Publications
Partners
As the healthcare industry reels from the revelation that six babies died from a Klebsiella pneumonia outbreak at the Thelle Mogoerane Hospital in Vosloorus, a veil of silence hovers over the Gauteng hospital, where nine babies died from an outbreak of necrotising enterocolitis.
A total of 42 cases of necrotising enterocolitis were reported at Thelle Mogoerane and another Gauteng hospital.
The National Institute for Communicable Diseases recorded the disease in 38 premature and four full-term babies.
Of the cases, 79% had a low birth weight of less than 1.5kg and 21% had a birth weight of more than 1.5kg.
Necrotising enterocolitis is a common and serious gastrointestinal disease occurring among newborns, particularly those born prematurely.
The tissue in the inner lining of the small or large intestine becomes enlarged and begins to die.
It requires emergency treatment.
The outbreak at the unnamed hospital was identified in April by a paediatrician, who sounded the alarm bell about a “cluster” of cases.
The institute said it “wasn’t at liberty” to disclose the name of the hospital, referring City Press to the Gauteng health department.
The department was sent questions for comment and to confirm the name of the hospital on Wednesday. By the time of going to print, it had not answered.
After posting a communiqué on the latest outbreak, dated September 17, this week, the institute removed it from its website after a call from City Press.
In May the institute said necrotising enterocolitis cases at the hospital started on March 17 “with an increase from March 20 onwards”.
By May at least 30 cases had been recorded.
Professor Nelesh Govender, head of the centre for healthcare at the institute, said no further cases had been noted recently.
“Necrotising enterocolitis is a common disease of premature babies and one expects to see occasional cases in neonatal units,” he said.
“However, when the number of diagnosed cases in a healthcare facility exceeds the expected baseline number of cases for that facility or unit/ward, an investigation is initiated to understand the cause and determine possible sources.”
He said that, having been alerted, a multisectoral outbreak investigation team – comprising the institute, and provincial and hospital personnel – was established to identify the possible source and the cause of the cases.
And, although the source of the outbreak still remained unknown, the team had noted a “concerning” presence of bacillus and streptococcus in opened and unopened mixed and dry milk formulas.
“Infant formula milk may be contaminated with bacteria during the manufacturing process or during preparation at the health facility. However, the presence of bacteria in milk is not sufficiently informative; bacterial counts and enterotoxin production must be determined. Health practitioners in the hospital routinely submit milk samples for microbiology analysis. The available laboratory results do not warrant further investigation,” he said.
Govender said the reason the number of cases could have reached baseline levels again was because of the interventions put in place during the investigation, such as the isolation of babies.
“An important way to stop the spread of healthcare-associated infections is for healthcare workers to adhere to infection prevention and control practices, such as effective hand hygiene [washing of hands using soap and water and alcohol-based hand rub] before and between caring for patients,” Govender said.
