South Africa has seen an increase in cases of foodborne illness, commonly known as food poisoning. Experts say this points to larger issues of limited access to food, safe water, and electricity. 

Food poisoning as an illness caused by consuming contaminated food or drinks. According to the World Health Organisation (WHO) this is a growing public health problem. Globally one in 10 people get sick from contaminated food.    

“It occurs when you ingest food that contains harmful bacteria, viruses, parasites, or toxins produced by microorganisms. Common symptoms of food poisoning include nausea, vomiting, diarrhoea, abdominal pain, and fever,” explains Dr Diane Rip, a food science lecturer at Stellenbosch University. 

The severity and duration of symptoms depends on the type and quantity of the contaminated food you ate. Individual factors such as age and overall health also determine how bad the illness will be. At its most severe people – especially very young children and the elderly – can die from foodborne illness. 

“Food poisoning typically affects the young and elderly more severely as these groups are particularly vulnerable to infection [due to still developing or weakened immune systems],” Rip explains. 

South Africa saw this play in real-life in 2017-2018 during the biggest recorded outbreak of the foodborne illness, listeriosis. More than 200 people died during the outbreak, mostly the elderly and children younger than five.  

Now the Gauteng health department is raising the alarm on a recent spike in incidents of food poisoning – particularly among children. According to the department, in the past six months alone 863 cases of food poisoning among school children were recorded in the province. The national health department says the country has recorded more than 1300 cases of food poisoning during the same period around the country. 

Drivers of food poisoning

Acting Gauteng health spokesperson Khutso Rabothata says the department continues to drive educational campaigns in communities particularly in the townships, informal settlements and hostels. Most cases are reported in these areas. 

Rabothata explains that these campaigns will “empower the communities with food safety such as food handling, preparation, storage, the importance of checking food expiry labels and hand washing before handling food”.

But the experts Health-e News spoke with believe that the reasons behind the rise in foodborne illness are socioeconomic. 

According to Rip, limited access to safe food exacerbates the issue of food poisoning. 

“When it comes to the increase in food poisoning cases among children, factors such as inadequate sanitation/hygiene practices, environmental factors (e.g. exposure to contaminated water sources), food insecurity, as well as a lack of hygiene education and child protection all demand attention. 

“For example, in areas with low-income households, where food choices are restricted, individuals are more likely to encounter low-quality or unsafe food and water. In saying this, food poisoning does not discriminate based on social status,” she says.  

Lesedi Baloyi, a biotechnologist at a private baking company says the recommendations by the department can only be followed if people from disadvantaged areas have access to sufficient resources in order to be able to restore their food. 

“The basic needs like water and electricity is a huge factor that plays along in these people’s lives because they probably don’t store food in the correct temperature or even have access to clean water,” she says. 

Baloyi says communities don’t always know how to read food labels. This is the norm globally, where half the world’s populations only “partly” understand what’s on food labels. 

Systemic issues behind illness

Professor Tracy-Lynn Field, the Claude Leon Chair in Earth Justice and Stewardship at the University of Witwatersrand whose research area include environmental law, human rights, climate change law and water law argues that the rise in cases underlined the importance of universal access to water and electricity to health. Field was speaking on environmental issues that lead to food poisoning. 

Field says people need access to clean water for drinking and to prepare food. While there’s been significant progress in this regard over the past 30 years, recent reports of water shortages and poor water quality are very concerning.

“In some areas of the country there are water challenges and interruptions. It is unclear how communities cope when there are water interruptions. We don’t know whether they rely on untreated water which can be contaminated with sewage or with chemicals,” she says. 

Field says South Africa must look into more diverse sources of electricity so that poor households can cook and store food safely. 

“There is a need for solar fridges so that communities can continue to refrigerate their food to keep it fresh even if there is loadshedding. We need to look for a more diverse source of electricity so that poor households can be able to cook more nutritious foods,”she says. 

Food safety education still key 

The rise in the consumption of minimally processed foods  (fresh fruits, vegetables, whole grains, nuts, meat, artificial sweeteners) that do not require an additional heating step, can contribute to instances of food poisoning, warns Rip.  

“It is also essential to educate children about the risks associated with playing in dirty/contaminated stagnant water, and to promote proper hygiene practices such as washing hands before handling food or eating,” she says. 

Rips says when handling food, agents such as bacteria present on the hands of the person preparing the food or on surfaces that touch food can be transferred, contaminating the food and promoting bacterial growth. 

“Additionally, food can become contaminated from the environment, such as soil or water sources. If not cooked thoroughly, contaminated food can cause food poisoning. If not correctly stored (e.g. refrigerated) after preparation, bacteria can grow to form toxins. Given that food poisoning can stem from various situations, implementing certain kitchen and health practices can help reduce the risk of consuming harmful microorganisms.”

She says when when pest control chemicals or substances come into contact with food or surfaces that touch food, it leads to food contamination. 

“If consumed, this contaminated food can cause food poisoning. Care should be taken when using these chemicals when used in food preparation or communal areas. Correct pesticide application guidelines should apply, with regular inspection to prevent recurrences,” she says. 

Rip says if you suspect you have food poisoning, seek medical attention if symptoms are severe or persistent. – Health-e News