As temperatures drop across the Western Cape, many families are doing everything they can to stay warm. Windows are shut against the cold, gas heaters and charcoal braziers are lit, and generators are used during power outages. While these measures may provide comfort, they can also create a deadly risk inside the home.

The Western Cape Department of Health and Wellness is urging residents to take precautions against carbon monoxide poisoning, known as the “silent killer” because it is impossible to see, smell or taste.

Carbon monoxide is produced when fuels such as charcoal, wood, paraffin, petrol, or gas do not burn completely. When fuel-burning appliances are used in enclosed or poorly ventilated spaces, the gas can quickly build up to dangerous levels without anyone realising it.

Carbon monoxide poisoning is one of the most easily missed medical emergencies during winter.

Carine Marks, director of the Tygerberg Poisons Information Centre, said carbon monoxide poisoning is often overlooked because its symptoms resemble common winter illnesses.

“Carbon monoxide poisoning is one of the most easily missed medical emergencies during winter. Early symptoms, including headache, dizziness, nausea, tiredness and confusion, are often mistaken for flu, fatigue, or a viral illness. By the time people realise something is wrong, the consequences can be severe.”

Over the past year, the National Poison Information Helpline recorded 25 reported cases of carbon monoxide poisoning, including eight children under the age of 12. However, Marks cautioned that these figures represent only a fraction of the true burden.

“Carbon monoxide poisoning is significantly under-reported. Many cases are never recognised, are misdiagnosed or never reach poison information centres. We suspect the true number of poisonings is much higher.”

Warning signs

One important warning sign is when several people in the same household develop similar symptoms at the same time.

“If more than one person experiences headaches, nausea, dizziness or unusual drowsiness while indoors, carbon monoxide exposure should be considered immediately. Leave the building, get into fresh air and seek urgent medical attention, even if symptoms begin to improve.”

Preventing carbon monoxide poisoning is simple but requires vigilance. Never use charcoal braziers (imbawula/mbawula), gas heaters, or other open-flame appliances in completely enclosed rooms. Keep a window or door slightly open to ensure adequate ventilation, even during very cold weather. Always place generators outdoors, well away from windows, doors, and air vents. Never sleep in a room where charcoal, gas, paraffin, or other fuel-burning appliances are in use.

ALSO READ: More than a million South Africans have left since 1990. New survey asks why.

Dr Bradley Browne of the Red Cross Poisons Information Centre said young children are particularly vulnerable because they breathe faster than adults, resulting in greater carbon monoxide exposure relative to their body weight. In addition, the symptoms of carbon monoxide poisoning in children are often non-specific, making the condition more difficult to recognise. Pregnant women should also take particular care, as the developing foetus is especially vulnerable to the effects of carbon monoxide poisoning.

We encourage every household to use heaters safely, ensure adequate ventilation, even when it is cold, and recognise the warning signs of carbon monoxide poisoning before it is too late.

“Every winter we see children requiring emergency care for preventable injuries and illnesses linked to unsafe heating practices. Carbon monoxide poisoning can progress rapidly and, without timely treatment, can have devastating consequences. It is all of our responsibility to ensure that we are keeping warm in a safe way.”

Browne encouraged families to make ventilation part of their winter safety routine. “A small gap in a window may seem insignificant, but it can save lives. We encourage every household to use heaters safely, ensure adequate ventilation, even when it is cold, and recognise the warning signs of carbon monoxide poisoning before it is too late.”