The 2017-2018 Listeria Outbreak in South Africa Case Study

Introduction

Foodborne illnesses remain common worldwide, although national governments and international institutions introduce various standards to prevent these health issues. Listeria monocytogenes cause listeriosis that is number three on the list of the most serious foodborne diseases (Jooste, Jordan, Leong, & Alvarez-Ordóñez, 2016). The mortality rate may reach up to 30%, with a major impact on such populations as neonates, the elderly, pregnant women, and immunocompromised people (Jooste et al., 2016). The 2017-2018 listeria outbreak in South Africa revealed people’s unpreparedness to react and the impact of the pathogen. The outcome of the outbreak was 674 patients with symptoms of different severity and 183 deaths (27%) (National Institute for Communicable Diseases, 2018). One of the peculiarities of this outbreak was the duration of the investigation that took over a year. This paper includes a brief analysis of the outbreak as well as the way it was and should have been handled by the Emirati government.

The Role of Epidemiological Approaches and Laboratories

Descriptive epidemiology plays the central role in detecting listeria outbreaks. Samples from meat-processing plants and retailers are sent to laboratories where the pathogen is detected (World Health Organization [WHO], 2005). The data also comes from the healthcare facilities where the patients with specific symptoms have been treated. For instance, it is reported that 59% of the cases were reported from Gauteng Province, 12% were from Western Cape, and 7% were from KwaZulu-Natal (National Institute for Communicable Diseases, 2018). As far as the affected population is concerned, of the cases with reported age, 42% were neonates. Molecular epidemiology is also widely used due to its potential to identify new types of pathogens and mutations, which can be important for the prevention and treatment of disorders. Epidemiology enables authorities, healthcare professionals, and researchers to trace the impact of illnesses and develop and implement effective strategies to safeguard public health.

The Duration of the Investigation

As has been mentioned above, one of the peculiarities of the 2017-2018 outbreak was the duration of the investigation aimed at detecting the causes of the spread of the disease. It is acknowledged that listeria can be difficult to trace due to the nature of the contamination and the fact that it can “hide” in various facilities (BBC, 2018). However, the period needed to detect the pathogen is far less than several months. Authorities reported that the investigation took over a year since meat-processing facilities did not provide samples while meat-processing companies even suspended their production (ABC, 2018). In simple terms, authorities had limited access to the necessary information. Clearly, this could have a considerable adverse impact on the quality of the investigation.

Apart from the exact reasons mentioned by the representative of the Health Ministry of South Africa, it is possible to name another significant cause of such delays and ineffectiveness. The lack of the corresponding legislation and standards is one of the underlying reasons for the severity of this year’s outbreak. For example, the South African Foodstuffs, Cosmetics, and Disinfectants Act (1972) does not include any data on L. monocytogenes. The Dairy Standard Agency recommends the absence of the pathogen in such products as raw and pasteurized milk, cream, and some other items (Jooste et al., 2016). It is noteworthy that South African National Standard, which is voluntary, allows up to 100cfu/g in meat products at the end of their shelf-life. Therefore, there are no sound standards as to the content of L. monocytogenes in meat products in South Africa. Authorities have developed some voluntary standards that are often ignored. Moreover, the existing procedures implemented when detecting the pathogen were ineffective since companies were given a plethora of opportunities to conceal deviations from guidelines, if any.

Steps to Undertake to Identify the Cause of the Outbreak Promptly

Public health specialists could contribute to the prompt identification of the reasons for the outbreak. All the patients with symptoms completed some surveys and were interviewed as to their ideas concerning possible reasons for their illness (National Institute for Communicable Diseases, 2018). However, this should have been the initial step. When detecting people’s views on the ways they contracted the disorder, healthcare professionals should have paid attention to exact products that could cause the disease, the place they were bought, the producer. After the collection of this information, authorities should have carried out investigations at the suspected places instead of waiting for companies to send the samples. It could have been beneficial to provide the data online and draw the public’s attention to the companies that were reluctant to cooperate. The publication of a list of the organizations that did not send the samples timely could lead to people’s reluctance to buy their products, which could motivate meat-processing facilities to be more cooperative.

The Way the UAE Did and Should React to Addressing the Issue

The United Arab Emirates is one of the major importers of South African meat products. Therefore, this country had to undertake certain measures to ensure the populations’ safety. The Emirati government banned the import of meat products from South African RCL Foods and Tiger’s Enterprise Food (Haza, 2018). Furthermore, the Emirati authorities launched a wide-scale screening of South African meat products that were sold in the country at that period. It is reported that retailers were cooperative as they wanted to make sure that the products they sell were safe (Haza, 2018). The government employed appropriate measures to minimize possible negative health effects.

These measures have proved to be effective and can be regarded as a proper reaction to the situation. Nonetheless, taking into account the duration of the South African investigation, Emirati authorities could have been more cautious. For example, it could be necessary to suspend all imports of South African meat products until the publication of the report on the exact causes of the outbreak. This would lead to certain challenges associated with the supply of meat products as new partners were to be found quickly. However, public health is the priority. Apart from what was done, it could be beneficial to carry out a nationwide educational program that would inform the public about the disease and some preventive measures, as well as the most vulnerable populations. The program could be implemented through the educational and healthcare systems of the country. The media also had to be one of the major platforms to disseminate information.

International Health Organizations

Countries are often reluctant to comply with certain standards and rules developed by international entities. In many cases, national interests and peculiarities are put forward. However, when it comes to public health, it can be crucial to be more responsible. The World Health Organization is seen as one of the primary international health institutions that set regulations and help countries to address various issues. For instance, the organization can provide financial and professional aid in detecting health issues, preventing and managing them (WHO, 2005). Nevertheless, these functions should be extended. Apart from the provision of some aid at the time of the crises, the organizations can develop guidelines for all countries to follow. The institution can collaborate with national health ministries on encouraging food producers to comply with the standards that have proved to be effective in some regions. As far as the outbreak in question is concerned, WHO could provide resources that would enable the South African government to implement investigations at the meat-processing facilities where the most cases were reported.

Health Communication and Food Recall Approaches

The 2017-2018 listeria outbreak in South Africa received wide coverage in the media. News, print sources, and social media the primary communication platforms. People shared their views and revealed their concerns. Authorities reported and informed people about numerous aspects of the problem. The South African government, as well as governments of other countries, utilized various food recall instruments to ensure their citizens’ safety (ABC, 2018). As mentioned above, the UAE banned the import of meat products while South African authorities focused on the investigation and communication with their citizens. The Ministry of Health of South Africa recommended retailers remove the products of the compromised companies from their shelves. South Africans were informed about the results of the investigation, possible health outcomes, and some prevention strategies.

These measures are quite successful when addressing the outbreaks of such scale. It is also pivotal to develop sound standards and guidelines aimed at preventing the reoccurrence of similar public health issues. For example, the South African government should start working on such strict standards that would replace the existing voluntary recommendations. Any country should make sure that such serious pathogens as L. monocytogenes will not spread so easily. Food producers should follow the introduced standards, and proper control should be ensured. The companies that fail to comply with the set rules will have to pay fines or even be prohibited from producing certain items. Bans of import can be the primary instruments countries can use to address the situation.

Communication with the public is another important domain to focus on. Authorities should articulate major messages via diverse channels. Social media can (and are likely to) play a central role in the spread of information. The government should make sure that all the relevant data is available to the public. The corresponding institutions should also analyze the feedback coming from people. Transparency is the key to the successful management and even prevention of various disease outbreaks.

Conclusion

To sum up, the 2017-2018 listeria outbreak in South Africa revealed some issues the country had in the sphere of health care. It became clear that the authorities had no sound instruments to access data necessary to detect the causes of the health issue. The case also unveiled the vulnerability of countries as contaminated products can appear in any part of the world. Food recall strategies remain some of the most effective tools to address the problem. The role of media (especially social media) is becoming more prominent than ever as this platform enables authorities to reach wide audiences. Social media also contribute to the empowerment of people who may force producers to be more responsible.

References

ABC. (2018). South African listeria outbreak largest on record WHO says as government blames food firms.ABC News. Web.

BBC. (2018). South Africa listeria: Source of ‘world’s worst outbreak’ found.BBC News. Web.

Haza, R. (2018). UAE bans South African meat from two firms following listeria outbreak.The National. Web.

Jooste, P., Jordan, K., Leong, D., & Alvarez-Ordóñez, A. (2016). Listeria monocytogenes in food: Control by monitoring the food processing environment. African Journal of Microbiology Research, 10(1), 1-14.

National Institute for Communicable Diseases. (2018). Situation report on listeriosis: Outbreak, South Africa, 2018. Web.

World Health Organization. (2005). International health regulations. Web.