Legislation and policy analysis on management of listeriosis epidemic disaster in South Africa.

Abstract

During the 2017-2018 listeriosis outbreak in South Africa (SA), the total number of cases reached 1,060. In this study, the disaster management response to the 2017-2018 South Africa listeriosis outbreak is analyzed. The hazard was in part the contamination of a brand of a ready-to-eat (RTE) "polony" with a strain of Listeria monocytogenes ST6. The initial phase of the 2017-2018 listeriosis outbreak was characterized by a rapid increase in the number of detected human cases. The listeriosis outbreak was officially proclaimed in December 2017, resulting in listeriosis being added to the list of notifiable diseases in SA. The delay between onset and proclamation was a result of the difficulty in identifica-tion of the actual number of cases of listeriosis in the country. The response to the disaster included the coordination of the National Department of Health, the National Institute of Communicable Diseases (NICD), businesses/producers of the contaminated brand of RTE products, and the public. Some of these activities led to the removal of the contami-nated products from the retail sector in March 2018, resulting in a decrease in the number of cases found in SA. In re-sponse to the outbreak, the National Department of Health formed a multisector incidence response team and imple-mented the Emergency Response Plan. Impacts of future listeriosis outbreaks could be mitigated by the adoption of international listeriosis guidelines such as the WHO/FAO and FDA. Practical steps in this context should include setting a limit of L. monocytogenes in RTE products. WHO/FAO and FDA listeriosis policies which are described "zero toler-ance" where a limit of < 100 L. monocytogenes cells/g at the moment of consumption is acceptable can be adopted. Additional resources must be provided for research into infectious doses and the various routes of human exposure.