TYPHOID FEVER – ZIMBABWE: HARARE
Another person has died from typhoid, and nearly 100 others have fallen ill in just one week. The Zimbabwean health ministry says at least 10 people have died, and more than 1800 have been infected with the disease since the outbreak began in October 2016.
In a weekly disease surveillance report, the ministry says that in just one week, one person died, and 86 others contracted typhoid. Most of these suspected infections were in Harare, and 30 percent were pre-school age children. With uncollected rubbish, frequent burst sewage pipes, and erratic water supplies, the disease can spread more easily.
Communicated by: ProMED-mail
Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the more common kinds of salmonellosis. Epidemiologically, usually spread by contaminated food or water, typhoid is not a zoonosis like the more commonly seen types of salmonellosis.
Clinically, vomiting and diarrhea are typically absent; indeed, constipation is frequently reported. As it is a systemic illness, blood cultures are at least as likely to be positive as stool in enteric fever, particularly early in the course of the infection, and bone marrow cultures may be the most sensitive.
The symptoms of classical typhoid fever typically include fever, anorexia, lethargy, malaise, dull continuous headache, non-productive cough, vague abdominal pain, and constipation. Despite the often high fever, the pulse is often only slightly elevated. During the 2nd week of the illness, there is protracted fever and mental dullness, classically called coma vigil. Diarrhea may develop but usually does not. Many patients develop hepatosplenomegaly