Immunology and Infectious Diseases Research Laboratory, Department of Microbiology, University of Karachi, Karachi, Pakistan.
BMC Public Health. 2009 Dec 20;9:476. doi: 10.1186/1471-2458-9-476.
This report is about the investigation of an outbreak of typhoid fever claimed three human lives and left more than 300 people suffered within one week. The aim of this report is to draw the attention of global health community towards the areas that are still far from basic human essentialities.
A total of 250 suspected cases of typhoid fever were interviewed, out of which 100 were selected for sample collection on the basis of criteria included temperature > 38 degrees C since the onset of outbreak, abdominal discomfort, diarrhea, vomiting and weakness. Food and water samples were also collected and analyzed microbiologically.
Inhabitants of village lived in poor and unhygienic conditions with no proper water supply or sewage disposal facilities and other basic necessities of life. They consumed water from a nearby well which was the only available source of drinking water. Epidemiological evidences revealed the gross contamination of well with dead and decaying animal bodies, their fecal material and garbage. Microbiological analysis of household and well water samples revealed the presence of heavy bacterial load with an average total aerobic count 106-109 CFU/ml. A number of Gram positive and Gram negative bacteria including Escherichia coli, Klebsiella, Bacillus species, Staphylococcus species, Enterobacter species, and Pseudomonas aeruginosa were isolated. Lab investigations confirmed the presence of multidrug resistant strain of Salmonella enterica serovar Typhi in 100% well water, 65% household water samples and 2% food items. 22% of clinical stool samples were tested positive with Salmonella enterica serover Typhi
This study indicated the possible involvement of well water in outbreaks. In order to avoid such outbreaks in future, we contacted the local health authorities and urged them to immediately make arrangements for safe drinking water supply.
本报告涉及一起伤寒疫情爆发的调查，该疫情在一周内导致三人死亡，300 多人患病。本报告旨在引起全球卫生界对仍远未达到基本人类生活必需品的地区的关注。
共访谈了 250 例疑似伤寒病例，其中 100 例根据标准采集样本，标准包括自疫情爆发以来体温>38°C、腹部不适、腹泻、呕吐和乏力。还采集了食物和水样进行微生物分析。
村民居住条件差，不卫生，没有适当的供水或污水处理设施等基本生活必需品。他们从附近的一口井中取水，这是唯一可用的饮用水源。流行病学证据表明，水井受到严重污染，有死动物和腐烂动物尸体、其粪便和垃圾。家庭用水和井水样本的微生物分析显示存在大量细菌负荷，平均总需氧量计数为 106-109 CFU/ml。分离出了一些革兰氏阳性和革兰氏阴性细菌，包括大肠杆菌、克雷伯菌、芽孢杆菌属、葡萄球菌属、肠杆菌属和铜绿假单胞菌。实验室调查证实，100%井水、65%家庭水样和 2%食物中存在多重耐药伤寒沙门氏菌血清 Typhi 菌株。22%的临床粪便样本检测出伤寒沙门氏菌血清 Typhi 阳性。
本研究表明可能与井水有关。为避免今后再次发生此类疫情，我们联系了当地卫生部门，敦促他们立即安排安全饮用水供应。
