Tshwane mayor Dr Nasiphi Moya said extra water tankers will be sent to Bronkhorstspruit, east of Pretoria, and nearby communities after 408 people fell ill from contaminated water.
Most of the victims are children under 4.
The city failed to warn residents that their water was unsafe following a disruption to its chlorine supply.
Moya said an additional water tanker would be deployed on Wednesday, bringing the total to 36, as the city works with national and provincial authorities to restore safe water supplies.
Between October 7 and October 18, 408 cases of gastrointestinal illness were reported in Zithobeni, Bronkhorstspruit, Dark City, Rethabiseng and Sokhulumi in Tshwane's Region 7, according to a joint statement by the national and provincial health departments and the city.
Contaminated water linked to outbreak
Laboratory results from stool samples analysed by the National Institute for Communicable Diseases (NICD), alongside water-quality tests, indicate that contaminated water from the treatment works caused the illnesses.
The NICD detected norovirus, Campylobacter and Shigella in three of the four stool samples analysed.
No cholera bacteria were found.
“The fact that mixed pathogens were found in the samples and the rapid spread point to a common water supply being the likely source of illness,” the statement said.
Water-quality tests conducted by the Department of Water and Sanitation (DWS) on October 14 found extremely high levels of E. coli and total coliforms in water from the treatment works and the Ekandustria and Zithobeni reservoirs.
Further tests are under way to identify other contaminants.
The DWS investigation found that problems with the city's chlorine supplier resulted in water from the plant being supplied without chlorination between September 24 and October 14.
The treatment works draws water from the Bronkhorstspruit River, which is polluted by sewage from dysfunctional wastewater treatment works in Victor Khanye Municipality and malfunctioning sewage pump stations operated by the city.
Investigators also found that several components of the plant, including pumps, sand filters and other mechanical equipment, were not functioning properly.
The city failed to warn residents that their water was unsafe.
Authorities have instructed residents not to use water from the affected system for drinking, cooking, bathing or other household purposes, even after boiling.
It may be used only for flushing toilets until further notice.
Tankers and emergency supplies
In an update on Tuesday, Moya said the city had expanded alternative water supplies, accelerated technical interventions and intensified public awareness campaigns.
She visited Dark City Clinic in Ekangala, Region 7, with senior city officials and ward 104 councillor Oupa Matshaine, following engagements with residents in Zithobeni.
Moya said the visits allowed officials to engage with residents and healthcare workers, assess conditions and ensure communities received support and information.
“As of today, 35 water tankers are operating across affected communities, comprising seven municipal vehicles and 28 service-provider vehicles,” she said.
An additional tanker was expected on Wednesday, bringing the total to 36.
She said safe drinking water continues to be supplied from the Cullinan Water Treatment Works.
Filling points and tankers are being tested regularly, while cleaning and disinfection measures are under way.
“Dedicated deliveries are also being made to critical institutions, including healthcare facilities and schools.”
Moya said the city is intensifying door-to-door awareness campaigns and working with ward councillors and committees to coordinate tanker distribution and inform residents where to access safe water.
Treatment plant rehabilitation
She said sufficient chlorine was now available to clean the plant and meet its ongoing treatment requirements, resolving the immediate supply interruption.
However, further technical work and testing are required before the facility can supply water for consumption.
Rand Water's technical teams are undertaking maintenance and assessing the interventions needed to restore the plant to the required standards.
Flushing and disinfection of the affected distribution network are also beginning, supported by daily water-quality monitoring by the city, the DWS and the Water Research Commission.
The work may require a temporary shutdown to install equipment.
Residents will be informed of any changes affecting their water supply. Rand Water has also restricted access to authorised personnel to allow urgent work to proceed safely.
Opposition parties demand accountability
Moya said the city would investigate the chlorine supply interruption, why the failure was not escalated appropriately and why residents were not warned in time.
The chief operations officer has been tasked with investigating procurement, operational and management processes and recommending corrective action.
“Where negligence or misconduct is identified, the city will act decisively in accordance with the applicable disciplinary processes,” she said.
Moya said she accepted political responsibility for the city's response, adding that administrative accountability was also necessary to protect residents' health and safety.
Former mayor and Democratic Alliance (DA) mayoral candidate Cilliers Brink opened a criminal case at the Bronkhorstspruit Police Station, seeking an investigation into the city's alleged failures.
Economic Freedom Fighters (EFF) treasurer-general and Tshwane mayoral candidate Omphile Maotwe also opened a case at the police station against Moya and city manager Johann Mettler over the alleged failure to address chlorine-related problems.
The Freedom Front Plus (FF Plus) lodged a complaint with the Public Protector, citing alleged maladministration, inadequate oversight and failures to communicate critical information to senior management and residents.
The party also complained to the Green Scorpions, environmental management inspectors, about sewage pollution in the Bronkhorstspruit River.
It said pollution from dysfunctional wastewater treatment works and sewage pump stations operated by Tshwane and Victor Khanye Municipality had worsened the crisis.
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