be performed on placenta samples for investigation of stillbirths/miscarriages. 01 January 2017 to 23 January 2018 (n=820)
Please contact the Centre for Enteric Diseases on (011) 555 0343 for further details
 The NICD continues to operate its 24-hour hotline for healthcare workers.