2023-04-26 20:08:00
Au Kenyafour people died and more than 600 were sick at two schools in Kenya, Mukumu Girls High School and Butere Boys High School in the kakamega county. The disease appears to have started on March 1, 2023, and as of April 14, 2023, 627 patients were ill, including 19 students admitted to 7 health facilities in the country. Symptoms include fever, abdominal pain, cramps, vomiting, and diarrhea. A teacher and three students died. Both schools have been closed by the Department of Education and Kakamega County Government, while the investigation continues.
Preliminary laboratory analysis of water, food and human samples revealed the presence ofE. coli enterotoxigenic (ETEC) and of Salmonella typhi, agent of typhoid fever. Tests carried out on cereals and legumes did not reveal the presence of aflatoxin. Laboratory tests for various other illnesses also came back negative.
Field investigations revealed possible contamination of the water tank. The agency said the illness was likely caused by a mixture ofE. coli and of Salmonella Typhi which can occur if water sources are contaminated. Person-to-person spread is likely due to close proximity to people.
Reminders
la la ftyphoid fever :
Typhoid fever at Salmonella typhi (such as paratyphoid fevers at Salmonella para-types A, B and C) are systemic bacterial infections with a digestive origin. The source of contamination lies in the faeces of sick people or healthy carriers but excretory of Salmonella.
The transmission is called fecal-oral:
- either directly by ingesting bacteria from contaminated stools,
- or most often indirectly by ingestion of water or food eaten raw (seafood, vegetables, etc.) and soiled by the stools of infected people (sewage, spreading, etc.).
Symptoms usually appear 1 to 3 weeks after exposure, and can be mild or severe. They include high fever, malaise, headache, constipation or diarrhea, pink spots on the chest, and damage to the spleen and liver. Asymptomatic carriage of the bacteria can follow the disease.
The management of typhoid or paratyphoid fever may require hospitalization. Treatment is with antibiotics. Lethality, which can reach 10% without antibiotic treatment, is less than 1% with appropriate antibiotic therapy.
THE Escherichia coli enterotoxigenic (ECET / ETEC in English)
THE E. coli enterotoxigenic agents are responsible for approximately one third of cases of traveler’s diarrhea in the intertropical zone tourists »). They are also the main cause of childhood diarrhea in developing countries with ECEP and the Rotavirus. ETEC infections show a seasonal periodicity and increase markedly during hot periods of the year.
After the initial stage membership et of colonisation, THE strains responsible of diarrhea develop different strategies. Ls VINEGAR produce two kinds of toxinss (« ST » thermostable et « LT » thermolabile, near the toxin of Vibrio cholerae) who disturbsnt reabsorption of water and electrolytes by the enterocytes.
THE symptoms are those of watery diarrhea without glairs or blood, little or not feverish, may be accompanied by vomiting, spontaneously resolving in 2 to 5 days. Usually mild, it can however lead to severe dehydration in young infants. There transmittedwe mainly do each othernt by contaminated water.
When traveling, the effects of diarrhea can be very serious, especially in children and the elderly.
Recommendation for the traveler
Vaccination against typhoid fever (Typhim Vi, Tyavax) is recommended in countries where hygiene is precarious for travelers whose stay is prolonged or is in poor conditions. As this vaccine only provides 50 to 80% protection, it does not replace hygiene measures, which are the only tools for preventing ETEC infections.
Those mingling closely with the local population in outbreak areas are recommended to take the following steps:
- wash hands frequently with soap and water, especially before taking food;
- avoid the use of collective towels;
- eat only cooked foods;
- avoiding the consumption of fish, shellfish, or seafood other than well-cooked or fried;
- carefully peel, otherwise cook or disinfect fruits and vegetables;
- drink only capsulated bottled mineral water or water treated (by chlorination, by Troclosene sodium or by boiling);
- do not consume ice cubes, ice cream or sorbets on public sale.
Source : ProMED
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