Fungal diseases can be extremely serious and, particularly for those with compromised immune systems, even life-threatening. People living with HIV; cancer patients; people who are admitted to hospital; people who are critically ill after trauma or surgery; and premature babies are among those most at risk.

The Fungal Disease Awareness Week is observed from 19-23 September 2022 and the aim is to highlight the importance of antifungal stewardship, reducing resistance to antifungal drugs, and recognising serious fungal diseases early enough in the course of a patient’s illness to provide lifesaving treatment.

Serious fungal diseases can occur together with other illnesses and can be mistaken for, or masked by these illnesses. Increased awareness about fungal diseases is one of the most important ways we can improve early recognition and reduce delays in diagnosis and treatment. We encourage healthcare providers and patients to “Think Fungus” when symptoms of infection do not get better with treatment.

Click here to learn more about fungal disease

Read more on fungal diseases that affect people with weakened immune systems

• Aspergillosis
• Candida auris infection
• Cryptococcal Disease
• Dimorphic Fungal Diseases
• Pneumocystis

*Updated Septermber 2022

As health systems face increasingly complex threats, training workers in field epidemiology is even more important.. The NICD, a division of the National Health Laboratory Service, embarked on a joint collaboration more than 15-years ago in establishing the South African Field Epidemiology Training Programme (SAFETP).  To date the program has trained 98 epidemiologists with the majority located in the public service in South Africa.

Field Epidemiologists, or ‘disease detectives’ are considered the cornerstone of public health preparedness and response. They often work long hours to complete arduous tasks that include contact tracing, case investigations, community engagement, data collection and analysis. The NICD and SAFETP will join TEPHINET and other global health partners in celebrating the invaluable role Field Epidemiologists play, and salutes those who have been at the forefront of disease outbreak response, both past and present.

For more information on SAFETP, contact Eudie Hlabioa on email EudieH@nicd.ac.za or click here.

Vaccines are widely acknowledged to be the most successful medical advance ever. Vaccines continue to save hundreds of thousands of lives annually. History is full of descriptions of the devastation wrought on populations by infectious diseases before the age of vaccination. Huge numbers were killed by diseases like measles and smallpox, and hundreds of thousands left paralyzed by polio.

Huge strides have been made in combating diseases such as polio, tuberculosis, measles, diphtheria, pertussis and tetanus using vaccination. Many of these diseases are now uncommon, and mothers today may have never even heard of friends who have lost children due to illnesses like measles or diphtheria.

The success of vaccines may therefore lead to complacency and a false sense of comfort, unless we remember the devastation that these diseases caused in years gone by.

 In some areas of Africa, it was customary for mothers not to name their babies until the measles season had passed, for fear they would not live through the season. Such fear of measles is no longer with us, and yet it is only by a continued sense of urgency that we can ensure that vaccine-preventable diseases do not return.

In South Africa, newer vaccines have been introduced as they have been developed, allowing protection against Haemophilus influenza type b, Streptococcus pneumoniae, hepatitis B, human papillomavirus and rotavirus. These vaccines are making a large impact on the health of South African children. We hope to see even more vaccines developed and implemented in the years to come.

You may be a parent and have some concerns with regards to vaccinating your child, here are a few frequently asked questions about vaccines;

Vaccine Common Questions

• Are Vaccines safe?
  Yes, vaccines are very safe. Vaccines are more studied for safety than any other medication.

• What are the possible side effects of vaccines?
  Like all medication, it is possible for a vaccine to cause side-effects. For the most part these are minor (for example, a sore arm or low-grade fever) and go away within a few days. Remember, vaccines are continually monitored for safety and are used to immunize millions of children in every country in the world each year. The decision not to immunize a child also involves risk and could put the child and others who come into contact with him or her at risk of contracting a potentially deadly disease.

• How do vaccines work?
  The process of vaccination involves giving a person small, harmless amounts of an infectious agent (for example a virus) in order for the immune system to see it and prepare itself for the next time it meets the same infectious agent. Some vaccines are weakened forms of live infectious agents (called live attenuated vaccines) and some are inactivated parts of the infectious agent.

• What are the risks of not vaccinating?
  The diseases vaccines prevent can be dangerous, or even deadly. Statistically, the chances of your child getting diseases such as measles, pertussis, or another vaccine-preventable disease might be low, and your child might never need the protection vaccines offer. However, you don’t want them to be lacking the protection vaccines provide if they ever do need it. Vaccination is the best way to protect your child from unpredictable side effects of serious infectious diseases. Vaccination protects your child, and children in your community.

• What diseases do vaccines prevent?
  Vaccines are available for these dangerous or deadly diseases. Over the years, these vaccines have prevented countless cases of disease and saved millions of lives.

• Chickenpox (Varicella)
• Diphtheria
• Flu (Influenza)
• Hepatitis A
• Hepatitis B
• Hib (Haemophilus influenzaetype b)
• Measles
• Meningococcal
• Mumps
• Pneumococcal
• Polio (Poliomyelitis)
• Rotavirus
• Rubella (German Measles)
• Tetanus (Lockjaw)
• Whooping Cough (Pertussis )

• Can I wait and vaccinate my child when they are a bit older?
  Children under 5 are especially susceptible to disease because their immune systems have not built up the necessary defences to fight infection. By immunizing on time (by age 2), you can protect your child from disease and also protect others at school or daycare.

• Are vaccines safe in pregnancy?
  The overriding principle is that for pregnant women, live vaccines should be avoided but non-live (inactivated) vaccines can be given. For specialist advice for particular medical conditions, please consult a doctor. Certain vaccines are particularly recommended for pregnant women, such as influenza vaccines and Tdap-IPV (tetanus, adult dose diphtheria, acelluar pertussis and IPV vaccine).

• My child has a weakened immune system (immune-compromised) – can he be vaccinated?
  The principle is that for people with weak immune systems such as those born with immune deficiencies, or those recovering from cancer or taking medication which dampens down their immune system, live vaccines should be avoided but non-live (inactivated) vaccines can be given. In fact, the non-live vaccines become even more important to protect the person from possible future infections.

It is possible that the immune response to vaccines may not be as strong as in a healthy person and the child may need re-vaccination once they are fully recovered. It is also important to check that all other children AND adults in the household have been vaccinated, in order to protect the child from catching diseases from them.

If household members require vaccination, inactivated vaccines should be given but a doctor should advise regarding whether live vaccines can be given to the household members. Some live vaccines given to household members may prove a risk to a child with a severely weakened immune system. See table 1 below for list of common live and non-live vaccines.

Prevention is always better than cure. Vaccines are the best prevention we can offer our children against infectious diseases – let’s make vaccine-preventable disease a distant memory for our children’s generation. Read more on vaccines here

Dr Melinda Suchard Head, Centre for Vaccines and Immunology National Institute for Communicable Diseases

Sexually Transmitted Infections (STIs) do not discriminate or respect boundaries; they can affect anyone who is sexually active regardless of nationality, race, ethnicity, religion, gender, sexual orientation, and economic status.

STIs are among the most common communicable diseases and constitute a major global public health burden.  The World Health Organization (WHO) estimated that, in 2016, there were approximately 377 million people aged 15-49 years newly infected with gonorrhoea, chlamydia, syphilis or trichomoniasis (four common, treatable STIs).  This corresponds to just over 1 million new STI cases worldwide every day.  In South Africa, estimates of people newly infected with STIs in 2017 were approximately 4.5 million for gonorrhoea, 6 million for chlamydia and 71 000 for syphilis.

People become infected with STIs through having unprotected vaginal, anal or oral sexual intercourse with infected partners.  A large proportion of people with STIs may not have any signs or symptoms, and so maybe unaware that they are infected.  Common symptoms and signs of STI include abnormal vaginal or penile discharge; pain during urination; ulcers in the genital area; swellings in the groin, and genital warts.  Untreated STIs result in long-term complications such as ongoing lower abdominal pain, infertility and adverse pregnancy outcomes like stillbirths and preterm delivery.  Treatment for STIs is given free of charge at primary healthcare clinics across South Africa.

The WHO is collaborating with partners to develop accurate, rapid, simple and affordable tests for STI screening at point of care (clinics).  People infected with STIs may be at increased risk of acquiring HIV, and also of transmitting HIV to partners if they have STI-HIV co-infection.  Therefore, HIV testing and linkage to care is an important part of STI management.  Elimination of mother-to-child transmission of both syphilis and HIV through the screening and treatment of pregnant women is a public health priority.

So how do we prevent the spread of STIs in our communities?

• We need to STOP STIGMA around STIs: so that those with infections can access care and treatment without fear of discrimination.
• We need to COMMUNICATE: talk freely with our partners about STIs and safe sex practices and educate our children about STI prevention.
• We need to COOPERATE: with each other and with healthcare workers, access treatment if infected and also refer partners for care.
• We need to CONDOMISE: consistent and correct condom use will protect against infection and prevent spread to others.

Learn more about the work of the Centre for HIV and Sexually Transmitted Infection by clicking here.

Resources:

https://www.cdc.gov/condomeffectiveness/male-condom-use.html

https://www.cdc.gov/condomeffectiveness/Female-condom-use.html

Globally it is estimated that up to 59 000 people die of rabies annually, this amounts to a rabies death every 10 minutes. Rabies is a neglected disease in most developing countries which means that although the tried-and-tested strategies for controlling and preventing the disease exits, it is not prioritized and invested in.

Rabies is a fatal viral infection of the brain that is transmitted from infected animals to humans. Rabies is a progressive disease and once a person starts developing symptoms it usually takes no more than two weeks for them to slip into a coma and die.

World Rabies Day, commemorated on the September 28th, focuses on rabies endemic countries, to increase community awareness of the disease and its prevention. World Rabies Day also raises the profile of national and local control programmes and acts as a springboard for year-round capacity building and awareness.

Human rabies can be prevented in almost 100% of cases if correct post-exposure preventative treatment is given timorously following exposure to suspected rabid animals. The rabies virus is transmitted from infected animals to humans through scratches, bites or licks on mucous membranes of the lips or eyes. The virus cannot be transmitted through intact skin, so touching, petting or being close to the animals is not a risk.

Outbreaks in domestic dogs only occur if the animals are not sufficiently vaccinated against the disease. Therefore any community in South Africa may be at risk for introduction of the virus when these measures are not in place. It is critically that all dog and cat owners ensure that their animals have been vaccinated against rabies within the past 3 years in order to protect their pets, themselves and their children against this uniform ally fatal disease. The first animal vaccine is given at three months of age with a booster within the following nine months.

Preventative measures include the following:  Washing of the wound very well for at least 10 minutes with water or soap and water to wash out the virus, and a course of rabies vaccinations into the arm so that the person can make antibodies against the rabies virus.  If there is a scratch with blood or a bite the addition of concentrated rabies antibodies into the wound is important to immediately ‘neutralize’ the virus.

Read more about Rabies