Published Date: 2014-07-08 23:55:11
Subject: PRO/EDR> Typhoid fever – Nepal: (Sagarmatha) increased incidence
Archive Number: 20140708.2595861
TYPHOID FEVER – NEPAL: (SAGARMATHA) INCREASED INCIDENCE
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Mon 7 Jul 2014
Source: Republica [edited]
The number of people suffering from [typhoid fever] is on the rise in the district [Saptari], with the rise in temperature and rainfall. The Gajendra Narayan Singh Hospital in Rajbiraj has been receiving an increasing number of people coming with complaints of viral fever and typhoid, according to Ram Kumar Diyali of the Emergency Ward of the hospital. Every day more than 40 persons suffering from typhoid and viral fever are coming to the hospital, compared to 3 to 4 persons 2 weeks ago, Diyali said.
Quick change in weather and failure to observe alertness in food habits have increased the spread of viral fever and typhoid, doctors said. “We are now suffering lack of beds as the hospital is receiving such patients from Siraha [and] Udayapur districts as well, including from neighboring village in India,” said Medical Superintendent Dr Saileksh Jha.
ProMED-mail from HealthMap Alerts
[Typhoid fever is caused by _Salmonella enterica_ subtype Typhi, _Salmonella enterica_ Paratyphi A, or _Salmonella enterica_ Paratyphi B. Humans are the only reservoir for typhi, whereas paratyphi A and B also have animal reservoirs. These organisms are transmitted by either an intestinal carrier or someone ill with typhoid fever, or by a non-human animal reservoir in the case of paratyphi A or B, usually by means of fecal contamination of food or water.
Typhoid fever is endemic in Nepal: cases of typhi infection peak in July and August, the months with highest annual precipitation, whereas cases of paratyphi A, which has become an increasingly important cause of typhoid fever in Nepal, occur equally throughout the year, possibly reflecting different modes of transmission (http://cid.oxfordjournals.org/content/57/10/e167.full).
Nepal has problems with unsafe drinking water and inadequate disposal of human excrement. Open defecation is very common in Nepal. According to the 2011 census, almost 40 percent of the total households do not have toilets (http://cbs.gov.np/wp-content/uploads/2012/11/National%20Report.pdf). In the least developed districts in the west, 75 percent are said not to have toilets, and public toilets, where available, are not used because of their filth (http://www.irinnews.org/report/90251/nepal-naming-and-shaming-open-defecation-offenders).