News
3 February 2012
Typhoid outbreak: Harare, Zimbabwe
Typhoid cases have peaked in Zimbabwe for the second time since a typhoid outbreak began in October 2011 [1, 2]. As of 22 January 2012, the Ministry of Health and Child Welfare have reported 1,865 cases of typhoid (878 in 2012). The majority of cases have been reported in the capital Harare, in particular in the residential suburbs of Kuwadzana and Dzivareskwa. No deaths have been reported [2].
This wave of infections has coincided with recent heavy rains in Harare [3].
Typhoid
Typhoid is a disease caused by Salmonella Typhi bacteria and is transmitted via food and water contaminated with faeces from an infected person. Symptoms of typhoid include fever, chills, headache, myalgia, malaise, anorexia, nausea and abdominal pain. Diarrhoea can occur early on in the illness. Typhoid is treated with antibiotics and supportive care.
Advice for travellers
Typhoid is known to occur in Zimbabwe, but this outbreak represents a large number of cases over a short period. Travellers at higher risk of typhoid include those visiting friends and relatives, young children, long-term travellers and those exposed to conditions of poor sanitation. Since 1 January 2007, four cases of typhoid have been reported in English travellers visiting friends and relatives in Zimbabwe, the most recent case in October 2011 [4].
All travellers should take food, water and personal hygiene precautions. Typhoid vaccination should be considered for travellers whose planned activities put them at higher risk. As typhoid vaccines are only 50% to 70% protective, vaccinated travellers are still advised to take food, water and hygiene precautions.
Additional travel health recommendations for Zimbabwe can be found on the NaTHNaC Country Information Page.
Advice for health professionals
Typhoid and paratyphoid (referred to as enteric fever) are notifiable diseases and require public health follow up. Revised operational guidelines for the public health management of typhoid and paratyphoid are available from the HPA website [5]. The Travel and Migrant Health Section of the Health Protection Agency undertakes enhanced surveillance of typhoid and paratyphoid reported in England, Wales and Northern Ireland [6].
References
1. The World Health Organization, Zimbabwe Weekly Epidemiological Bulletin. Epidemiological week 50 (week ending 18 December 2011). [Accessed 3 February 2012]. Available at: http://www.who.int/hac/crises/zwe/sitreps/zimbabwe_epi_
2. The World Health Organization, Zimbabwe Weekly Epidemiological Bulletin. Epidemiological week 3 (week ending 22 January 2012). [Accessed 3 February 2012]. Available at: http://ochaonline.un.org/OchaLinkClick.aspx?link=
3. Integrated Regional Information Networks (IRIN). Zimbabwe: Typhoid stalks Harare. 30 January 2012. [Accessed 3 February 2012]. Available at: http://www.irinnews.org/report.aspx?reportid=94758
4. Personal Communication. Health Protection Agency 3 February, 2012.
5. Health Protection Agency, Chartered Institute of Environmental Health. Public Health Operational Guidelines for Typhoid and Paratyphoid (Enteric Fever). February 2012.
http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/
6. Health Protection Agency. Enhanced Surveillance of Enteric Fever. [Accessed 3 February, 2012]. Available at: http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPA
Links
Health Protection Agency: typhoid
NaTHNaC Health Information Sheet: typhoid and paratyphoid
NaTHNaC Health Information Sheet: prevention of food and water-borne diseases
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