After bacterial infections, Strand beachgoers call for effective water-quality flag system
Beachgoers have contracted lingering infections linked to high bacteria counts in the water at Strand Beach. Calls are mounting for clearer and more frequent communication of coastal water-quality status.
In interviews with Daily Maverick, beachgoers have shared their experiences of becoming extremely ill with lingering infections after using Strand Beach, Cape Town, for training and recreation. Experts believe the infections are caused by high bacteria counts in the water due to sewage contamination.
Most of the beachgoers who spoke to Daily Maverick were aware that there were problems with the water quality at the time caused by the ailing Ou Trappies sewer line. Many had seen signs at Strand warning beachgoers not to enter the water but were unaware of the severity of the health risks they faced.
When a coastal pollution incident is detected, the City of Cape Town has a response protocol to swiftly contain and rectify the situation, which entails the temporary closure, with signage, of the affected section of the beach until the water is safe again.
The city says all water-quality information is available on its coastal water-quality webpage, and physical signage is used when a site is affected. However, the city’s water-quality review on the webpage has been criticised for displaying incomplete information that is not updated regularly.
In the past, the city’s water-quality review assigned an overall risk level for each recreational node, but this has been missing from recent reviews.
Beachgoers say the city’s measures are not sufficient as the signage is often a flimsy board which is easily blown away or stolen. They complain that they do not have accurate and periodical information on the water quality at Strand and other beaches.
Daily Maverick has previously reported that data from the City of Cape Town’s website have shown “poor” water quality at a number of the city’s most popular beaches, including Strand.
Water-quality flag system
Jamii Hamlin, who represents surfers, lifesavers and other beach users in Strand and Helderberg, has long stated that the warning system to advise the public of beach closures and potential health risks was not effective.
“Unfortunately, Strand is not alone, as poor water quality remains the mean average for most of the recreational beaches around the Peninsula and thus I believe if the city were to adopt a water-quality flag system it would greatly reflect the accountability the government continually strives for,” Hamlin said.
Bays of Sewage is a community group created to raise awareness about the impacts of Cape Town’s marine sewage outfalls at Hout Bay, Camps Bay, and Green Point on humans and marine life. The community group advocates for better notification and communication of the status of coastal water quality around Cape Town.
Byron Herbert from Bays of Sewage has encouraged beachgoers to report potential sewage-related illnesses to [email protected] as they were developing a database to raise awareness about illnesses caused by poor coastal water quality.
Mark Jackson, who filmed the Bays of Sewage documentary, said part of the problem was that politicians value public perception more highly than public health.
“This is why, often, when there is an incident of sewage-beach contamination, the city’s only response might be to just erect a few signs. But we know these signs are ineffective, and that many beach users miss or ignore them,” he said.
Read more in Daily Maverick: Cape Town’s beaches may be more hazardous to health than they seem, according to sewage test results
Water treatment expert Professor Leslie Petrik of the Department of Chemistry at the University of the Western Cape, said the bacterial counts at Strand and many other beaches had been chronically poor.
Most of the bacteria in samples taken from water bodies by Petrik’s team have been highly antibiotic-resistant, meaning they do not die when infections are treated with most frontline antibiotics.
“There is a clear link between the sewage-contaminated seawater and picking up an infection that is resistant. Our studies indicate that the chemical contamination in sewage is implicated in developing antibiotic-resistant genes in microbes that survive contact. So a wound occurring in contaminated seawater would very likely be infected with such resistant organisms,” Petrik said.
Jo Barnes, a senior lecturer emeritus in epidemiology and community health at Stellenbosch University, said: “I am of the opinion that a water-quality flag system based on risk should be displayed at each beach, based on weekly or monthly average quality, and the public educated about the risks of swimming around our coastline.”
Responding to this suggestion, City of Cape Town coastal manager Gregg Oelofse said that they would need “lots of signs to explain the flags and colours, and what they mean to the people. We do this with our shark spotting flags and still people get confused after 16 years.”
Six days in ICU
Jean Degenaar, a champion open-water swimmer from the Warrior Swimmers group in Strand, has been regularly swimming from Strand Surf Lifesavers Club to Hibernian Towers and back for about four years. Between the end of September and November 2023, Degenaar suffered from a lack of energy and sinusitis.
She was hospitalised on 13 November for two weeks with severe abdominal pain and vomiting. The official diagnosis was pancreatitis and she spent six days in the ICU.
“My lungs filled up with fluid and I had to have drains in both. I was in bad shape, taking strong antibiotics and morphine for pain. I think my recovery was due to being fit. But I can only put this episode down to swimming in poor water quality. The E. coli levels at that time were pretty high,” she said.
After this harrowing experience, Degenaar no longer swims in the ocean and will use pools until she is sure the coastal water conditions are pristine. She said the city needed to improve its water-quality information system and also advocated a water-quality flag system.
Craig Hoblyn, who has been swimming, surfing and diving at Strand Beach for more than 30 years, became violently ill with fever, chills, stomach cramping, vomiting, diarrhoea and nausea on 23 September. He was admitted to the Hermanus Mediclinic ER the following morning.
“I had blood tests … which confirmed a severe bacterial infection — the doctor attributed the infection to raw sewage exposure in the Strand ocean water. I have been on antibiotics — three weeks on, I was still not fully recovered.”
Hoblyn said there was a warning board on the beach when he surfed, but he never imagined he would become so ill.
“We were quite aware … that the water quality at Strand had become quite poor. I mean, you could literally see it, smell it; it was quite evident but you sort of chose to go ahead or not. They did put up a sign that the water was unfit for recreational use. It was a small board in the corner that I think later on blew away or was rubbed out or something,” he said.
Read more in Daily Maverick: Barbara Creecy chides City of Cape Town over ‘inadequate’ public engagement on sewage pumped into sea
Another surfer, Emmanuel (who did not want his surname published), expressed concerns about the lack of public awareness and warning systems regarding water quality at Strand Beach.
In May 2023, he contracted an antibiotic-resistant bacterial infection with high counts of E. coli and faecal bacteria after cutting his foot in the water at Strand Beach. This is according to a bacterial culture test by PathCare, dated 19 June 2023, and seen by Daily Maverick.
The initial treatment included disinfection, stitches, a five-day antibiotic course and antibacterial gel. Despite this, the wound remained infected, leading to two additional five-day antibiotic courses. A test revealed the presence of E. coli and faecal bacteria. Targeted antibiotics were prescribed, and the infection finally subsided almost two months after the initial laceration.
Poor water quality
Strand Beach is one of Cape Town’s beaches that is plagued by chronic water-quality problems, and this has been exacerbated by ailing and ageing sewage infrastructure in the area. There have been 28 repairs to the Ou Trappies sewer line over the past four years, which has resulted in sewage being discharged into the ocean. Upgrades to the pipeline are being finalised and will continue until 2026.
Read more in Daily Maverick: Western Cape’s Strand residents and surfers up in arms over sewage flowing into streets and ocean
The City of Cape Town’s Oelofse, shared the city’s E. coli (sewage bacteria) data for Strand in September 2023, which is when some people using the beach became ill. On 8 September, the city closed the beach to all recreational users because of the Ou Trappies sewer line failure.
Oelofse said the city did not have data for enterococci (bacteria found in high concentrations in human faeces), at the time E. coli should not exceed 250 colony-forming units (CFU) per 100ml. On 20 September, the E. coli count at Strand Beach was more than double that, at 602cfu per 100ml.
According to the city’s water-quality review, the enterococci count for Strand Beach was 20cfu per 100ml on 8 November, 50cfu per 100ml on 22 November and 4cfu per 100ml on 13 December. Water with a concentration of below 35cfu per 100ml is considered safe for recreational purposes.
The city’s most recent enterococci results for Strand (10 January) showed less than 1cfu per 100ml — indicative of a steady improvement in the water quality.
Oelofse said, “Water-quality data is not real-time. City samples are taken twice a month and used to calculate a risk category — water quality is not a real-time reading and uses past data to indicate risk. This is the same all over the world.”
However, beachgoers have argued that the City’s bi-monthly water sampling is unreliable because extended periods of poor water quality resulting from changing wind direction, currents and storms could be overlooked in these readings.
Response from the city
In response to the experiences of the three beachgoers who became sick, City of Cape Town spokesperson Luthando Tyhalibongo said: “The context of these incidents (months after the fact) and at one location only, is extremely important.
“I want to caution upfront that these incidents cannot be used as a fair and reasonable indication of Cape Town’s coastal water quality in general, at this point in time.”
Tyhalibongo said the city’s Coastal Management Branch had contacted some of the individuals who raised concerns. One of them reportedly saw a “Water closed to all” sign but decided to surf anyway, while another swam in September when swimming at the beach was prohibited due to the Ou Trappies sewer line failure, and this is when she became unwell.
Tyhalibongo described it as “a huge accomplishment” that all of Cape Town’s beaches had remained open during the festive period.
However, earlier this month, Camps Bay’s Blue Flag status was temporarily lowered as a result of a sewage spill from a nearby toilet block.
A senior city official told Daily Maverick that if the water quality was poor and the data reflected that, then the city would have no problem warning of the risks of swimming, but “the data doesn’t support that narrative at all. Repeated tests show that water quality at key recreational nodes is really good. This should be good news for people.”
Tyhalibongo said, “In areas with chronic pollution, or close to pollution sources such as river mouths or stormwater drains that may contaminate coastal waters, there is permanent formal pollution signage in place. However … the public often ignores the signage.
“The city cannot accept responsibility for those who ignore the signage on site. Still, the city is always open to working with local stakeholders to raise further awareness.” DM