Typhoid outbreak under control

A recent typhoid outbreak in the capital, Dushanbe - one of the largest outbreaks to strike the country in years - is now under control, according to a World Health Organisation (WHO) official. "The situation is now under control," Dr Nazira Artykova, a WHO liaison officer, told IRIN from Dushanbe on Monday, confirming that at least one person had officially died of the disease. According to latest figures, there were 390 confirmed cases and 958 suspected cases of the disease after a major supply of piped water became infected in the north of the city, she explained. But given an efficient response by the Tajik authorities, the source of contamination was quickly identified and treated with chlorine, supplied by the United Nations Children's Fund to the Tajik Republican Sanitary and Epidemiological Service, which is continuing to monitor all water sources in the Varzob area on a daily basis. Initial reports indicate that the outbreak was centred in the Frunze district of Dushanbe, which has an overall population of close to 1 million. Typhoid is contracted when people eat food or drink water that has been infested by Salmonella typhosa. Generally recognised by the sudden onset of sustained fever, severe headache, nausea and severe loss of appetite, typhoid is sometimes accompanied by a hoarse cough and constipation or diarrhoea. Case-fatality rates of 10 percent can be reduced to less than 1 percent with appropriate antibiotic therapy. Paratyphoid fever shows similar symptoms, but tends to be milder and the case-fatality rate is much lower. The annual occurrence of typhoid fever worldwide is estimated at 17 million cases, with about 600,000 deaths. Some strains of Salmonella typhosa are resistant to antibiotics. Regarding the disease's current rate of spread, the medical official noted that with the commencement of Ramadan, the Islamic holy month of fasting, on Sunday, the number of cases were expected to drop temporarily, but would probably later pick up again due to certain social events specific to the religious period. As for efforts under way to mitigate the disease's spread, Artykova emphasised the need for greater health education activities to be launched towards raising community awareness of the risk factors, particularly in the area of hygiene and boiling of running water. In collaboration with the health ministry, WHO, along with the UN Office for the Coordination of Humanitarian Affairs (OCHA), the World Food Programme (WFP), the UK-based international medical relief charity Merlin, and the International Federation of the Red Cross and Red Crescent, among others, had combined their efforts to facilitate and provide the necessary drugs, food and consumable supplies, she noted. Meanwhile, Dr Lasha Goguadze, the health adviser for the Federation's activities in Europe, told IRIN from Geneva that in light of reports from their delegation in Dushanbe, the situation had improved somewhat, noting, however, that a joint coordination meeting between the various agencies - both Tajik and international - was set to take place on Monday afternoon. "We hope that the government, together with other organisations, can control the situation," the official said, noting that as the infection source had been treated and medication provided, the situation had stabilised. Typhoid is endemic in the impoverished nation of close to 7 million, which has been grappling with crumbling health-care and water-supply systems, ever since the collapse of the former Soviet Union in 1991. "Every year, outbreaks are reported in the country, Goguadze said. According to one BBC report, in the first nine months of this year to the end of September, 545 cases were diagnosed in hospitals in Dushanbe. In 1997, as many as 80 people reportedly died from typhoid in Tajikistan, after the authorities failed to stem its spread, infecting some 10,000 people, another BBC report said.