An outbreak of cholera has killed at least 10 people near South Africa’s capital of Pretoria, health authorities said Sunday, urging the public to be “extra vigilant”.

The Department of Health in Pretoria’s Gauteng province said 95 people visited a local hospital since Monday showing cholera symptoms, including diarrhoea, stomach cramps and nausea.

Lab tests on Sunday confirmed at least 19 were cases of cholera, the department said in a statement, adding 37 people were still undergoing treatment.

The victims included a three-year-old child and nine adults.

Nomantu Nkomo-Ralehoko, the provincial head for health, said additional staff, including medics and nurses, were being mobilised to deal with the outbreak, which was centred in Hammanskraal, an area north of Pretoria.

“We would like to reiterate and urge the public to avoid known or suspected contaminated food, water and surfaces and wash hands thoroughly with soap before handling food or after using the bathroom,” said Nkomo-Ralehoko.

Cholera is contracted from a bacterium that is generally transmitted through contaminated food or water.

Earlier, the city of Pretoria urged residents of Hammanskraal and surrounding areas not to drink from the tap, adding water tankers were being supplied.

Cholera has experienced a global resurgence since 2021 after a decade of steady decline, according to the United Nations, which this week warned one billion people in 43 countries were at risk.

The disease is not endemic in South Africa.

But the country reported a few cases this year on the back of outbreaks in nearby Malawi and Mozambique — the two most heavily affected countries in 2023, according to the UN.

The World Health Organisation has blamed the global rise in cases on poverty, conflict and climate change.

AFP