causing illness in 11 155 individuals, with 78% (8 680/11 155) hospital visits, 4% (494/11 155) hospital admissions and 0.4% (49/11 155) deaths. Most of the outbreaks were reported in warmer months, from KwaZulu-Natal (141/327, 43%), Gauteng (63/327, 19%) and Mpumalanga (40/327, 12%) Province. Institutional outbreaks were most common (106/327, 32%), followed by households' outbreaks (89/327, 27%), and community outbreaks (35/327, 11%). Specimens were collected in 73% (239/327) of outbreaks. Stool samples were collected in 62% (147/239), food samples in 55% (132/239) and water samples in 14% (33/239). Enteric pathogens isolated in stools included Salmonella species (29/147, 20%), Clostridium perfringens (12/147, 8%), Bacillus cereus (7/147, 5%), Shigella species (6/147, 4%) and Listeria monocytogenes (2/147, 1%). Pathogens isolated from food samples were Salmonella species (15/132, 11%), Escherichia coli species (14/132, 11%), Bacillus cereus (13/132, 10%), Clostridium perfringens (4/132, 3%), and Listeria monocytogenes (4/132, 3%). Water contamination indicators found were high Escherichia coli and total coliforms counts (3/33, 9%).
Conclusion:Although FBDs outbreaks are a notifiable medical condition in South Africa, they are likely underreported. There is great variability in outbreaks investigation and reporting throughout the country. The lack of epidemiological data limited the analysis. This review is based on outbreaks reported to NICD, is not a true representative of the burden of FBDs in the country. Strengthening and training to improve outbreak investigations, including specimen and epidemiological data collection and reporting is recommended.