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Friday, December 14, 2012

TYPHOID FEVER UPDATE 2012 (12): ZIMBABWE (HARARE)

A ProMED-mail post
http://www.promedmail.org
Archive Number: 20121209.1443859
Date: Wed 5 Dec 2012 
Source: Zimeye [edited]
http://www.zimeye.org/?p=68014

A life threatening typhoid outbreak has been reported in Harare's Dzivaresekwa high-density suburb and surrounding areas, about 10 km from the capital city. An alert was sent out last night [4 Dec 2012] through the Harare Residents Trust issuing caution to people in the area. It is reported that school children at Nhamburiko Primary School have recorded the highest figures of affected people to date.

Harare city council authorities have been blamed for the outbreak due to council's failure to provide clean water supplies to residents. The capital is not new to the bacteria [_Salmonella enterica_ serotype Typhi], and earlier this year [2012], environmental scientists revealed that many water sources across the city have been affected due to sewer spillage.

One Hararian protested against the mayor: "The Mayor looks down upon the poor and the marginalised. He thinks they are lazy and do not want to develop. But give him an opportunity, [and] he is convincing in his presentations but lacks on delivery and relevance to the citizenry."

A statement by the Harare Residents Trust reads: "Alert: There has been a typhoid outbreak in Dzivarasekwa. The local clinic has transferred about 15-16 people to Beatrice Infectious [Diseases] Hospital every day since last week. The most affected are the pupils at Nhamburiko Primary School. Harare City Council's failure to provide clean water to the residents is compounding the situation!"

Presidential Health consultant Dr Timothy Stamps has provided guidance on identifying typhoid as follows:

Typhoid is especially an urban disease. The diagnosis can only be made definitely by either a blood culture (which indicates that the infectious organism has gotten into the blood system) or by rectal swab/faecal culture of the causative organism. Indirect methods such as the Widal titre (O and H antigens) are of limited value, especially as an outbreak progresses.

The classical picture of typhoid fever is a temperature which is intermittent for the 1st week or so of the illness, then becoming persistent and sometimes very high, coupled with vague symptoms such as headache, weakness, sore joints, abdominal pains (especially in the appendix area), and constipation (kufufutirwa) rather than diarrhoea (manyoka).

Most typhoid sufferers react badly to aspirin, headache pills, or powders and in a generalised outbreak should be restricted.

Rose spots, which disappear on pressure, occur on the chest and upper abdomen in the 1st week of the disease; they are not easy to detect in most Zimbabweans.

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