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Why Bulawayo is typhoid-free

What is typhoid?: Typhoid is an infectious disease of the intestines that is caused by bacteria salmonella typhi.

By Nesisa Mpofu

Symptoms of typhoid: It manifests with fever abdominal pains, headaches, initial constipation and later diarrhoea in some cases, which may be bloody. There may be eruption of red spots on the chest and abdomen.

Transmission: It is primarily transmitted through the faeco oral route (the faeces of the infected person indirectly contaminating food or water). In the urban set up, drinking water coming into contact with sewerage, which is likely to occur if water is collected from shallow wells.

Treatment: A lot of antibiotics can be used to treat the disease.

What are the chances of contracting typhoid in Bulawayo?

* Bulawayo tap water is safe; typhoid is not endemic in the city, meaning no confirmed transmission of the disease has been reported.

* There have been several cases of suspected typhoid in the city. There were seven reported cases last week from Mpilo Hospital, one from Galen house.

* Our emergency response and preparedness team has investigated these and found them to be non-typhoid.

Widal test: This is a screening test for typhoid. It has a lot of false positives and the definite test is blood culture. The test has to be interpreted with care.

Widal test interpretation

The antibodies develop at the end of the first week and the titres rise during second, third and fourth week, after which they slowly decrease. Hence a Widal test performed early in the first week may give negative results.

A single Widal test is not sufficient for correct results and at least two tests should be conducted.

The level of antibodies of a population in a given area indicates the baseline titre. One has to know this before interpreting a Widal test. O antigen with a titre of 100 or more and H antigen with a titre of 200 or more are deemed important.

Patients who have already undergone antibiotic treatment may not show any increase in titre on a Widal test.

Patients vaccinated against salmonella may show false positive reactions which can be verified with another Widal test in the next week. Then vaccinated people will not show any increase in titre, while untreated cases will show rise in titre in the Widal test results.

Patients with past history of enteric fever may have salmonella antibodies and hence may show false negative reactions. This can be verified with a second test in the next week, which shows rise in titre.

Prevention

* Good hygiene practices to be maintained;
* Handwashing after visiting the bathrooms;
* Drink water from safe sources; if in doubt boil;
* Proper disposal of waste
* Prompt treatment at onset of symptoms

Nesisa Mpofu is the Bulawayo City Council’s senior public relations officer

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