Abstract
BackgroundThis report is about the investigation of an outbreak of typhoid fever claimed three human lives and left more than 300 people suffered within one week. The aim of this report is to draw the attention of global health community towards the areas that are still far from basic human essentialities.MethodsA total of 250 suspected cases of typhoid fever were interviewed, out of which 100 were selected for sample collection on the basis of criteria included temperature > 38°C since the onset of outbreak, abdominal discomfort, diarrhea, vomiting and weakness. Food and water samples were also collected and analyzed microbiologically.ResultsInhabitants of village lived in poor and unhygienic conditions with no proper water supply or sewage disposal facilities and other basic necessities of life. They consumed water from a nearby well which was the only available source of drinking water. Epidemiological evidences revealed the gross contamination of well with dead and decaying animal bodies, their fecal material and garbage. Microbiological analysis of household and well water samples revealed the presence of heavy bacterial load with an average total aerobic count 106-109 CFU/ml. A number of Gram positive and Gram negative bacteria including Escherichia coli, Klebsiella, Bacillus species, Staphylococcus species, Enterobacter species, and Pseudomonas aeruginosa were isolated. Lab investigations confirmed the presence of multidrug resistant strain of Salmonella enterica serovar Typhi in 100% well water, 65% household water samples and 2% food items. 22% of clinical stool samples were tested positive with Salmonella enterica serover TyphiConclusionsThis study indicated the possible involvement of well water in outbreaks. In order to avoid such outbreaks in future, we contacted the local health authorities and urged them to immediately make arrangements for safe drinking water supply.
Highlights
This report is about the investigation of an outbreak of typhoid fever claimed three human lives and left more than 300 people suffered within one week
Epidemiological analysis of food items indicated no statistical association with outbreak
The well was found to be polluted with dead and decaying bodies of birds, their fecal material and garbage which supported our suspicion regarding its involvement in disease outbreak
Summary
This report is about the investigation of an outbreak of typhoid fever claimed three human lives and left more than 300 people suffered within one week. The aim of this report is to draw the attention of global health community towards the areas that are still far from basic human essentialities. BMC Public Health 2009, 9:476 http://www.biomedcentral.com/1471-2458/9/476 more than 80% of global cases, South Asia is the most commonly reported region for the acquisition of typhoid fever since 1996 to 2005 [2]. There are several hospital based studies carried out in Pakistan that describe high incidence rate of typhoid fever in children [4,5]. In remote areas where people live under low socioeconomic conditions and without basic necessities of life such as water, food, electricity and transport, incidence rate is much higher and often associated with small disease outbreaks
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