South Africa's Dirty Little Secret: Update

The number of baby deaths in the Ukhahlamba region of Eastern Cape Province has risen to 123, according to an article in Port Elizabeth's "The Herald Online".

I first reported this story on April 23rd. At that time, 80 babies were thought to have died of diarrhea and other complications after having consumed contaminated tap water. The safety of the region's water supply had been compromised by a breakdown in the drinking water treatment system – a breakdown that was allowed to persist for several months.

Until recently, the South African government had done nothing to correct the source of the problem, other than to form a committee to investigate. That committee is compiling a report to present to the health ministry.

According to the latest article, the government has finally taken steps to carry out an emergency upgrade of the water treatment system. Perhaps we have seen the end of this outbreak, at last.

South African Baby Deaths - Still No Action

I referred last week to an article carried in The Herald Online (Port Elizabeth, South Africa) that reported on nearly 80 baby deaths, which were blamed on contaminated tap water in the Eastern Cape province of South Africa.

The Democratic Alliance (DA), a South African opposition party, is calling for an investigation into the handling of this outbreak and the water contamination that preceded it. The DA is suggesting that charges of criminal negligence might be warranted.

The tap water became contaminated as a result of a breakdown in the system last October – a mechanical problem that has yet to be corrected. Residents served by the municipal water system were never notified of the problem.

But the district municipality apparently is still not convinced that the babies died as a result of drinking the polluted tap water. "There is," said municipal manager Zolile Williams, "currently no conclusive evidence that water is the cause." He added that the municipality believed the children (all between 3 days and 1 year old) had not been exposed to contaminated water, since they had access to boiled water.

The municipal authority still has not issued a public health warning to residents.

Food Poisoning Around The World - This Week's Itinerary

This week, our tour of food poisoning venues includes stops in the United States, England, Hong Kong, Bangladesh and Vietnam.

Alabama, USA
Some attendees at a church lunch in Dothan, AL experienced nausea, vomiting and lethargy after their meal. The 28 individuals reported eating "...chicken and rice, green beans and a brownie..." according to a report on WTVY, a local CBS affiliate. The local health department is investigating, and hopes to have some test results within the next 48 hours.

Shropshire, England
A second boy has been diagnosed with an E. coli O157:H7 infection in the last few weeks. Doctors suspected appendicitis at first, but then determined that he was suffering from a severe case of E. coli O157:H7. The victim, whose kidneys have been affected, is being treated in Birmingham Children's Hospital. Health officials are of the opinion that this case is not connected with an earlier case of E. coli O157:H7 in the same part of the country.

Hong Kong (via Cambodia)
Ten members of a tour group developed symptoms of dysentery after returning from a trip to Cambodia. The five men and five women, aged 26 to 65, complained of fever, abdominal pain and diarrhea. Hong Kong's Centre for Health Protection is contacting other tour participants to determine whether there were any more victims.

Bangladesh
Warm weather is exacerbating an outbreak of diarrhea in this country. The International Center for Diarrhea Disease Research in Dakka received 418 patients on April 17th, and an additional 221 by 3pm on April 18th. The situation is not expected to improve as long as the weather remains hot.

Vietnam
Finally, we return to Vietnam for an update on this Southeast Asian country's cholera outbreak. Health authorities have received reports of more than 1,800 cases of acute diarrhea in 19 cities and provinces since March 5th. Cholera has been confirmed in 326 patients. The outbreak is still confined mostly to the northern part of Vietnam, including the cities of Hanoi and Hai Phong.

The country is trying to address the underlying causes of the outbreak. The Health Ministry has announced that it will spend US$80 million on six new food safety programs, and the government has been dredging and disinfecting contaminated waterways in an effort to control the spread of the cholera.

That's this week's whistle-stop tour. Watch for the next installment in a few days.

Ten Reasons To Avoid Raw Milk - Part One

Yesterday, I posted a warning about raw milk in Washington State that is being recalled due to the presence of Campylobacter. I promised to talk about the reasons to avoid drinking raw milk or eating other dairy products (such as cheese or yogurt) made from unpasteurized milk.

Reason #10. Rabies
Rabies is usually present in the saliva of an infected animal and is transmitted by a bite. But there is some question as to whether rabies might also be present in milk. In the 1990’s a total of 88 people in Massachusetts received rabies vaccine treatment after drinking raw milk from a cow that later was diagnosed with rabies.

Reason #9. Mycobacterium tuberculosis and M. bovis
These bacteria can be transmitted in the milk of infected cattle and cause tuberculosis.

Reason #8. Mycobacterium paratuberculosis
This species causes Johne’s disease in cattle and is believed to trigger Crohn’s disease.

Reason #7. Chronic Diarrhea Syndrome (Brainerd's Disease)
It’s not always possible to figure out what causes a disease. In 1983-84, more than 120 people in Brainerd, Minnesota were afflicted with chronic diarrhea lasting at least one year for many of them. While the precise cause of the illness was never discovered, the cases were clearly linked to raw milk from a single dairy. Other outbreaks of this syndrome have been reported since the 1980s - always linked to drinking raw milk or untreated water. The cause is still a mystery.

Reason #6. Brucella abortus
This pathogen has been mostly, but not completely, eradicated from cattle in the U.S., Canada and many other developed countries, thanks in part to the development of a vaccine and to the culling of diseased cattle. Unfortunately, it remains a serious problem in many less-developed countries in Africa, Asia, and Latin America, including Mexico. Undulant fever, which is transmitted in the milk of infected cattle, is a long-term, chronic disease that is difficult to treat and is known to cause miscarriages. The bacteria are killed by pasteurization, but are very content to survive in cheeses made from unpasteurized milk.

Tomorrow, I'll cover Reasons #1-5.