00:00:00
Speaker 1: Earning questions. Insightful answers. Listener's Choice. With Clemens Manyatela.
00:00:05
Speaker 2: Listener's Choice feature, which we do every single Wednesday after the news at 11 o'clock. And this is an opportunity for you to co-curate the content of the show with us. Because we spend the whole time deciding what we're going to do on a Monday, Tuesday, Thursday, Friday. And this is an opportunity for you to tell us what we must talk about.
00:00:25
Speaker 1: And.
00:00:26
Speaker 2: If you want to do that, you can send me an email on cm at 702.co.za. And you can tell us maybe there's an issue that you think we haven't sufficiently conversed. Maybe there's an issue that you still have a lot of questions about. You want us to bring in an expert who can respond to that. Just send me an email on cm at 702.co.za if you want to suggest something for us to discuss on the show. Today, we have been asked to talk about E.
00:00:57
Speaker 1: Coli.
00:00:58
Speaker 2: So we're going to spend some time understanding E. coli and how to stay safe. This is a name many of us have heard, usually in connection with contaminated food or water. But what does it actually mean when this bacterium is detected in a water supply? And how worried should we be? Because the question has become particularly urgent following COVID. a gastrointestinal illness outbreak in Bronco Spray in surrounding communities where over 400 cases were reported between the 7th and the 18th of October. And if you check the preliminary water tests, you see that they found high levels of E. coli while health authorities detected other disease-causing pathogens in samples from infected patients. So the incident has raised some serious questions about water treatment, sewage pollution, public health warnings, and also the safety of the water coming out of our taps. But beyond brongor spray, what should the rest of us understand about E.
00:02:06
Speaker 1: Coli?
00:02:07
Speaker 2: And how does it get into our water and food? What symptoms should we look out for? And more importantly, what practical steps can we take to protect ourselves, particularly our children or even our older relatives and people with weakened immune systems. So to help us understand the science and separate fact from fear and explain what South Africans need to know, we've invited Dr. Karine Lachminarian, who is a senior pathologist at the Center for Enteric Diseases at the NICD, who's joining us now via Zoom. Thank you so much for making time for us, doctor.
00:02:47
Speaker 1: Good morning.
00:02:48
Speaker 4: Good morning, Chairman. Thank you for having me.
00:02:52
Speaker 1: Let's start with understanding what E.
00:02:54
Speaker 2: Coli is. What exactly is it and why does its presence in water raise alarm?
00:03:02
Speaker 4: Okay, so let's talk about E. coli. I'm a microbiologist by training, so I have to say the full name. It's actually Escherichia coli, which is a beautiful name. And it's a rod-shaped bacteria that is commonly found in the lower intestines of humans and warm-blooded animals. And these exist in all of our guts as normal, harmless bacteria that help us to maintain a healthy digestive tract. But there are certain strains. They're called the diureogenic E. coli strains. that do have the potential to cause diarrheal diseases. And when we look at it, we panic when we say there's E. coli in the water, and rightfully so, because E. coli is basically a smoke alarm, and it raises the possibility that there is recent fecal contamination in the water supply. And this is because E. coli doesn't grow or reproduce on its own in the natural environment. It has to come originally from the gut of humans and animals. And therefore, we say that if a water sample is contaminated with E. coli, that it is proof of recent fecal contamination. So something along the water supply line would have been breached for us to find this E. coli within the water.
00:04:42
Speaker 1: Okay, so are all the strains of it harmful?
00:04:48
Speaker 4: Not all. There's six specific pathotypes, we call them. If you can just bear with me while I say these boggling names. The entropathogenic E. coli, which is associated more with infant diarrhea. And then we have endotoxigenic E. coli, which we see in traveler's diarrhea. There's endohemorrhagic E. coli, which causes bloody diarrhea and a very severe form of diarrhea. And then you get two others that are called the endoaggregative E. coli, which causes persistent diarrhea. as well as enteroinvasive E. coli, which causes bloody diarrhea when the E. coli invades into the gut and causes a bleeding. So those are the specific pathogenic types that we identify in patients with diuregenic E. coli infection.
00:05:52
Speaker 1: How does E.
00:05:53
Speaker 2: Coli, though, get into drinking water in the first place? Can the sewage leaks... or maybe even failing wastewater treatment works, contaminated rivers, or problems that water treatment plants allow bacteria to reach our taps.
00:06:10
Speaker 4: Yeah, so that's the, you've actually answered the question quite nicely. So how it actually comes into the taps is that I think in our country, infrastructure failures, so leaking, broken sewer lines, cracked taps or cracked underwater pipes, that allow dirty wastewater to cross-contaminate clean tap water. So if you're thinking about it, it's basically cross-contamination of sewage water into the clean water plant. And then you also have sewage overflow. So this is also relevant to us because heavy storms, as we're seeing with climate change in our country, heavy storms can overwhelm the urban sewer systems, and this causes raw sewage to actually spill into local waterways and into street-level water.
00:07:10
Speaker 2: So how do we prevent this then? What should a properly functioning water treatment system be doing to prevent this?
00:07:19
Speaker 4: So, you know, I'm not a water and sanitation.
00:07:22
Speaker 1: I'm sorry, and I know you're not an engineer.
00:07:27
Speaker 4: So I don't know exactly what to do. I mean, I can't answer that to the detail, but it lies with, you know, having good water infrastructure, ensuring that the water is properly sanitized with chlorine. And I think that is the responsibility of the water and sanitation department and really it stems from there and just keeping the infrastructure safe. and in good condition.
00:07:59
Speaker 2: What symptoms should make someone suspect a water.
00:08:03
Speaker 1: Or foodborne infection? What should we be looking out for?
00:08:07
Speaker 4: Okay, so when you say you've drank contaminated water now and you feel like you may have a gastrointestinal illness, So what you would present is with diarrhea. So that means you'll have a loose frequent stool. You'll be passing loose frequent stool. You'll also be increasingly thirsty over and above the normal thirst that you may feel. You'll have a dry mouth and lips, which is indicative of some degree of dehydration. You'll also have dark urine, meaning that your body is trying to concentrate and preserve whatever water it has. And, you know, there are some other symptoms like you may feel lightheaded or dizzy in some circumstances. You'd also see, you know, some people present with stomach cramps, nausea, loss of appetite, you're unable to eat, vomiting at some times. And in cases you do get fever, headaches as well. muscle aches and fatigue.
00:09:22
Speaker 2: And do we have particular groups in society that are more at risk? Because I think I've seen somewhere that diarrhea can become dangerous quite quickly with babies or young children.
00:09:34
Speaker 4: Yes, so that we need to protect our high risk groups. And that was the problem in this outbreak is that most of our children were severely affected with diarrhea. So babies and children under the age of six, as well as older adults over the age of 65, so our elderly population, and people with underlying comorbid conditions. which weakens their immune system, like diabetes, HIV, cancer patients, they are all at increased risk of contracting gastroenteritis and being susceptible to these pathogens purely because their immune systems are weakened and they are unable to fight against these bacteria efficiently.
00:10:26
Speaker 2: Are there any signs of dehydration? What is it that we should look out for? Maybe if someone really suffers from serious dehydration, it could be as a result of that water or foodborne infection.
00:10:42
Speaker 4: Okay, so let's talk about the babies. I think that sometimes they can't talk to us. So we have to parents have to look out for what we call altered responsiveness. So the child is usually lethargic, listless, drowsy, sometimes may appear confused or just having difficulty waking, just, you know, very low energy. And severe dehydration signs in children are no wet diapers. So their diapers aren't wet. They haven't urinated for over six to eight hours. That's a warning sign. You'd also get no tears when they're crying. And that is together with a very dry mouth and lips. And sometimes their lips could even be blue or their skin can be mottled and pale in appearance. And in your adult patients, it's very similar to the symptoms that I mentioned before in that you will be increasingly thirsty. You'll have your dry mouth and lips very, very weak. You know, gastrointestinal diseases, it weakens you. to the point where you feel like, oh my gosh, something is wrong. I need to seek healthcare. So those are some of the things that we need to look out for.
00:12:12
Speaker 1: All right.
00:12:15
Speaker 4: 011-883-0702.
00:12:15
Speaker 2: You can give us a call if you've got a question for Dr. Karin Lachminarian, who is a senior pathologist at the Center for Enteric Diseases at the NICD. You can send WhatsApps as well on 0727-021702. Before I go to those questions, doctor, I want to understand perhaps what we should be doing at home to keep ourselves safe. I imagine people listening to us are thinking, you know, how should we clean containers used to collect water, for instance, or what are the essential precautions around drinking water or brushing your teeth or washing fruits and preparing baby formula or What are the precautions we need to take?
00:13:04
Speaker 5: Okay, so I think for now, the city of Thuane has released, and this is in general as well, so it's not only for the outbreak, but official advisory from the Department of Health at the moment says that we should not be using water in the first place, right? And the people need to be using the municipal water tankers that are being provided.
00:13:31
Speaker 4: But in terms of simple things like brushing your teeth, washing your fruit and veg, you shouldn't be using the tap water at the moment in the city of Tawane, in the areas that are affected. What we need to do is boil our water. So there are some reports where they say boiling water does not help. That's largely untrue when it comes to bacteria and viruses. So the best thing we can do for ourselves now is boiling water. Boiling kills the organisms like E. coli, norovirus, salmonella, shigella. It effectively kills the bacteria. And when I mean boiling, I mean you need to bring your water to a rolling boil for up to three minutes, and then you allow it to stand and cool. And if you're putting your water into a potable container or your storage containers, the way I would suggest that we clean those containers is wash it with hot water, hot, clean water and soap, use soapy liquid. You can also use your household bleach. So you would use your bleach and you would make sure you would basically mix one teaspoon of your regular bleach. And remember that your regular bleach needs to contain five to 8% of sodium hypochlorite. So you're going to say if it's a quick recipe, you mix one teaspoon of regular bleach to every four cups of water and you pour the solution into your containers, shake it well so that it reaches every surface of that container. And then you rinse that off and you allow it to air dry, preferably in the sun, and then you fill your clean water. So that is the best way at the moment for us to protect ourselves from contaminated water sources in the current situation and even going forward.
00:15:44
Speaker 2: Yeah, and I think going forward, I mean, there are people who may not be living in Tuaninao, but I think some of the precautions you mentioned, that's still applicable.
00:15:53
Speaker 1: Right, just to be more extra cautious.
00:15:57
Speaker 4: Okay.
00:15:58
Speaker 2: If someone develops diarrhea, for instance, what should they do? What should they try and avoid?
00:16:07
Speaker 4: Okay, so diarrhea is most often self-limiting, meaning that you will treat yourself, your immune system takes care of you in a healthy adult, right? If you do have mild diarrhea, so you are going to the bathroom a little more often than you normally do and your stool is loose and you're not completely fatigued and you don't have signs of severe dehydration, which is your lethargy and listlessness, you can treat yourself at home with drinking oral rehydration solutions. And your oral rehydration solution, I will just give you another quick recipe. It's basically one liter of boiled cold water, six teaspoons of sugar, and half a teaspoon of salt. And these teaspoons should be flat. And so you make that solution for yourself and you keep drinking that. And the reason why we need the salt and sugar is is to replace all the electrolytes that we are losing with the diarrhea. We should not rush into treating ourselves with antibiotics. I think that if you are sick enough to visit the healthcare facility, please allow the general practitioners or the doctors, whichever doctor you may be visiting, to prescribe that antibiotic for you because they are better informed as to the choice of antibiotic to use in the specific patient. And then in terms of like foods, you know, we talk about eating the right diet when you have diarrhea, and it's called the BRAT diet. So it's bananas, rice, applesauce, and toast. So keep to that in the first 48 hours. And then we should avoid any sort of caffeine, alcohol, energy drinks, sodas, alcohol, coffee. They all increase and contribute to fluid loss in the gut. And it also irritates the gut. And so we should also stay away from dairy products and greasy and spicy foods as well.
00:18:33
Speaker 1: It's a tough one. Okay.
00:18:37
Speaker 2: I've got some questions coming from our listeners and some calls as well. Let me start with this one. Someone wants to know, doesn't boiling water that has fluoride turn into fluorine, which is more harmful.
00:18:53
Speaker 1: Please. Can you clarify that?
00:18:55
Speaker 4: I actually don't know the answer to that. We don't, um, Generally, we don't really think, we don't, I don't know about that really. The fluorine, what I do know though, is that what boiling doesn't do is eradicate chemical contaminants. So boiling fails to remove chemical contaminants such as like lead, arsenic, nitrates, and things like that, pesticides. So that's what I do know. I'm not sure about the flow rate.
00:19:34
Speaker 1: No worries. Got you.
00:19:36
Speaker 2: Some WhatsApps are coming through on 072702 and 702. Aisha is calling us from Pretoria. Aisha, I understand you are a water scientist and you can help us with what needs to be done to prevent. E. coli infections.
00:19:51
Speaker 1: Good morning.
00:19:52
Speaker 3: Good morning. Thank you very much for taking my call. I was screaming through here while some questions were being asked. So let me just say I'm a water scientist. I do process audits and risk assessments of water and wastewater treatment plants, municipal plants. All municipalities are required to treat the water to acceptable limits as per the national standard SANS 241, and that means there should be zero E. coli in the final water. Conventional treatment will definitely kill the E. coli, and it's simple chlorination that is practiced throughout all conventional plants in South Africa. The problem is, I would like to know, Why was there repeated failures for microbiological compliance at these treatment plants and it was not a boil water notice, was not issued to the public? Because let me just say the regulation is very clear. The revised norms and standards, water and sanitation norms and standards that was issued in 2025 says it is an offense if a boil water notice is not issued when there are repeated micro failures. So I just feel sad that these failures have been notified to the Department of Water and Sanitation. Where was it escalated in the city of Tswane? I would like to know. And why did people not respond to this knowing that it was unsafe water? And you know what? To the listeners, it wasn't just this one month, three months that they didn't have chlorine. First of all, chlorine should be a standard item on every water treatment plant's budget. You have to chlorinate. If you do nothing, the one thing you do is disinfect the water because even if there's sand in the water and there's no bacteria, then people are safe. So that is, for me, that is gross negligence. I don't understand that. For now, people can boil the water. If you boil the water, you will kill the E. coli because that's the quickest way to get rid of it. In addition, what listeners can do, if they want to, they can take one liter of water and add in one teaspoon of jic. Leave it for an hour so that the jic breaks down, which is essentially chlorinating the water, and the water will be free of pathogens.
00:21:56
Speaker 4: All right.
00:21:56
Speaker 2: Aisha in Pretoria, thanks. Aisha is a water scientist. They wanted to respond to what can be done and even with the treatment of water to prevent E. coli infections. Someone, doctor, was asking about Jojo tanks, just a water tanker. Is there anything that they can do to treat their water or they don't have to worry if there is no scenario where.
00:22:23
Speaker 1: You know, the E.
00:22:23
Speaker 2: Coli infections or So they're asking how can they be more cautious even with their tank water? Is there anything they need to do or they're safe until there's a lamb being raised?
00:22:36
Speaker 4: I do feel that is for a water and sanitation specialist and for the Georgia tank installers to actually answer. But I do know that there are some chlorine tablets that you can treat the water with. I think it also depends on how your Jojo tanks are connected to your homes. Is it connected to the municipal water or is it connected with the storm water? But I would advise against drinking the Jojo tank water without actually boiling the water and cooling it and making it 100% safe for consumption. Yeah.
00:23:14
Speaker 2: Well, thank you so much for help. helping us understand more about E. coli and how we can stay safe, Dr. Karine Lachminarian, Senior Pathologist at the Center for Enteric Diseases at the NICD.
00:23:29
Speaker 1: That takes us to 11.30.
Speaker 1: Earning questions. Insightful answers. Listener's Choice. With Clemens Manyatela.
00:00:05
Speaker 2: Listener's Choice feature, which we do every single Wednesday after the news at 11 o'clock. And this is an opportunity for you to co-curate the content of the show with us. Because we spend the whole time deciding what we're going to do on a Monday, Tuesday, Thursday, Friday. And this is an opportunity for you to tell us what we must talk about.
00:00:25
Speaker 1: And.
00:00:26
Speaker 2: If you want to do that, you can send me an email on cm at 702.co.za. And you can tell us maybe there's an issue that you think we haven't sufficiently conversed. Maybe there's an issue that you still have a lot of questions about. You want us to bring in an expert who can respond to that. Just send me an email on cm at 702.co.za if you want to suggest something for us to discuss on the show. Today, we have been asked to talk about E.
00:00:57
Speaker 1: Coli.
00:00:58
Speaker 2: So we're going to spend some time understanding E. coli and how to stay safe. This is a name many of us have heard, usually in connection with contaminated food or water. But what does it actually mean when this bacterium is detected in a water supply? And how worried should we be? Because the question has become particularly urgent following COVID. a gastrointestinal illness outbreak in Bronco Spray in surrounding communities where over 400 cases were reported between the 7th and the 18th of October. And if you check the preliminary water tests, you see that they found high levels of E. coli while health authorities detected other disease-causing pathogens in samples from infected patients. So the incident has raised some serious questions about water treatment, sewage pollution, public health warnings, and also the safety of the water coming out of our taps. But beyond brongor spray, what should the rest of us understand about E.
00:02:06
Speaker 1: Coli?
00:02:07
Speaker 2: And how does it get into our water and food? What symptoms should we look out for? And more importantly, what practical steps can we take to protect ourselves, particularly our children or even our older relatives and people with weakened immune systems. So to help us understand the science and separate fact from fear and explain what South Africans need to know, we've invited Dr. Karine Lachminarian, who is a senior pathologist at the Center for Enteric Diseases at the NICD, who's joining us now via Zoom. Thank you so much for making time for us, doctor.
00:02:47
Speaker 1: Good morning.
00:02:48
Speaker 4: Good morning, Chairman. Thank you for having me.
00:02:52
Speaker 1: Let's start with understanding what E.
00:02:54
Speaker 2: Coli is. What exactly is it and why does its presence in water raise alarm?
00:03:02
Speaker 4: Okay, so let's talk about E. coli. I'm a microbiologist by training, so I have to say the full name. It's actually Escherichia coli, which is a beautiful name. And it's a rod-shaped bacteria that is commonly found in the lower intestines of humans and warm-blooded animals. And these exist in all of our guts as normal, harmless bacteria that help us to maintain a healthy digestive tract. But there are certain strains. They're called the diureogenic E. coli strains. that do have the potential to cause diarrheal diseases. And when we look at it, we panic when we say there's E. coli in the water, and rightfully so, because E. coli is basically a smoke alarm, and it raises the possibility that there is recent fecal contamination in the water supply. And this is because E. coli doesn't grow or reproduce on its own in the natural environment. It has to come originally from the gut of humans and animals. And therefore, we say that if a water sample is contaminated with E. coli, that it is proof of recent fecal contamination. So something along the water supply line would have been breached for us to find this E. coli within the water.
00:04:42
Speaker 1: Okay, so are all the strains of it harmful?
00:04:48
Speaker 4: Not all. There's six specific pathotypes, we call them. If you can just bear with me while I say these boggling names. The entropathogenic E. coli, which is associated more with infant diarrhea. And then we have endotoxigenic E. coli, which we see in traveler's diarrhea. There's endohemorrhagic E. coli, which causes bloody diarrhea and a very severe form of diarrhea. And then you get two others that are called the endoaggregative E. coli, which causes persistent diarrhea. as well as enteroinvasive E. coli, which causes bloody diarrhea when the E. coli invades into the gut and causes a bleeding. So those are the specific pathogenic types that we identify in patients with diuregenic E. coli infection.
00:05:52
Speaker 1: How does E.
00:05:53
Speaker 2: Coli, though, get into drinking water in the first place? Can the sewage leaks... or maybe even failing wastewater treatment works, contaminated rivers, or problems that water treatment plants allow bacteria to reach our taps.
00:06:10
Speaker 4: Yeah, so that's the, you've actually answered the question quite nicely. So how it actually comes into the taps is that I think in our country, infrastructure failures, so leaking, broken sewer lines, cracked taps or cracked underwater pipes, that allow dirty wastewater to cross-contaminate clean tap water. So if you're thinking about it, it's basically cross-contamination of sewage water into the clean water plant. And then you also have sewage overflow. So this is also relevant to us because heavy storms, as we're seeing with climate change in our country, heavy storms can overwhelm the urban sewer systems, and this causes raw sewage to actually spill into local waterways and into street-level water.
00:07:10
Speaker 2: So how do we prevent this then? What should a properly functioning water treatment system be doing to prevent this?
00:07:19
Speaker 4: So, you know, I'm not a water and sanitation.
00:07:22
Speaker 1: I'm sorry, and I know you're not an engineer.
00:07:27
Speaker 4: So I don't know exactly what to do. I mean, I can't answer that to the detail, but it lies with, you know, having good water infrastructure, ensuring that the water is properly sanitized with chlorine. And I think that is the responsibility of the water and sanitation department and really it stems from there and just keeping the infrastructure safe. and in good condition.
00:07:59
Speaker 2: What symptoms should make someone suspect a water.
00:08:03
Speaker 1: Or foodborne infection? What should we be looking out for?
00:08:07
Speaker 4: Okay, so when you say you've drank contaminated water now and you feel like you may have a gastrointestinal illness, So what you would present is with diarrhea. So that means you'll have a loose frequent stool. You'll be passing loose frequent stool. You'll also be increasingly thirsty over and above the normal thirst that you may feel. You'll have a dry mouth and lips, which is indicative of some degree of dehydration. You'll also have dark urine, meaning that your body is trying to concentrate and preserve whatever water it has. And, you know, there are some other symptoms like you may feel lightheaded or dizzy in some circumstances. You'd also see, you know, some people present with stomach cramps, nausea, loss of appetite, you're unable to eat, vomiting at some times. And in cases you do get fever, headaches as well. muscle aches and fatigue.
00:09:22
Speaker 2: And do we have particular groups in society that are more at risk? Because I think I've seen somewhere that diarrhea can become dangerous quite quickly with babies or young children.
00:09:34
Speaker 4: Yes, so that we need to protect our high risk groups. And that was the problem in this outbreak is that most of our children were severely affected with diarrhea. So babies and children under the age of six, as well as older adults over the age of 65, so our elderly population, and people with underlying comorbid conditions. which weakens their immune system, like diabetes, HIV, cancer patients, they are all at increased risk of contracting gastroenteritis and being susceptible to these pathogens purely because their immune systems are weakened and they are unable to fight against these bacteria efficiently.
00:10:26
Speaker 2: Are there any signs of dehydration? What is it that we should look out for? Maybe if someone really suffers from serious dehydration, it could be as a result of that water or foodborne infection.
00:10:42
Speaker 4: Okay, so let's talk about the babies. I think that sometimes they can't talk to us. So we have to parents have to look out for what we call altered responsiveness. So the child is usually lethargic, listless, drowsy, sometimes may appear confused or just having difficulty waking, just, you know, very low energy. And severe dehydration signs in children are no wet diapers. So their diapers aren't wet. They haven't urinated for over six to eight hours. That's a warning sign. You'd also get no tears when they're crying. And that is together with a very dry mouth and lips. And sometimes their lips could even be blue or their skin can be mottled and pale in appearance. And in your adult patients, it's very similar to the symptoms that I mentioned before in that you will be increasingly thirsty. You'll have your dry mouth and lips very, very weak. You know, gastrointestinal diseases, it weakens you. to the point where you feel like, oh my gosh, something is wrong. I need to seek healthcare. So those are some of the things that we need to look out for.
00:12:12
Speaker 1: All right.
00:12:15
Speaker 4: 011-883-0702.
00:12:15
Speaker 2: You can give us a call if you've got a question for Dr. Karin Lachminarian, who is a senior pathologist at the Center for Enteric Diseases at the NICD. You can send WhatsApps as well on 0727-021702. Before I go to those questions, doctor, I want to understand perhaps what we should be doing at home to keep ourselves safe. I imagine people listening to us are thinking, you know, how should we clean containers used to collect water, for instance, or what are the essential precautions around drinking water or brushing your teeth or washing fruits and preparing baby formula or What are the precautions we need to take?
00:13:04
Speaker 5: Okay, so I think for now, the city of Thuane has released, and this is in general as well, so it's not only for the outbreak, but official advisory from the Department of Health at the moment says that we should not be using water in the first place, right? And the people need to be using the municipal water tankers that are being provided.
00:13:31
Speaker 4: But in terms of simple things like brushing your teeth, washing your fruit and veg, you shouldn't be using the tap water at the moment in the city of Tawane, in the areas that are affected. What we need to do is boil our water. So there are some reports where they say boiling water does not help. That's largely untrue when it comes to bacteria and viruses. So the best thing we can do for ourselves now is boiling water. Boiling kills the organisms like E. coli, norovirus, salmonella, shigella. It effectively kills the bacteria. And when I mean boiling, I mean you need to bring your water to a rolling boil for up to three minutes, and then you allow it to stand and cool. And if you're putting your water into a potable container or your storage containers, the way I would suggest that we clean those containers is wash it with hot water, hot, clean water and soap, use soapy liquid. You can also use your household bleach. So you would use your bleach and you would make sure you would basically mix one teaspoon of your regular bleach. And remember that your regular bleach needs to contain five to 8% of sodium hypochlorite. So you're going to say if it's a quick recipe, you mix one teaspoon of regular bleach to every four cups of water and you pour the solution into your containers, shake it well so that it reaches every surface of that container. And then you rinse that off and you allow it to air dry, preferably in the sun, and then you fill your clean water. So that is the best way at the moment for us to protect ourselves from contaminated water sources in the current situation and even going forward.
00:15:44
Speaker 2: Yeah, and I think going forward, I mean, there are people who may not be living in Tuaninao, but I think some of the precautions you mentioned, that's still applicable.
00:15:53
Speaker 1: Right, just to be more extra cautious.
00:15:57
Speaker 4: Okay.
00:15:58
Speaker 2: If someone develops diarrhea, for instance, what should they do? What should they try and avoid?
00:16:07
Speaker 4: Okay, so diarrhea is most often self-limiting, meaning that you will treat yourself, your immune system takes care of you in a healthy adult, right? If you do have mild diarrhea, so you are going to the bathroom a little more often than you normally do and your stool is loose and you're not completely fatigued and you don't have signs of severe dehydration, which is your lethargy and listlessness, you can treat yourself at home with drinking oral rehydration solutions. And your oral rehydration solution, I will just give you another quick recipe. It's basically one liter of boiled cold water, six teaspoons of sugar, and half a teaspoon of salt. And these teaspoons should be flat. And so you make that solution for yourself and you keep drinking that. And the reason why we need the salt and sugar is is to replace all the electrolytes that we are losing with the diarrhea. We should not rush into treating ourselves with antibiotics. I think that if you are sick enough to visit the healthcare facility, please allow the general practitioners or the doctors, whichever doctor you may be visiting, to prescribe that antibiotic for you because they are better informed as to the choice of antibiotic to use in the specific patient. And then in terms of like foods, you know, we talk about eating the right diet when you have diarrhea, and it's called the BRAT diet. So it's bananas, rice, applesauce, and toast. So keep to that in the first 48 hours. And then we should avoid any sort of caffeine, alcohol, energy drinks, sodas, alcohol, coffee. They all increase and contribute to fluid loss in the gut. And it also irritates the gut. And so we should also stay away from dairy products and greasy and spicy foods as well.
00:18:33
Speaker 1: It's a tough one. Okay.
00:18:37
Speaker 2: I've got some questions coming from our listeners and some calls as well. Let me start with this one. Someone wants to know, doesn't boiling water that has fluoride turn into fluorine, which is more harmful.
00:18:53
Speaker 1: Please. Can you clarify that?
00:18:55
Speaker 4: I actually don't know the answer to that. We don't, um, Generally, we don't really think, we don't, I don't know about that really. The fluorine, what I do know though, is that what boiling doesn't do is eradicate chemical contaminants. So boiling fails to remove chemical contaminants such as like lead, arsenic, nitrates, and things like that, pesticides. So that's what I do know. I'm not sure about the flow rate.
00:19:34
Speaker 1: No worries. Got you.
00:19:36
Speaker 2: Some WhatsApps are coming through on 072702 and 702. Aisha is calling us from Pretoria. Aisha, I understand you are a water scientist and you can help us with what needs to be done to prevent. E. coli infections.
00:19:51
Speaker 1: Good morning.
00:19:52
Speaker 3: Good morning. Thank you very much for taking my call. I was screaming through here while some questions were being asked. So let me just say I'm a water scientist. I do process audits and risk assessments of water and wastewater treatment plants, municipal plants. All municipalities are required to treat the water to acceptable limits as per the national standard SANS 241, and that means there should be zero E. coli in the final water. Conventional treatment will definitely kill the E. coli, and it's simple chlorination that is practiced throughout all conventional plants in South Africa. The problem is, I would like to know, Why was there repeated failures for microbiological compliance at these treatment plants and it was not a boil water notice, was not issued to the public? Because let me just say the regulation is very clear. The revised norms and standards, water and sanitation norms and standards that was issued in 2025 says it is an offense if a boil water notice is not issued when there are repeated micro failures. So I just feel sad that these failures have been notified to the Department of Water and Sanitation. Where was it escalated in the city of Tswane? I would like to know. And why did people not respond to this knowing that it was unsafe water? And you know what? To the listeners, it wasn't just this one month, three months that they didn't have chlorine. First of all, chlorine should be a standard item on every water treatment plant's budget. You have to chlorinate. If you do nothing, the one thing you do is disinfect the water because even if there's sand in the water and there's no bacteria, then people are safe. So that is, for me, that is gross negligence. I don't understand that. For now, people can boil the water. If you boil the water, you will kill the E. coli because that's the quickest way to get rid of it. In addition, what listeners can do, if they want to, they can take one liter of water and add in one teaspoon of jic. Leave it for an hour so that the jic breaks down, which is essentially chlorinating the water, and the water will be free of pathogens.
00:21:56
Speaker 4: All right.
00:21:56
Speaker 2: Aisha in Pretoria, thanks. Aisha is a water scientist. They wanted to respond to what can be done and even with the treatment of water to prevent E. coli infections. Someone, doctor, was asking about Jojo tanks, just a water tanker. Is there anything that they can do to treat their water or they don't have to worry if there is no scenario where.
00:22:23
Speaker 1: You know, the E.
00:22:23
Speaker 2: Coli infections or So they're asking how can they be more cautious even with their tank water? Is there anything they need to do or they're safe until there's a lamb being raised?
00:22:36
Speaker 4: I do feel that is for a water and sanitation specialist and for the Georgia tank installers to actually answer. But I do know that there are some chlorine tablets that you can treat the water with. I think it also depends on how your Jojo tanks are connected to your homes. Is it connected to the municipal water or is it connected with the storm water? But I would advise against drinking the Jojo tank water without actually boiling the water and cooling it and making it 100% safe for consumption. Yeah.
00:23:14
Speaker 2: Well, thank you so much for help. helping us understand more about E. coli and how we can stay safe, Dr. Karine Lachminarian, Senior Pathologist at the Center for Enteric Diseases at the NICD.
00:23:29
Speaker 1: That takes us to 11.30.
