Conference Abstract | Volume 9, Abstract 058 (ConfProc7) | Published: 01 Jul 2026
Sibongile Lusizi1,2,3,&, Letlotlo Kukuu-Diloane2, Karabo Seloana2, Hellen Kgatla1, Mari van der Westhuizen2, Mpho Moshime-Shabangu4
1South Africa Field Epidemiology Training Programme, National Institute for Communicable Diseases, a Division of National Health Laboratory Services, Johannesburg, South Africa, 2Gauteng Department of Health, Child Health/Expanded Programme for Immunisation, Communicable Disease Control, Outbreak Response, Tshwane District Health Services, Pretoria, South Africa, 3School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa, 4Gauteng Department of Health, Primary Health Care, National Health Insurance, Tshwane District Health Services, Pretoria, South Africa
&Corresponding author: Sibongile Lusizi; SAFETP, National Institute for Communicable Diseases, a Division of National Health Laboratory Services, Johannesburg, South Africa, Email: sibongilelusizi5@gmail.com
Received: 25 Aug 2025, Accepted: 28 Oct 2025, Published: 01 Jul 2026
Domain: Infectious Disease Epidemiology
Keywords: Typhoid fever, sporadic, investigation, Tshwane District
©Sibongile Lusizi et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Sibongile Lusizi et al. Descriptive investigation of laboratory-confirmed typhoid fever cases and contact tracing in Tshwane District, Gauteng Province, South Africa, July 2025: A case series. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfProc7):058. https://doi.org/10.37432/JIEPH-CONFPRO7-0058
Typhoid fever, caused by Salmonella enterica serovar typhi, is a significant public health concern in South Africa. Sporadic cases are escalating into outbreaks due to water and sanitation challenges. In July 2025, Tshwane District Health Services was notified of three laboratory-confirmed typhoid fever cases. Investigations were initiated to determine the extent of the outbreak, identify the source of infection and trace contacts.
We conducted a case series of confirmed cases in Tshwane District, reported between May and July 2025, and followed up contacts for potential asymptomatic secondary cases. A case was confirmed when Salmonella typhi was isolated from stools through rectal swabbing or blood culture. Testing of water sources, environmental inspections, and rectal swabbing of contacts were performed. Data sources included case investigation forms, field investigation notes, clinical records, and laboratory results in the Notifiable Medical Conditions system. Exposures of interest included social gatherings, travel, food, and water sources. Data were analysed using descriptive statistics and epidemic timelines.
Three laboratory-confirmed cases with no epidemiological links were detected. Case 1 is a 35-year-old female from northern Tshwane. Case 2 is a 31-year-old male from central Tshwane who travelled to Limpopo Province 14 days before the onset of symptoms. Case 3 is a 17-year-old learner from eastern Tshwane who attended a school camp in the north. Of 17 contacts, 15 (88%) were tested and all were negative. All patients survived. Report delays ranged from 5 to 44 days (median: 19). Environmental inspections showed reliance on shared water tankers in the north, with no testing done in the central region. A water sample collected in the eastern region tested negative for Salmonella typhi.
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