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Service delivery update - Week ending 11 December 2012
Combined Harare Residents Association (CHRA)
December 11, 2012

Residents of Dzivarasekwa, Mufakose, Budiriro, Glen View and Highfields are being encouraged to desist from using water from unprotected wells. This has come from a research that has unravelled that the unprotected underground water contains salmonella-typhea, a bacterium which causes typhoid. Currently, Glen View has been hit by an acute Typhoid outbreak which has seen the death of 5 people so far. CHRA remains concerned by the unending spree of diarrheal diseases which has been worsened serious water shortages. We urge residents to practise and maintain good hygienic standards. Below is a flyer that was prepared by the research team in order to raise awareness on the issue of diarrheal diseases followed by the service delivery update.

Typhoid, Cholera and Dysentery Alert

Three Most Important gastro-intestinal tract infections

Typhoid Fever: Typhoid fever is a systemic infection caused by bacilli Salmonella typhi. Signs and symptoms appear 8 to 14 days after infection

Symptoms: high fever, prostration, abdominal pain, and a rose-colored rash, headache, pharyngitis, constipation, anorexia, and abdominal pain and tenderness

Cholera: Cholera is an acute infection of the small bowel caused by Vibrio cholera. Signs and symptoms appear within 1 to 3 days after infection

Symptoms: mild and uncomplicated diarrhea, Abrupt, painless, watery diarrhea and vomiting are usually the initial symptoms, Stool loss in adults, severe water and electrolyte depletion leads to intense thirst, oliguria, muscle cramps, weakness, and marked loss of tissue turgor, with sunken eyes and wrinkling of skin on the fingers.

Dysentery: Shigellosis is an acute infection of the intestine caused by Shigella bacilli. Signs and symptoms appear after 1 to 4 days of infection

Symptoms: fever, nausea, vomiting, and bloody diarrhea, gripping abdominal pain, urgency to defecate, and passage of formed feces that temporarily relieves the pain. These episodes recur with increasing severity and frequency. Diarrhea becomes marked, with soft or liquid stools containing mucus, pus, and often blood

Diagnosis: Clinical judgment of Typhoid, cholera and dysentery confirmed by culture

Transmission Mode and risk factors: Fecal-Oral Route of Transmission

• Typhoid, cholera and dysentery bacilli, are shed in stool of asymptomatic carriers and/ or in stool or urine of people with active disease
• Poor hygiene after defecation may spread bacteria to community food or water supplies
• In endemic areas where sanitary measures are generally inadequate, bacteria is transmitted more frequently by water than by food
• Flies may spread the organism from feces to food
• Transmission by direct contact (fecal-oral route) may occur in children during play and in adults during sexual practices.

Prevention:

• patients must be reported to the local health department and prohibited from handling food until proven free of the organism
• drinking water should be purified
• sewage should be disposed of effectively
• milk should be pasteurized
• chronic carriers should avoid handling food
• adequate patient isolation precautions should be implemented
• travelers in endemic areas should avoid ingesting raw leafy vegetables, other foods stored or served at room temperature, and untreated water.
• unless water is known to be safe, it should be boiled or chlorinated before drinking.
• thorough hand washing after using toilet and before handling food

NB: Use of oral rehydration fluids (SSS) is of great importance in Cholera and dysentery; these infections are curable, so please seek early treatment when you see any of these signs.

Service delivery update

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