When the world’s worst rampage of listeriosis was at its peak, more than 30 confirmed cases were added to the outbreak weekly. After South Africa’s health officials identified the source and recalled the product from the market, the number of new confirmed cases was cut in half. And during the first week of April, it was cut in half again with only eight new cases.

A new report by South Africa’s National Listeria Incident Managment Team (IMT), formed by the National Department of Health (NDoH), says those eight new cases include one report from October 2017 that is being “retrospectively reported.” The IMT’s purpose is to “strengthen coordination of outbreak response and strengthen health systems to prevent further outbreaks.”

The world’s worst listeriosis outbreak now includes 1,019 laboratory-confirmed cases including 199 deaths. The recall increased by 50 cases since March 4-5 when authorities recognized the source of the epidemic as ready-to-eat processed meats products manufactured at Enterprise Foods’ Polokwane production facility and recalls were ordered.

South African health officials expected it would take several weeks to extinguish the listeriosis outbreak. Ending it requires removal of all contaminated product from both homes and the supply chain. Also, the incubation period for Listeria runs as long as 70 days. That is the time between when exposure occurs and when symptoms begin to appear.

Before 2017, South Africa experienced 60 to 80 laboratory-confirmed listeriosis cases each year. In July 2017, it reported a spike in cases to the National Institute for Communicable Diseases (NICD). Dr. Aaron Motsoaledi, SA’s Minister of Health, declared the outbreak last December.

Through the IMT, identification, and inspection of food-processing plants and strengthening the health system is the focus of South Africa’s emergency management.

Along with the NICD and the World Health Organization (WHO), a two-day meeting of provincial and national stakeholders gets underway today. It follows a WHO Listeriosis Technical Meeting held last week in Johannesburg to help other African countries prepare contingency plans to respond and control listeriosis.

South Africa’s health authorities have reached out to 145 key groups of people in the country’s nine provinces about the listeriosis challenges. These include food handlers, community leaders and institutions like schools and hospitals.

Environmental health officers and risk communication specialists are targets for a “top up” skills training. Risk training for food processing plants is also being rolled out.