A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 21 May 2010
Source: IOL (Independent Online, South Africa), The Star report [edited]
The diarrhoea that killed 6 babies at Charlotte Maxeke Johannesburg
Academic Hospital was caused by a norovirus, a type of
community-acquired virus [infection] that causes stomach [illness],
CEO Barney Selebano confirmed yesterday [20 May 2010]. He explained
that the babies were susceptible to the virus because of their weak
[undeveloped] immune systems. "Those babies have never been out of
the hospital," he said.
All the babies in the neonatal ward were born prematurely and weigh
less than 1 kg [2.2 lb]. At the time of the infection, there were
about 50 babies in the ward -- 15 more than the stipulated maximum of 35.
Selebano said the virus was spread to the babies by human movement in
the hospital. "People walk all around the hospital and encounter
other diseases, and then come back into the neonatal ward," he said.
He added, however, that the hospital had saved all the other babies
in the ward and no new infections had been detected. "There are
always infections in a hospital, but this one has been contained."
Gauteng Health MEC Qedani Mahlangu said the investigation into the
babies' deaths would be concluded by the end of the month [May 2010].
Meanwhile, Mahlangu said the deaths of 11 babies at Natalspruit
Hospital on 11 May 2010 were ascribed to neonatal sepsis, low birth
weight, prematurity, or stillbirth, and were unrelated to the
diarrhoea that killed the 6 babies at Charlotte Maxeke.
The Star [newspaper] has established that 30 babies died at
Natalspruit between 9 and 18 May 2010. At least 3 of the 30 deaths
are understood to be under investigation.
[Byline: Solly Maphumulo, Kristen van Schie]
HealthMap Alerts via ProMED-mail
[Premature infants in neonatal care units are vulnerable to many
infections, but norovirus infection has rarely, if ever, been
reported as a specific cause of death. A lapse in infection control
procedures, as a result of overcrowding, seems likely to be
responsible for this tragic outbreak.
Noroviruses are a group of related, single-stranded RNA,
non-enveloped viruses that cause acute gastroenteritis in humans. The
incubation period for norovirus-associated gastroenteritis in adults
is usually between 24 and 48 hours (median in outbreaks, 33 to 36
hours), but cases can occur within 12 hours of exposure. Norovirus
infection in adults usually presents as acute-onset vomiting, watery
non-bloody diarrhea with abdominal cramps, and nausea. Low-grade
fever also occasionally occurs. Diarrhea is more common than vomiting
in children. Dehydration is the most common complication, especially
among the young and elderly.
Noroviruses are transmitted primarily through the fecal-oral route,
either by consumption of fecally contaminated food or water or by
direct person-to-person spread. Environmental and fomite
contamination may also act as a source of infection. Good evidence
exists for transmission due to aerosolization of vomitus that
presumably results in droplets contaminating surfaces or entering the
oral mucosa and being swallowed. No evidence suggests that infection
occurs through the respiratory system. For further information see
The HealthMap/ProMED-mail interactive map of South Africa at
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