Prevalence of Enteroviral Meningitis in the Garden Route

Meningitis is an inflammation of the membranes that cover the brain and spinal cord, usually caused by a bacterial or viral infection.

Viral meningitis is usually less severe than bacterial meningitis.  Enteroviral Meningitis is not classified as a notifiable disease – notifiable diseases are those that is required by law to be reported to government authorities. Meningitis can also be caused by injuries, cancer or drugs, therefore it is important to know the cause because the treatment is specific. 

Since 01 February 2019, hundred and eighty-two (182) suspected cases of enteroviral meningitis were reported in the Garden Route District Municipal area of jurisdiction.

The distribution of cases in the region are as follows;

Region Number of cases Confirmed cases Suspected cases
George 71 11 60
Mossel Bay 44 44
Knysna 66 66
Hessequa 1 1

The report will be updated as soon as more current statistics is received.

Over the past decade, small outbreaks of Enteroviral Meningitis has been reported in South Africa. With the outbreak in the Garden Route District municipal area, the relationship with climate change will be investigated. 

According to Mr Clive Africa, GRDM Executive Manager: Community Services, “Good hygiene practises like thorough handwashing is essential to combating the disease”. 

Enteroviral meningitis occurrences in South Africa

Seasonal peaks of enteroviral meningitis occur in the warmer months. Limited information is available about the serotypes of enterovirus that occur in South Africa.

Between November and December 2015 a possible outbreak of enterovirus were reported in the Tshwane District. Forty-two (42) cases were reported of which forty (40) was under the age of 10 years old and the other two (2) cases adults.  Thirty-one (31) cases tested positive for the enterovirus. The National Institute for Communicable Disease requested that samples be submitted for further testing and genotyping.

Prevention and Control

To prevent the further spread of the disease the Municipal Health Department of the Garden Route District Municipality are implementing awareness campaigns in the affected areas. Awareness campaigns will comprise mainly of health and hygiene education. We are currently busy translating education material into the three official languages.  


The following symptoms can be observed with exposure to enteroviral meningitis, namely;

The most common symptoms in children include;

  • Fever
  • Poor eating
  • Irritability,
  • Lethargy (lack of energy)
  • Sleepiness

Symptoms present in adults may include;

  • Fever
  • Stiff neck
  • Headache
  • Dislike of bright lights (photophobia)
  • Lethargy
  • Sleepiness
  • Lack of appetite
  • Nausea and
  • Vomiting

Alternative symptoms are diarrhoea and abdominal pain. Muscle pain, joint aches, sore throat and rash have also been reported. Acute flaccid paralysis has very rarely been associated with enteroviral meningitis.

Causes and vulnerable members of society

The most common causes of viral meningitis are non-polio enteroviruses, but other viruses’ can also cause meningitis, namely;

  • Mumps virus
  • Herpes virus
  • Measles virus
  • Influenza virus
  • Arbovirus (West Nile virus) 

People of all ages are at risk, but children younger than 5 years old and those with weakened immune systems (immune compromised) have a higher risk of getting the disease. There is no specific treatment for enteroviral meningitis, however, most cases completely recover within 7 to 10 days. Supportive treatments are used to relieve symptoms. Antibiotics have no effect on enteroviral meningitis.

For more information relating to Municipal Health and Environmental Management Services, contact the GRDM offices in the relevant offices in the region:

George Community Services, Tel: 044 803 1522

Knysna Community Services, Tel: 044 382 7214

Mossel Bay Community Services, Tel: 044 693 0006

Plettenberg Bay Community Services, Tel: 044 5011600

Oudtshoorn Community Services, Tel: 044 272 2241

Riversdale Community Services, Tel: 028 713 2438

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