Suspected typhoid cases hospitalised in Jalal-Abad

Over two dozen people suspected of contracting typhoid have been hospitalised in the southern province of Jalal-Abad, regional authorities have confirmed to IRIN. "Some 30 residents in the border villages of Burgandy and Mombekovo [close to Uzbekistan] of Nooken District are hospitalised," Aryn Akparaliev, the provincial deputy governor, told IRIN in Jalal-Abad, adding that in 21 of the cases, the diagnosis had been confirmed. His comments come amid other reports that the number of people being hospitalised had already reached 50. The source of the outbreak, according to the provincial authorities, is the contamination of the Maily-Suu river as a result of the local sewage disposal plant in Maily-Suu town discharging waste water due to repletion of reservoirs following recent heavy rainfalls in the area. All those infected were members of farmer families, who had consumed water from the Maily-Suu river, while harvesting cotton and rice, Akparaliev explained. "Half of the infected are children," Liudmila Blokhina, a provincial administration official, added. Such outbreaks are not unusual in the impoverished region. One local medical attendant told IRIN in Nooken that there had been numerous typhoid outbreaks during Soviet times due to Maily-Suu sewage contaminating water. In an effort to tackle the issue, groups of doctors were calling on every household in the affected villages, conducting preventive treatment of the people who were said to have been in contact with infected patients. According to the Jalal-Abad provincial administration, waste water discharge has been stopped, thanks to emergency measures and supplies of safe drinking water to the villages having been organised. "Our patients say that in the villages water standpipes often do not work due to breakdowns and electricity cuts," Ashirbu Dermankulova, a nurse at the local hospital in Nooken District, told IRIN. The cross-border Maily-Suu river, discharging into the Syrdar'ya, one of Central Asia's most important water sources, flows close to "well-known" uranium waste dumps, making the potential risk of radioactive contamination equally dangerous. Earlier this year, there were incidents of radioactive dumps being uncovered due to flooding. Several years ago, sewage discharge into a canal resulted in a typhoid outbreak in the southern province of Osh, leading to the hospitalisation of more than 600 people. Cases of the disease are regularly registered during the hot summer months in neighbouring Batken Province as well, where less than two weeks ago some 26 typhoid cases of typhoid were confirmed. The outbreak was seen by the Kyrgyz health experts as a probable extension of an earlier outbreak of the disease in neighbouring Tajikistan's capital, Dushanbe, in which hundreds of cases had been confirmed after a contamination of that city's water sources. Meanwhile, local experts in Jalal-Abad identify antiquated water purification and sewage systems as the main culprits in the most recent cases. Earlier, Tajimamat Akhmatkulov of the Asian Development Bank [ADB] Project Implementation Unit in Osh, told IRIN that about 52 percent of villages in Osh Province used to have access to water during the Soviet times, but that percentage fell drastically following independence in 1991, when more than 90 percent of the country's water supply systems in rural areas fell into disrepair, apparently from lack of maintenance. In an effort to address the issue of safe drinking water, a critical element in the development of rural communities and prevention of water-related diseases, Kyrgyzstan is implementing large-scale water supply projects in rural areas with the assistance of international donors, including the ADB and the World Bank. The ADB operates mainly in southern Kyrgyzstan, while the World Bank carries out its activities in the north. "There is a need for large-scale preventive and educational measures," said local doctors, emphasising the importance of a comprehensive and concerted approach to the problem. According to the World Health Organisation, typhoid is contracted when people eat food or drink water infected with 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 is estimated at 17 million cases, with approximately 600,000 deaths. Some strains of Salmonella typhosa are resistant to antibiotics.