The health department in Gauteng province declared a cholera outbreak on Sunday in Hammanskraal, an area about 50km (31 miles) north of capital Pretoria, in the City of Tshwane.
Almost 100 people have been seen at hospital, and 37 have been admitted to wards, the city government said on Monday, 22 May, warning residents of Hammanskraal and surrounding areas not to drink tap water.
"We are drinking that water, but they don't want to clean that water, or to... put another pipe to give us the all right water," said 36-year-old Sello Samuel Lekoto, an unemployed resident of Hammanskraal who is being treated at Jubilee Hospital for cholera.
The municipality said in statements that the water supplied by the city in Hammanskraal is not potable, but that the city provides clean drinking water through tankers to informal settlements several times a week.
"The issue of water in Tshwane has been a problem for a number of years," South Africa's deputy minister of water and sanitation David Mahlobo said in a briefing.
"There have been problems politically... (and) issues over conflicts in such a way that citizens were exposed," he said.
Cholera can cause acute diarrhoea, vomiting and weakness and is mainly spread by contaminated food or water. It can kill within hours if untreated.
South Africa has confirmed 41 cases nationwide, including 34 in Gauteng province, one in Limpopo province and six in Free State, a health department spokesperson said. The cases in Free State province are not connected to the others, he added.
South Africa reported its first cholera death in February, after the virus arrived in the country from Malawi.
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