Bronkhorstspruit – More than 400 children have fallen ill and presented with stomach cramps and diarrhoea at Bronkhorstspruit Hospital, some 50 km east of the capital, Pretoria.
For more than a week, national and provincial Department of Health and City of Tshwane Rapid Response Teams have been on site trying to find out the cause of the spike in gastrointestinal illness affecting children and communities in Bronkhorstspruit, Tshwane.
Following reports of an unusually high number of patients presenting with stomach cramps and diarrhoea at Bronkhorstspruit Hospital, these authorities moved in on 13 October 2026.
“Between 7 and 18 October 2026, 408 cases of gastrointestinal illness have been reported,” the Departments of Health, Water and Sanitation and the Gauteng government said in a joint statement made available to The Bulrushes on Monday, 19 October 2026.
“Most of the patients are under four years old.”
Ill individuals from Zithobeni, Bronkhorstspruit, Dark City, Rethabiseng and Sokhulumi in Tshwane’s Region 7, have been treated at the hospital and local clinics.
No deaths have been reported to date.
Those affected by the illness were from areas that are largely supplied with water by the City of Tshwane’s Bronkhorstspruit Water Treatment Works (BWTW).
Last week, on 13 October 2026, the Health Minister requested the Department of Water and Sanitation to test the quality of water supplied from the BWTW.
The Ministries of Water and Sanitation and Health, the Gauteng Provincial Government, and the City of Tshwane met last night, Sunday, 18 October 2026, to receive an update from an intergovernmental technical team on the coordinated response.
The meeting, led by Ministers of Water and Sanitation Pemmy Majodina and Health Dr. Aaron Motsoaledi, Gauteng Premier Panyaza Lesufi and Tshwane Executive Mayor Dr. Nasiphi Moya, received a consolidated update report from the intergovernmental technical team.
The report detailed the number and location of gastrointestinal illness cases, laboratory test results, findings from the Department of Water and Sanitation’s investigation into the cause of the problem, actions already taken, and the additional urgent measures being implemented to protect communities.
“Between 7 and 18 October 2026, 408 cases of gastrointestinal illness have been reported. Most of the patients are under four years old,” the joint statement said.
“No deaths have been reported to date.
“The number of new cases per day peaked on 13 October with 72 cases reported.
“On 18 October, 16 new cases were reported.”
Bronkhorstspruit Hospital has established an isolation area and overflow beds for affected patients. Most patients have been rehydrated and discharged within a day.
A four-level surge plan is in place to expand beds, deploy additional staff, refer patients to Mamelodi Regional Hospital, Tshwane District Hospital or Pretoria West District Hospital where necessary, and escalate to provincial support if required.
Laboratory tests of stool specimens from infected patients by the National Institute for Communicable Diseases (NICD), and water quality tests indicate that residents were being exposed to contaminated water from BWTW.
“The NICD tests detected Norovirus, Campylobacter and Shigella in three of four specimens analysed, together with other pathogens that cause stomach cramps and diarrhoea,” revealed the joint statement.
However, no cholera bacteria were found in the sampled stools.
“The fact that mixed pathogens were found in the samples and the rapid spread point to a common water supply being the likely source of illness,” the joint statement further said.
“This is corroborated by water quality tests conducted by DWS on 14 October, which found extremely high levels of E. coli and total coliforms in the water emanating from the BWTW and in the Ekandustria (near Dark City) and Zithobeni reservoirs.”
Further tests were being conducted to confirm whether any other harmful contaminants were present in the water.
Further specimens are being collected by the NICD to strengthen the epidemiological evidence and to determine whether a formal outbreak declaration is required.
In addition, the Department of Water and Sanitation has appointed the Water Research Commission to conduct independent water quality tests.
The Water Research Commission started testing on 18 October and has conducted more tests today, with results expected from Wednesday.
The Water Research Commission has also been requested to conduct an independent investigation of the causes of contaminated water being supplied to residents.
This report will be released by 28 October 2026.
The Department of Water and Sanitation investigation found that the City of Tshwane experienced difficulties with its chlorine supplier, which resulted in water emanating from BWTW not being chlorinated between 24 September and 14 October.
“The BWTW abstracts water from the Bronkhorstspruit River, which is badly contaminated with sewage pollution from upstream dysfunctional wastewater treatment works (WWTW) under Victor Khanye Municipality as well as from dysfunctional City of Tshwane sewage pump stations,” the joint statement said.
The investigation also found that the City of Tshwane had failed to warn residents in the affected areas of Bronkhorstspruit that the water being supplied had not been chlorinated.
Residents were not warned that unchlorinated water should not be drunk or used for cooking, washing, or bathing, even after boiling, as required by the 2025 Compulsory Standards for Water Services issued under the Water Services Act.
As part of the Department of Water and Sanitation’s regulatory function, necessary accountability steps have been initiated against those responsible for the water pollution and for adherence to norms and standards governing the provision of water and sanitation.
City of Tshwane closed the BWTW on 14 October.
The chlorine supply was restored by 15 October, and the City of Tshwane reopened the BWTW to supply water into the distribution system on 16 October, but informed residents that the water was not yet suitable for drinking.
Since 14 October, CoT said it has been distributing drinking water to residents using water tankers.
The water tankers obtain water from the Cullinan WTW, and the City of Tshwane and the Department of Water and Sanitation have conducted laboratory tests on the water from the Cullinan WTW, which indicate that the water is safe to drink.
City of Tshwane said it was in the process of increasing the supply of this clean drinking water to the affected areas using additional water tankers (36 in total).
Testing of this water will be conducted on a continuous basis by both the City of Tshwane and the Department of Water and Sanitation.
The DWS investigation also found that various components of the BWTW were not working, such as pumps, sand filters, and other mechanical equipment.
City of Tshwane is in the process of appointing Rand Water as an implementing agent to further improve the performance of the BWTW.
Together with Department of Water and Sanitation engineers, Rand Water is in the process of developing an implementation plan with timeframes in this regard.
Part of this planning will include assessing whether the BWTW should be isolated for a further period to enable essential work to be carried out.
At this stage, it is not possible to give a timeframe for when residents will again be able to drink water emanating from the BWTW.
The refurbishment and upgrading of the BWTW has been a longstanding priority for the City of Tshwane, with the municipality spending R21 million in the current financial year and substantial financial commitments towards the project over successive financial years.
Together, these allocations represent more than R107 million in expenditure and planned investment over the three-year period.
While substantial resources have already been invested and further funding committed, the work remains ongoing, with the City’s focus on addressing longstanding infrastructure deficiencies, improving operational reliability and progressively restoring the plant’s capacity to provide residents with a safe and dependable water supply.
The meeting last night agreed that the City of Tshwane must immediately improve its communication to residents and keep residents informed of the situation and where and when they can obtain clean drinking water from the water tankers.
City of Tshwane has issued an improved comprehensive advisory notice to residents today.
In addition, health promoters will continue to conduct loud-hailing and household-level awareness on boiling water, safe storage, disinfection of containers, and hygiene practices.
Until further notice, residents of areas supplied by BWTW must not drink water from their taps or use the water for bathing, brushing teeth, washing food, washing clothes, and cooking.
The water can only be used for flushing toilets.
Previously stored water should be discarded, and water containers must be disinfected using household bleach.
Drinking water obtained from water tankers should be stored in clean containers with lids.
Residents who develop symptoms of illness should seek medical attention early and report suspected cases to their nearest healthcare facility or local health authority.
Early reporting protects not only individuals and families, but also enables health authorities to respond quickly and prevent further spread.
