What started as a small outbreak of “pink eye” at the Mangosuthu University of Technology in Umlazi, KwaZulu-Natal, has ballooned to more than 13,000 cases of conjunctivitis, with concerned health practitioners calling on the provincial health department to find the pathogen causing the spreading infection.

Nevashan Govender, the operations manager for the Emergency Operations Centre at the National Institute for Communicable Diseases (NICD), said the centre was aware of a “possible conjunctivitis outbreak” and has been monitoring it.

On 5 March, the KwaZulu-Natal health department said there were 2,971 cases in the province, 843 of which were new. Most of these cases were in the eThekwini district, and some in the Ugu district.

The department said health education to prevent the spread of the disease was continuing.

On 22 March, speaking at the provincial executive council, KwaZulu-Natal premier Nomusa Dube-Ncube said this number stood at 13,593 cases.

She urged preventative measures such as hand washing so that the health system didn’t become “overwhelmed”.

The National Eye Health Advocacy Project said it believes there could be a link between the outbreak and possibly contaminated water in the province and added that there should be greater alarm about the outbreak.

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It called on the health department to publish more information about the type of conjunctivitis that clinics and hospitals were diagnosing.

“Many ocular diseases can be attributed to contaminated water and we use the term ‘water-related ocular diseases’ to denote this spectrum of diseases. [These diseases] are directly related to human interaction with contaminated water and can occur through toxic, allergic, inflammatory or infective mechanisms,” it said.

It also warned that conjunctivitis could cause severe damage and even blindness in immunocompromised individuals and the elderly.

“We assert that the recent outbreak of ‘pink eye’ could likely be attached to the lack of access to clean, safe water. Beyond ‘pink eye’, additional risks present for ocular disease linked to acanthamoeba and pseudomonas, both of which require extensive public health awareness and urgent preventive measures from authorities.”

Acanthamoeba is a microscopic single-celled living organism that can cause rare but severe infections of the eye, skin and central nervous system. Pseudomonas is a type of bacteria.

“While the department has advised the public to exercise good hygiene as a preventive measure, we wish to highlight that good hygiene is unavoidably attached to access to safe and clean water, a right enshrined in our Constitution.

“We call upon provincial and district departments responsible for health, environmental health, and water and sanitation to act swiftly. Reaching the point of the infectious outbreak of ocular disease is alarming and has far-reaching impacts on individuals and communities.”

Govender said the Emergency Operations Centre could not comment on speculation about contaminated water.

“The scope of the investigation is within the mandate of the KwaZulu-Natal provincial authorities. The NICD assists the province in its primary capacity for specialised testing to identify the causative pathogen,” Govender added.

Neither the KwaZulu-Natal health department nor the eThekwini Municipality had responded by the time of publication to questions about their investigations into the outbreak or the possibility of contaminated water being the cause. DM

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R29.