U.S. health expert wants South Africa to keep tabs on cholera outbreak

January 10, 2001
Web posted at: 2:44 p.m. EST (1944 GMT)

From staff and wire reports

(CNN) -- As South African and international health authorities vowed to battle cholera outbreaks that have killed dozens of people and infected thousands more, a key U.S. health official called for sharp improvements in public health measures to stop the spread of the disease.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told CNN Wednesday that South Africas current cholera problems were serious, but not insurmountable.

"There have been much, much worse epidemics in previous years," Fauci said. "But what were seeing now, with the 16,000- to 17,000-plus cases, is something that one must pay attention to."

Recently, cholera has been reported in South Africa, Swaziland, Mozambique, Malawi, Zambia and Zimbabwe and appears to be spreading among communities with no access to clean water, despite efforts by health officials and the World Health Organization.

MESSAGE BOARD Reform in South Africa

AUDIO Dr. Anthony Fauci discusses the cholera outbreak in southern Africa Stopping cholera's spread WAV sound South African response to the outbreak WAV sound

Latest figures show 63 people have died since August and 475 new cases have been reported in the past 24 hours, bringing the total number of cases to 16,569, according to Reuters news reports.

South Africa has called in the WHO for advice and funding to combat the epidemic in its eastern province of KwaZulu-Natal.

"This is the season when we expect cholera outbreaks in the subregion and we have not been surprised," said Paul Lusamba, a regional adviser for WHO.

Cholera is caused by a bacterium spread through water and unsanitary conditions, said Fauci, of NIAID, a part of the U.S. National Institutes of Health. The disease causes severe diarrhea -- its victims die from the shock of dehydration.

Despite initial concerns as the number of cholera cases escalated rapidly, the South African health ministry reported that its countermeasures were working.

In a statement, the ministry said the country had surpassed expectations in containing cholera and had kept the fatality rate below 0.5 percent of reported cases.

Fauci agreed that the measures were working, but warned more work is needed.

"So far, it looks like the government of South Africa is responding quite well in the containment of it -- theres no guarantee the country will avoid a larger cholera outbreak," he said.

Economic analysts have warned of a detrimental impact on production if cholera breaks out in the slums of South Africas industrial heartland, the Gauteng province, where a high percentage of the labor force lives.

Fauci

It has been difficult to curb the disease in KwaZulu-Natal because of the remoteness of rural communities, a lack of health care facilities and the dependence of villagers on polluted streams as their only source of water.

The disease has spread across the border, infecting villagers in neighboring Swaziland where seven people have died in the eastern region of Lubombo, bordering KwaZulu-Natal.

Zambian authorities said cholera had been reported in its farming central region but the situation was under control.

Fauci vowed to push for more public health measures across the region to improve sanitation and waste disposal, which would not only suppress cholera, but also control the spread of other diseases.

"Cholera is just one of the things that we need to address in developing nations," he said.

Southern Africa battles cholera outbreaks
January 9, 2001
Mozambique faces disease, more rain
February 22, 2000
Relief workers battle cholera outbreak in East Africa
December 18, 1997

National Institute of Allergy and Infectious Diseases
NIAID - Dr. Fauci
South Africa Department of Health
WHO - Cholera

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