Growing death toll in South Africa’s coronavirus outbreak

Deaths and serious injury reports from the virus are up after an outbreak of the disease at Durban’s Sanatorium hospital in June 2016.

Strikes and crowded conditions are likely to make it harder to contain the outbreak

Lets get this straight: two children are going to hospitals or emergency departments in South Africa every two hours because of the rising number of cases of suspected human coronavirus (HCMV). The emergence of the virus in the country is a challenge, a source of safety concerns and a potential public health crisis.

The National Health Laboratory Service (NHLS) confirms more than 15,000 medical cases a year, a third of which are confirmed as flu. Hospitalisations from HCMV are rising, with reports of 29 children in isolation and 35 hospitalised children between October 2017 and December 2017.

Hospital admissions in the upstate area where these cases are happening are also rising, with child admissions from early April 2017 up 46% on the same period last year.

This is a worrying trend with higher-risk areas of the country already beginning to show early signs of HCMV, including Iva Valley Hospital in Port Elizabeth.

The deaths and serious injury reports from the virus are up after an outbreak of the disease at Durban’s Sanatorium hospital in June 2016. With reports going up fourfold between early March and June 2018, likely evidence of a sharp increase in cases of the virus in people living in the area around the hospital, including children, suggests there are now additional patients.

The National Health Department (NHW) and the South African Medical Research Council (SaMRC) are trying to determine the cause of the increase in cases, with a focus on the upstate area in KwaZulu-Natal.

There is uncertainty about when and where HCMV started circulating in South Africa, and the cause of the increase in incidents isn’t yet known, but initial evidence seems to show a link to the SESMC

SESMC is a higher-risk strain of HCMV that could be behind the high number of admissions and deaths in the upstate area.

This strain can cause flu-like symptoms in children but HCMV can also cause serious disease in adults, particularly those with weakened immune systems. The severity of illness depends on the genetic make-up of the virus.

There is uncertainty about when and where HCMV started circulating in South Africa, and the cause of the increase in incidents isn’t yet known, but initial evidence seems to show a link to the SESMC strain.

The fact that the higher-risk strain is producing illness seems to be a sign that it has already spread to the hospital area in question, and could drive outbreaks in other areas of the country in the future.

A high-risk HCMV strain has also been detected in Mozambique. It has been showing up in research animals for many years and an outbreak recently occurred in a community where there is usually no risk of exposure to HCMV. The outbreak is ongoing and is being investigated by the Mozambican government.

Jinsu is located above Hjemkom Lodge in the wealthy Sandton area of Johannesburg, adjacent to FNB stadium. Photograph: Alamy Stock Photo

How have we got here?

The Sanatorium hospital has been under investigation since late 2016 for severe infection control and bio-security problems, including an outbreak of possible Mers like pathogen Sudan V. That report was not released to the public until December 2017.

The Sanatorium hospital is a large facility, and the infection control problems in the building continued after SESMC appeared there in June 2016. The number of suspected cases there steadily increased after SESMC emerged.

This suggests that existing infection control and bio-security problems have contributed to the spread of HCMV between the upstate area and the hospital.

The answer will not be easy and will require long-term investigations. HCMV is associated with severe illness for adults, especially those with weakened immune systems. Children are at risk of illness and death from the disease in the summer months of June and July.

The emergence of HCMV in the South African region may mean that more cases are diagnosed and more children are hospitalised. Deaths and serious injury reports are up, and emergency room waits for suspected HCMV patients are up.

Both the national government and the SaMRC are working to deal with the outbreak, but strikes and crowded conditions may make it harder to contain the epidemic. Hopefully, these measures will continue to prevent the disease’s spread.

Fees are due to rise 10-15% in 2018-19, the first increase in four

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