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5 ways to prevent and control Typhoid fever

Hand washing and boiling water before drinking are considered to be important factors in preventing and controlling Typhoid fever, says the NIDC. Picture: Pixabay

Hand washing and boiling water before drinking are considered to be important factors in preventing and controlling Typhoid fever, says the NIDC. Picture: Pixabay

Published Feb 19, 2022

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Durban - The National Institute for Communicable Diseases this week confirmed an outbreak of enteric fever also known as typhoid fever in the North West and Western Cape.

The NICD said typhoid is a potentially life-threatening infection.

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It is caused by the bacterium Salmonella Paratyphi A, B and C.

"These bacteria only infect humans, and humans are the only reservoirs. Transmission of the infection is by the faecal-oral route - through ingesting food or water that has been contaminated with faeces of an infected person. It is a disease of poverty, because it is usually associated with a lack of clean drinking water and poor sanitation.

“The disease continues to be a public health problem in many lower and middle income countries in Africa, the Americas, South-East Asia and the Western Pacific regions," the NICD explained.

The most characteristic symptom is a high fever which is usually prolonged, and other symptoms include fatigue, headache, nausea, abdominal pain, and constipation or diarrhoea. Severe disease may occur, and can lead to severe complications which can be fatal.

The prevention and control of enteric fever

The measures to prevent and control enteric fever have long been known, and proven to be very effective. They include:

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  • Water and sanitation infrastructure: safe drinking water and improved sanitation
  • Public health measures: correctly diagnosing and treating cases, finding and treating carriers
  • Food safety
  • Health education: hand washing, food safety practices
  • Vaccination: the World Health Organization recommends that countries with very high burdens of disease or high burdens of antibiotic resistant S. Typhi include typhoid vaccination in their vaccination programmes. Typhoid vaccination can also be one of the tools used for controlling outbreaks, along with providing safe water and improved sanitation and other public health measures.

Should you find yourself experiencing any of the symptoms, you are advised to immediately seek treatment. Enteric fever is readily treatable with antibiotics, and most patients recover without complications. However, the fatality rate for patients with severe disease who develop serious complications can be up to 30%.

The results of WGS and cgMLST analysis are still pending for several isolates from cases detected in Western Cape and North West provinces during January 2022, so case numbers may change as these results become available. Picture: NICD

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Preventive measures for the public include:

  • Hand hygiene. Wash hands with soap and safe water before eating or preparing food, and after using the toilet or changing a baby’s nappy.
  • Food safety practice. Follow the World Health Organization’s five keys to safer food: keep clean; separate raw and cooked; cook thoroughly; keep food at safe temperatures; and use safe water and raw materials.
  • Using safe water. If people are concerned about the quality of water they use for drinking and cooking, then it is recommended to treat the water first by boiling it or treating it with household bleach by adding 1 teaspoon of household bleach to 20-25 litres of water, mix well and leave it to stand for at least 30 minutes before use.

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