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Gauteng Health department issues urgent warning after huge spike in child food poisoning cases

Gauteng Health department issues urgent warning after huge spike in child food poisoning cases
Takudzwa Pongweni
By Takudzwa Pongweni
5 Sep 2024
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The Gauteng Department of Health has raised an urgent alert following a dramatic increase in foodborne illnesses among children. Recent incidents have resulted in several fatalities, with the province reporting 207 cases and 10 deaths since February 2024.

On 29 August 2024, two serious incidents were reported. At Dr George Mukhari Academic Hospital in Pretoria, two young brothers, aged 4 and 6, died from a suspected foodborne illness after eating pap and soup at home. A 3-year-old cousin, who did not eat the same food, was observed and discharged as asymptomatic. 

In Vosloorus, three children, aged 3, 5, and 6, were taken to Jabulani Dumane Community Health Centre with symptoms of vomiting and weakness. The 3-year-old and 5-year-old died on arrival, while the 6-year-old was stabilised and transferred to Thelle Mogoerane Regional Hospital, where he remains in critical condition. The children had shared potato chips with a 28-year-old uncle, who also showed symptoms but was later discharged.

Read in Daily Maverick: Joburg authorities crack down on spaza shops after deaths and community outrage

The Gauteng Department of Health has since issued a warning to parents and caregivers to exercise extreme caution to protect children from foodborne illnesses. This alert comes amid a troubling rise in food poisoning cases affecting children in townships, informal settlements, and hostel communities.

Since February 2024, Gauteng has reported a staggering 207 food poisoning cases among children, with 10 resulting in fatalities. Ekurhuleni district has been the hardest hit, recording 119 cases and four deaths, followed by Johannesburg with 40 cases, Pretoria had 31 cases resulting in three deaths, while West Rand district had 14 cases and Sedibeng district had three cases and three deaths.

Common sources of foodborne illness


Mthokozisi Nkosi, a food safety and public health expert, highlights that foods of animal origin — like raw meat, poultry, eggs, milk, and shellfish — are common sources of foodborne illness. Fruits and vegetables can also be risky, especially in areas with contaminated water. Ready-to-eat products, such as cold meats and vienna sausages, are also prone to contamination.

The causes of food safety issues are varied, but often stem from inadequate manufacturing practices and failure to ensure suppliers meet food safety standards. For instance, meat processors should source from registered abattoirs to ensure the meat has undergone the necessary checks. Buying from unregistered sources increases the risk of contamination and diseases, like tuberculosis, which can affect the entire supply chain.

In production facilities, handling large volumes of products creates an environment where pathogens can thrive. Proper cleaning and training are crucial. This includes using the right equipment and ensuring food handlers are well trained to understand the risks associated with the food they handle.

“Without proper training, handlers might not recognise the dangers, such as the risk of E. coli contamination from improper handwashing, which can lead to serious illness if faecal matter contaminates the product that consumers purchase,” said Nkosi.

Growing concerns over food fraud


Fraudulent foods are becoming more common and include products from unregistered facilities, those manufactured in different countries without proper oversight, or items containing illegal ingredients. Some examples include diluted or contaminated beverages, counterfeit alcoholic beverages, counterfeit spices, and falsely labelled expired or low-quality food items.

“For example, they would use ingredients that are supposed to only increase the economic value of the food, but not necessarily the nutrient density or the quality of the food. They are only focusing on the fact that we need to supply consumers with this particular product,” said Nkosi.

The presence of fake foods poses significant risks to public health and safety in South Africa. If you, as a consumer, observe any illegal activities related to the manufacturing, preparation, or selling of food, you should report them to the environmental health practitioners in your municipality. 

“The municipality is your first point of contact. Environmental health practitioners, empowered by law, work with the South African Police Service or metro police to shut down non-compliant facilities. The municipality’s Department of Public Health, community safety, or environmental health will send environmental health practitioners for inspection, and if a facility fails to meet regulations, it can be legally closed,” said Nkosi.

When purchasing food products, Nkosi highlighted several key factors to ensure safety:

  1. Store reputation: assess whether the shop values its reputation and consumer safety by providing products that do not compromise health.

  2. Packaging information: check for essential details on the packaging, such as expiry dates, traceability information (e.g. batch codes) and manufacturer contact details.

  3. Storage conditions: be aware of red flags like improper storage temperatures for temperature-sensitive products. For instance, if items that should be kept at low temperatures are not, this is a concern.

  4. Product condition: look for signs of poor handling, such as expired vegetables, unlabeled products, or careless storage that exposes products to environmental contaminants.

  5. Hygiene issues: watch for pests like flies or rodents, and signs of poor sanitation, such as droppings, which indicate potential health risks.


Nkosi added that when buying food from street vendors or informal traders, similar food safety principles applied.

“For cooked foods, I think that maybe the risk profile is reduced, for example amagwinya, the risk profile is less but with raw meat it doesn’t matter where you buy it, the cleanliness of the facility and compliance with temperature requirements still matter,” he said. 

Non-perishable foods, provided that they come from reputable brands, are typically safe and consumers should check the condition of fruits and vegetables for signs of spoilage before purchasing them, and always wash them before consumption.

How education, community action can curb outbreaks


Nkosi suggested that schools were an effective setting for food safety education due to their controlled environment, which allowed for the use of visual aids and real-life case studies. He highlighted that threats like the Listeriosis outbreak and Covid-19 were invisible but devastating, underscoring the importance of using visual aids to teach about harmful bacteria and their serious health impacts.

Gauteng MEC for Health and Wellness, Nomantu Nkomo-Ralehoko, expressed deep concern over the rising death toll and outlined the steps being taken to address the crisis. 

“We are working with various stakeholders and the Gauteng Department of Education to raise awareness in townships, informal settlements, and hostel communities and implement health education sessions in schools. These sessions cover crucial topics such as hand hygiene, proper food handling, water hygiene, and sanitation.”

Local municipalities, backed by environmental health teams, are increasing inspections and pushing small businesses in townships, informal settlements, and hostel areas to obtain compliance and zoning certificates, with non-compliant vendors facing fines and possible closure. Outbreak response teams are intensifying food safety health education and will be conducting an awareness blitz in Pretoria and Ekurhuleni in the coming days

Regulations in place but enforcement lacking


Nkosi said there was always room for improvement when it came to food safety regulations, although it was not the regulations that were a problem, but rather the lacklustre implementation of the regulations. 

An example of this is South African Regulation R638 of 2018 for Food Premises that outlines the standards for maintaining hygiene and food safety in establishments such as spaza shops. It mandates regular inspections and requires environmental health practitioners to enforce these standards, offer guidance to shop owners, and address violations, including the sale of counterfeit foods. Unfortunately, compliance with this requirement is not consistently enforced by municipal inspectors before issuing food trading permits or certificates of acceptability.

“The problem is the inspectors themselves, they don’t enforce the regulation when they do inspections. They don’t do thorough inspections, they don’t do follow-ups,” he said.

Inspection frequency depends on the risk profile of the facility. High-risk establishments should be inspected every three months, moderate risk ones every six months, and low-risk facilities at least once a year,  Nkosi said.

“However, there is a severe shortage of environmental health practitioners — World Health Organization guidelines recommend one environmental health practitioner for every 10,000 people, but currently the ratio is approximately one environmental health practitioner for every 35,000 to 40,000 people, so across the board there is a dire shortage,” he said. 

From reactive measures to proactive oversight


Nkosi highlighted that the core issue with food safety was the government’s reactive approach. Regulations were typically introduced in response to specific incidents, such as those involving meat or peanuts, rather than through a comprehensive review of all food sectors. A more effective strategy would be a holistic assessment of all industries to prevent recurring problems.

Currently, regulations focused on specific sectors like dairy or processed meat, with varying standards for microorganism testing. There was no uniform standard across all food categories, and facilities often relied on general frameworks like Codex Alimentarius.

Neglected inspections in townships pose growing risks


Townships often received inadequate inspection attention, and it was widely acknowledged that spaza shops in these areas presented significant risks.

“But there isn’t any strategy or a proactive approach to look at these shops that are located in townships, affecting township communities, how to actually make sure that our most vulnerable communities are not affected. And their risk is slightly different because they have fraudulent foods as well,” said Nkosi. 

“I think that is a huge, huge gap where incidents of food fraud are coming up, and there isn’t really a strategy that speaks to food fraud.”  DM

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