More than 400 cases of gastrointestinal illness have been reported in communities around Bronkhorstspruit, east of Pretoria, with most patients younger than four, after the City of Tshwane failed to warn residents that their water was unsafe following a disruption to its chlorine supply.
Water and Sanitation Minister Pemmy Majodina, Health Minister Aaron Motsoaledi, Gauteng Premier Panyaza Lesufi and Tshwane Mayor Dr Nasiphi Moya met on Sunday to discuss the outbreak and the response.
The illness has affected residents of Zithobeni, Bronkhorstspruit, Dark City, Rethabiseng and Sokhulumi in Tshwane's Region 7.
Patients have received treatment at Bronkhorstspruit Hospital and local clinics.
More than 400 cases reported
Between October 7 and 18, 408 cases of gastrointestinal illness were reported, according to a joint statement from the national and provincial health departments and the City of Tshwane.
The number of new cases peaked on October 13, when 72 were recorded.
On October 18, 16 new cases were reported. No deaths had been reported at the time of the update.
“Most of the patients are under four years old,” the statement said.
“Brokhorstspruit Hospital has established an isolation area and overflow beds for affected patients,” it added, saying that most patients had been rehydrated and discharged within a day.
It said a four-level surge plan is in place to expand bed capacity, deploy additional staff and refer patients to other hospitals if necessary.
Tests link illness to contaminated water
According to the statement, on October 13 Motsoaledi requested an investigation by the Department of Water and Sanitation (DWS) into the quality of water supplied by the Bronkhorstspruit Water Treatment Works, which serves the affected communities.
Laboratory results from stool samples analysed by the National Institute for Communicable Diseases (NICD), together with water-quality tests, indicate that exposure to contaminated water from the treatment works caused the illnesses.
The NICD detected norovirus, Campylobacter and Shigella in three of the four stool samples analysed.
“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.
“No cholera bacteria were found in the sampled stools."
Water-quality tests conducted by the 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 potential contaminants and strengthen the epidemiological evidence, the statement said.
Chlorine supply failure left water untreated
The DWS investigation found that difficulties with the city's chlorine supplier resulted in water from the plant going unchlorinated between September 24 and October 14.
The treatment works draws water from the Bronkhorstspruit River, which is heavily polluted by sewage from dysfunctional wastewater treatment works upstream in Victor Khanye Municipality and malfunctioning sewage pump stations operated by the city.
“The DWS investigation found that the CoT (City of Tshwane) experienced difficulties with its chlorine supplier which resulted in water emanating from BWTW not being chlorinated between 24 September and 14 October,” the statement said.
The investigation also found that the municipality had failed to warn residents that the water was unsafe.
“The CoT (City of Tshwane) had failed to warn residents in the affected areas of Bronkhorstspruit that the water being supplied had not been chlorinated,” the statement said, adding that it should not be used for drinking, cooking, washing or bathing, even after boiling.
Clean water supplied by tankers
The city closed the plant on October 14.
Chlorine supplies were restored by October 15, and the plant reopened on October 16 to supply water to the distribution system.
However, residents were warned that the water was not yet safe to drink.
“Since 14 October, CoT has been distributing drinking water to residents using water tankers,” the statement said.
The tankers collect water from the Cullinan Water Treatment Works and laboratory tests by the city and the DWS indicate that this water is safe to drink.
The municipality is increasing supplies by deploying an additional 36 tankers.
“Testing of this water will be conducted on a continuous basis, by both CoT and DWS,” the statement said.
The DWS has appointed the Water Research Commission (WRC) to conduct independent water-quality tests.
The testing began on October 18, with results expected from Wednesday.
The WRC is also investigating the causes of the contamination, with its report expected by October 28
Treatment plant faces infrastructure problems
The DWS investigation found that several components of the treatment works, including pumps, sand filters and other mechanical equipment, were not functioning properly.
The city is in the process of appointing Rand Water as an implementing agent to improve the plant's performance.
Engineers are said to be developing an implementation plan, including an assessment of whether the plant should remain closed for further repairs.
“At this stage, it is not possible to give a timeframe for when residents will again be able to drink water emanating from the BWTW,” the statement said.
The city said it had spent R21 million during the current financial year on refurbishment and upgrades, with expenditure and planned investment exceeding R107 million over three years.
“Together, these allocations represent more than R107 million in expenditure and planned investment over the three-year period,” the statement said.
Residents warned against using tap water
Residents in areas supplied by the treatment plant have been warned to not drink tap water or use it for bathing, brushing their teeth, washing food or clothes, or cooking until further notice.
The water may be used only for flushing toilets.
“Previously stored water should be discarded and water containers must be disinfected using household bleach,” the statement said.
“Drinking water obtained from water tankers should be stored in clean containers with lids.”
The city has vowed to improve communication with residents, including providing regular updates on where and when clean drinking water is available.
It also urged residents who develop symptoms to seek medical attention promptly and report suspected cases to their nearest healthcare facility or local health authority.
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