The disease reporting system in South Africa is based on government law (the Health Act, Act No. 61 of 2003), together with regulations on the reporting of specific diseases to the Local, Provincial and/or National Health Department.
Who should notify
The first health care professional to come into contact with a patient presenting with one of the prescribed Notifiable Medical Conditions (NMC) is required by law to notify. This may include clinic personnel, infection control nurses, other hospital staff or private medical practitioners. In the event of deaths (or cases) in the community, a member of the community is obliged to notify the event.
Which diseases to notify
Currently 33 broad medical conditions are currently notifiable in South Africa (see List of Notifiable Medical Condition). Some conditions (e.g. Tuberculosis and viral hepatitis) have been divided into various components, resulting in more than 40 notifiable medical conditions.
Notifiable medical conditions have been sub-divided into two categories according to type of disease:
Category 1 NMC are conditions that require immediate reporting by the most rapid means available upon clinical or laboratory diagnosis followed by a written or electronic notification to the Department of Health within 24 hours of diagnosis by health care providers.
Any health care professional identifying even a single case of a disease (presumptive of laboratory confirmed) contained in Category 1 should make and immediate notification directly to the designated local health officer through fax or telephonically as rapidly as possible. The local health officer must report to the Provincial health officer and/or National Department of Health. Where it is applicable, laboratory confirmation should be obtained at the earliest opportunity and reported to the designated health officer. After reporting, telephonically/fax, it is still required of the health care provider to send a complete GW17/5 form to the designated local health authority within five days after telephonic reporting.
Category 2 NMC are conditions that must be notified through a written or electronic notification to the Department of Health within 7 days of diagnosis by health care providers.
The notification system is based on clinical notifications and, therefore, all suspected cases of a notifiable condition must be notified immediately.
Reporting a Notifiable Disease during an outbreak
During an outbreak of a notifiable disease, report all cases by phone, email or fax. Daily reporting by health facilities should be maintained through an Outbreak Case Line Listing Form as well through the notification form (GW17/5) to the local health authority that must report to the provincial health officials and the National Department of Health.
Priority Reporting of MDR & XDR-TB
Tuberculosis (TB) is one of 33 medical conditions, which is notifiable in terms of the National Health Act (Act 61 of 2003). The Directorate: Epidemiology and Surveillance have instituted a priority reporting for MDR and XDR TB. This means that all health care facilities, public and private, including clinics, hospitals, laboratories, general practitioners and private specialist doctors, are required to report all cases of MDR and XDR TB to the Department of Health within 24 hours.
How to notify
The initial notification of a medical condition is done on a case-based form; can be downloaded from:
https://www.nicd.ac.za/wp-content/uploads/2020/11/COVID-19_Case_Notification_Form_05June2020.pdf
Once the NMC Case Notification Form has been completed, the top copy of the form must be sent to: NMCsurveillanceReport@nicd.ac.za or faxed to 086 639 1638. A copy/photograph of the form can be sent via sms or whatsapp to 072 621 3805.
The NMC Case Notification Form must then be sent to NMC focal person at the Health Establishment level.
Refer to Standard Operating Procedures: Paper based reporting of Notifiable conditions for further information: https://www.nicd.ac.za/nmc-overview/
List of Notifiable Medical Conditions
Category 1
Acute flaccid paralysis
Acute rheumatic fever
Anthrax
Botulism
Cholera
Food borne illness outbreak
Malaria
Measles
Meningococcal disease
Plague
Poliomyelitis
Rabies (human)
Respiratory disease caused by a novel respiratory pathogen**
Rift valley fever (human)
Smallpox
Viral haemorrhagic fever diseases*
Waterborne illness outbreak
Yellow fever
Category 2
Agricultural or stock remedy poisoning
Bilharzia (schistosomiasis)
Brucellosis
Congenital rubella syndrome
Congenital syphilis
Diphtheria
Enteric fever (typhoid or paratyphoid fever)
Haemophilus Influenza type B
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Lead poisoning
Legionellosis
Leprosy
Maternal death (pregnancy, childbirth and puerperium)
Mercury poisoning
Pertussis
Soil-transmitted helminth infections
Tetanus
Tuberculosis: pulmonary
Tuberculosis: extra-pulmonary
Tuberculosis: multidrug-resistant (MDR-TB)
Tuberculosis: extensively drug -resistant (XDR-TB)