Outbreak and management of enteric fever

ABSTRACT

An outbreak of enteric fever occurred in the PCSIR campus colony, Karachi during the months of January-February, 1995 due to contamination of drinking water with sewage water. Forty-four [23.28%] cases out of 189 residents of the colony clinically diagnosed as enteric fever, were followed up. Twenty-eight [63.64%] cases were bacteriologically confirmed as typhoid fever because of the isolation of salmonella typhi from their blood or bone marrow. Culture and sensitivity tests showed that all strains were resistant to amoxycillin, cotrimoxazole, chloramphenicol, augmentin, and fosfomycin but sensitive to quinolones and third generation cephalospoirns. Almost all the adult cases were treated with quinolones for 10-14 days with excellent results. However, children were initially treated with amoxycillin, and then changed over to cefixime and ceftriaxone, due to failure of treatment with amoxycillin. They responded satisfactorily to these drugs. As immediate protective measures. Residents were advised to boil the water before drinking. Chlorination of the water in the underground storage tanks was regularly undertaken. Leakages in the piped supply line were fixed on an emergency basis. These measures helped to avert another typhoid epidemic on the campus