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Death, Denial And Fear: What Listeriosis Cost South Africa

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December 25, 2017, was the worst Christmas for the Warmback family.

The festivities began two days before with the arrival of Keith and Glenda Warmback’s children from the US. There was food and celebration as the couple saw their one-year-old granddaughter for the first time.

“That evening, we went out and my wife had a chicken salad [from one of the fast food restaurants]. The following day my wife Glenda started having a tummy ache. She went to lie down for a while. She fell asleep and I woke her up around 5PM and she said she couldn’t get out of bed because she wasn’t feeling well and had a running tummy,” says Keith.

Keith says he was woken up by barking dogs, in their room where Glenda was asleep, at about midnight.

“I went to see what was going on and I found Glenda on the floor. She said she thought she had a stroke,” he recalls.

He bundled her up and rushed her to the nearest private hospital.

“The staff was disastrous… They were disinterested in my wife’s condition and three others who were there with similar symptoms,” says Keith.

According to Keith, it was just the beginning of a series of mistakes. Eventually, Glenda’s lungs collapsed and she died at 2AM on Christmas day. She was 61 years old; they had been married for 41 of those.

“The painful thing is the incompetence at the hospital,” says Keith.

Keith Warmback lost his wife Glenda to Listeriosis on the Christmas day of 2017. Photo by Motlabana Monnakgotla.

Doctors sited natural causes as a cause of death. The problem is, just 20 days before, the health minister had announced a foodborne outbreak called listeriosis. According to Keith, Glenda had all the symptoms and blood tests indicated she had it but she was never treated for it.

READ MORE: The Rat Race Against The silent Killer

At the time of going to press, Glenda was one of 183 South Africans who had died from this disease since January 2017; 978 had been infected. It is the world’s worst outbreak of listeriosis, according to the World Health Organization (WHO).

“Listeriosis is the name of a disease that people develop when they eat food that is contaminated with the bacterium called listeria,” says Dr Juno Thomas, head of the Centre for Enteric Diseases at the National Institute for Communicable Diseases (NICD).

According to Thomas, this bacterium is found worldwide. It can be in soil, water and even faeces in many animals.

“Once in the environment, it is very difficult to get rid of because it attaches to things very easily. Once it attaches itself in an environment, it produces a layer of a sticky sugary slime that sticks onto the surfaces and makes it difficult to remove and resistant to disinfectants,” says Thomas.

According to Health Minister Aaron Motsoaledi, South African hospitals saw and treated an average of 60 to 80 patients affected by listeria between 2013 and 2016 with no problems.

Then, in July last year, doctors started seeing more cases of newborn babies born with listeria.

Keith looks at an image of his wife (right), Glenda Warmback. Photo by Motlabana Monnakgotla.

It was a cause for concern. They informed the NICD. A search, led by Thomas, began. On November 29, they found that at the time, 557 people had been infected.

“A team from the NIDC interviewed 109 patients to obtain details about foods they had eaten in the month before falling ill. Eighty five percent of the people reported eating ready-to-eat (RTE) processed meat products, of which polony was the most common, followed by viennas/sausages and then other ‘cold meats’,” says Motsoaledi.

Sixty percent of cases were reported in Gauteng, 13% in the Western Cape and 7% in KwaZulu-Natal.

“We think it affected Gauteng the most because of consumer behavior. Things like sausages, polony and viennas are staple street and household foods in Gauteng because they are affordable and quick to prepare. The economy of Gauteng also plays a factor. There are many more people who can afford to buy these items than other provinces,” says Thomas.

Even armed with this information, the source of the outbreak remained unknown.

Symptoms of Listeriosis:

  • Fever
  • Diarrhoea
  • Vomiting

“When you have an outbreak like this you have no idea where it comes from. We also had not seen many cases of listeriosis in the country, meaning it wasn’t a big health priority compared to all the other issues we have to deal with. For example, we saw 30,000 cases of malaria last year, rabies is a big concern, TB and many others were more severe,” says Thomas.

With hard work and vigilance, the outbreak was traced from Soweto.

Nine crèche kids under the age of five got ill and were admitted to the Chris Hani Baragwanath Hospital. Tests revealed that they had been infected. A team went to the crèche the very day and found kids had eaten polony manufactured by Enterprise Foods, owned by Tiger Brands.

“We then visited the Enterprise Foods factory in Polokwane that makes this brand. We took over 28 samples and they tested positive for the outbreak strain. The conclusion from this is that the source of the present outbreak can be confirmed to be the Enterprise Food production facility in Polokwane,” she says.

On Sunday March 4, Motsoaledi ordered a safety recall of all products from Tiger Brands.

READ MORE: A Deadly $75-Billion Business

After Motsoaledi’s announcement, Tiger Brands shares fell more than 10% when the market opened on Monday.

“It is devastating for me that our business is linked to this outbreak… we detected low levels of listeria in our products on the 14th of February. We took immediate precautionary measures which included immediately halting production of the affected product, quarantining all affected product within our distribution center and withdrawing all affected products manufactured on that day,” says Tiger Brand CEO Lawrence MacDougall at a press briefing the next day.

MacDougall, however, controversially denied any responsibility for the deaths.

“There is no direct link with the deaths to our products that we are aware of at this point. Nothing… All of our tests and results indicate that we kept a very high standard of quality protocols within those sites. The expectations going forward is that those standards are significantly increased if there is going to be a zero detection of listeria going forward,” he says.

Motsoaledi argues that there is proof the ST6 strain was found at their facilities.

“The fact remains that we have had an outbreak of listeria, we informed them [Tiger Brands], in terms of fair administrative justice, that we got the results and we were going public with them. I don’t think they did enough to make sure their produce is safe for consumption by the public. I believe the best way is for this to be a civil case rather than a government case,” says Motsoaledi.

Renowned corruption buster and private forensic investigator Paul O’Sullivan agrees. He is filing criminal charges against the board of Tiger Brands and has called upon them to step aside pending the outcome of the investigations.

O’Sullivan has teamed up with human rights lawyer Richard Spoor to bring charges.

“What is particularly shocking is that Tiger Brands, in its most recent annual report, placed product quality as number nine on the list of risks facing the company, when it should have been be at number one. We cannot think of a greater risk to the sustainability of any food company, than that of killing off your customers through recklessness or gross negligence. We are 100% certain that it will rank top of the list in next year’s annual report.”

What O’Sullivan finds completely unacceptable is that Tiger Brands is still in denial.

“On the one hand they close and deep-clean all the affected facilities, on the other hand they deny culpability and say they will meet each civil claim on its own merits, thereby indicating they will make it a long-haul for the litigants,” he says.

Gareth Lloyd-Jones, Chief Commercial Officer at hygiene and sanitation service provider Ecowize, however says government is to blame. He argues there should be a surveillance system that protects consumers.

“This type of rigorous investigation has been going on for the past couple of months, which is admirable, relevant and necessary and should have been part of a more robust routine surveillance and monitoring process in terms of food safety and legislation requirements,” he says.

According to retail analyst Syd Vianello, this can tarnish a brand that has spent decades trying to live up to high standards.

“How long is it going to take [Enterprise Foods] to convince consumers that the Enterprise brand is good for purchase again? We are talking about the value of the brand and the protection of the brand equity, insurance won’t even cover you for those kinds of losses. These can carry on for a very long time,” he says.

There is also a rub-off effect.

Ronald Dube, a manager at a supermarket in Johannesburg, says people have been returning all cold meats regardless of brand.

“People are afraid and have been returning all sorts of meat. We have also noted that sales of processed foods have gone down, no matter the brand,” he says.

Many people have also thrown away their cold meats but, according to Dr Johan Schoonraad, waste expert and group tactical specialist at EnviroServ Waste Management, there are only two options for disposing of listeria infected food waste – incineration or treatment and landfill disposal.

“The scale of the problem is too big for the incineration industry to deal with in any sort of reasonable timeframe, which leaves waste management companies with the option to do treatment and disposal to landfill,” he says.

Schoonraad says treatment can take many routes. You could sterilize the food waste, heating it and ensuring the material internally gets to 100 degrees which would kill the bacteria.

“If this was done, we could then landfill it without further treatment being required before disposal,” he says.

The other option is to chemically treat it prior to disposal.

According to Schoonraad, the problem is municipal landfills often have poor access control. The risk here, he says, is that the informal sector could enter and scavenge food material, which is then sold or eaten and could spread the disease.

“However, licensed hazardous waste sites have strict access control with no scavenging allowed at these facilities,” he says.

Nevertheless, South Africa remains in fear of this deadly disease.

Who is mostly at risk:

  • Pregnant women
  • Neonates (first 28 days of life)
  • Very young infants
  • Elderly persons >65 years of age
  • Anyone with a weakened immune system (due to HIV infection, cancer, diabetes, kidney disease, liver disease, people with transplants and those on immunosuppressive therapy such as oral corticosteroids, chemotherapy, or antiTNF therapy for auto-immune disease)

Health

[BREAKING] Coronavirus Update: Global COVID-19 cases pass one million

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While most cases of the COVID-19 coronavirus have been reported in the U.S. , Europe, and China, the virus is spreading rapidly across the African continent.

The confirmed worldwide cases for the virus have surpassed a million with the current figure being at 1,005,858.

The increase in new reported cases around the world has led the World Health Organization (WHO) to declare the coronavirus a global pandemic.

The death toll continues to rise globally, and is currently at 51,644.

Italy leads with 13,915. Spain is second with 10,096 . The U.S. is third with 5,768. France is fourth with 4,503, and China, where the virus originated from, is fifth with 3,318.

The figure of the global recoveries stands at 210,577.

Here are the numbers in Africa:

Country Confirmed Cases Confirmed DeathsConfirmed Recoveries
Algeria9868661
Angola821
Benin131
Botswana41
Burkina Faso2881650
Burundi3
Cameroon284710
Cabo Verde (Cape Verde)61
Central African Republic (CAR)3
Chad7
Congo2222
Cote d’Ivoire (Ivory Coast)19419
Democratic Republic of the Congo (DRC)123113
Djibouti40
Egypt86558201
Equatorial Guinea151
Eritrea22
Eswatini (formerly Swaziland)9
Ethiopia293
Gabon181
Gambia412
Ghana204531
Guinea52
Guinea-Bissau9
Kenya11034
Liberia6
Libya10
Madagascar59
Malawi3
Mali363
Mauritania612
Mauritius1697
Morocco6914430
Mozambique10
Namibia142
Niger745
Nigeria184220
Rwanda84
Senegal195155
Seychelles10
Sierra Leone2
Somalia51
South Africa 1,462550
Sudan822
Tanzania2012
Togo39217
Tunisia455145
Uganda45
Zambia391
Zimbabwe91

Note: The numbers will be updated as new information is available.

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Health

Surge Of Smartphone Apps Promise Coronavirus Tracking, But Raise Privacy Concerns

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Topline: A pan-European team of researchers announced Wednesday their plan to release a smartphone app that would notify users if they’ve been exposed to someone infected with coronavirus, the latest example of tech-driven coronavirus solutions that have also raised concerns about user privacy.

  • A European project called Pan-European Privacy Preserving Proximity Tracing is working toward releasing a coronavirus tracing app in the next week that would use anonymous Bluetooth technology to track when a smartphone comes in close range with another, so if a user were to test positive for coronavirus those at risk of infection could be notified.
  • Contact tracing, or determining people who may have been exposed to someone with a virus, is an established aspect of pandemic control and was used effectively to tackle coronavirus in countries like China, Singapore and South Korea in the form of smartphone tracking.
  • University of Oxford researchers and the U.K. government are working on a similar project— but unlike other smartphone tracking systems, the British version in development would be based on voluntary participation and bet on citizens inputting their information out of a sense of civic duty.
  • The U.S. government is in talks with companies like Facebook FB and Google GOOGL and other tech companies about tracking if users are social distancing using large amounts of anonymous, aggregated location data— this information is less precise, and more likely to anticipate outbreaks rather than pinpoint individuals who have been exposed to the virus.
  • 1.5 million Israelis have voluntarily downloaded a mobile app that alerts users if they’ve come into contact with someone with coronavirus— but Prime Minister Benjamin Netanyahu has still ordered that potential coronavirus carriers have their phones monitored, a controversial move the government says is necessary, as the 17% of the population using the app is not enough to fight off the pandemic.  
  • Moscow , on a city-wide lockdown since Monday, announced Wednesday that a new phone app that will officials to track the movements of people diagnosed with coronavirus in the capital city would be launched on Thursday, saying the government will lend a smartphone to anyone unable to download the app.

Crucial quote: “We’re exploring ways that aggregated anonymized location information could help in the fight against [coronavirus]. One example could be helping health authorities determine the impact of social distancing, similar to the way we show popular restaurant times and traffic patterns in Google Maps ,” Google spokesman Johnny Luu told the The Washington Post. He made sure to note it “would not involve sharing data about any individual’s location, movement, or contacts.”

Key background: Private and public entities alike are looking for ways to fight off coronavirus as the pandemic continues. On Wednesday, there were more than 900,000 confirmed cases worldwide and nearly 50,000 deaths.Officials told The New York Times NYT that The National Health Service, Britain’s centralized national health system, is trusted by citizens— and paired with the strong data privacy laws in place, said they think people would agree to join the effort to share their private information to help trace infections. However, American tech firms are reported to still be skeptical about sharing substantial data with the U.S. government ever since Edward Snowden revealed the NSA was collecting information from the firms clandestinely. 

Surprising fact: The information tech companies have access to data that sheds light on Americans’ behavior in light of the coronavirus pandemic. According to a Facebook analysis, restaurant visits fell about 80% in Italy and 70% in Spain— while Americans only stopped eating out at a rate of 31%.

Carlie Porterfield, Forbes Staff, Business

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Economy

5 Tips For SMEs To Counter The Covid-19 Crisis

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It was recently reported by ratings agency S&P Global that the coronavirus outbreak has plunged the world into a recession. On the home front, a sudden surge in COVID-19 cases in the country resulted in the President of South Africa imposing a 21-day country-wide lockdown, starting from Thursday, 26 March 2020. Combine this with the fact that the country also recently announced to be in its third recession since 1994 it’s safe to say that many businesses are beginning to feel the effects of the pandemic.

The impact of the coronavirus on small businesses is likely to be substantial, especially for local businesses who are already feeling the pinch, as financial and market uncertainty can easily translate into an emotional crisis that can overwhelm our systems. However, help is on the way as the Department of Small Business Development announced that a Debt Relief Fund has been set up to assist small, medium and micro enterprises impacted by COVID-19.

While this relief is welcomed, it is still vital for leaders to step up. The world has been through crises before, but during these significantly difficult times, the economic impact may be as severe or possibly worse. As such, those in leadership positions must use past crises as examples and apply what was learnt to keep the country on course and minimise the impact of the pandemic.

Karl Westvig, CEO at Retail Capital, has pinpointed the visible areas that are affected and outlined a few pointers to help small business owners weather the storm.

Liquidity

The first victim of panic is liquidity – banks, asset managers and funders stop lending. When they cannot calculate the potential risk, they will not lend.  Therefore, it is critical to shore up cash by drawing down on available facilities and suspending any unnecessary investments. Reduce expenses and manage cash flow daily.

Get Your Best Team on It

When a business is growing, we tend to shift our best people into roles linked to growth and new initiatives. In a crisis, these people need to move into the highest priority roles. These roles would include collecting from customers, raising facilities or engaging key clients.

Morale and Communication

People need leadership. This would include authentic and regular communication about the situation, what the business requires and how this will be achieved. You can’t control the circumstances, but you can control the response and actions. This will create more certainty.

Hands-on

Events evolve quickly and every day is critical. Leaders must be hands-on. They have to be in touch with customers, suppliers, funders and staff. They have to collect data on everything – the mood, the financial metrics, even customer stories. Some of the best information is anecdotal, not just big data.

Policies

It’s tough to lead when you don’t understand all the underlying levers. These can change in a crisis. What worked in a stable environment can go out of the window in an instant. The best approach is to start again, listen to customers and then adapt your policies within your framework.

“This is not a manual on how to handle the current crisis, but hopefully, the points mentioned above can add to what you are already doing. In simple terms, it is easy to be overwhelmed, so tackle a few things very quickly and with commitment. This will create certainty and lead to action. The alternative is paralysis,” concludes Westvig.

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