Date: Mon 7 Aug 2017 15:50 CST
Source: Prensa Libre [in Spanish, machine transl., edited]
So far, 60 positive cases and 2 deaths of typhoid fever have been confirmed [in Peten department], officials say. The Health Minister, Lucrecia Hernandez, confirmed that the outbreak began in the municipality of Dolores, Peten department. The 1st documented case occurred on 9 Jul 2017 and to date 60 cases have been reported. "Of these 2 persons died, the 1st on 17 Jul 2017 and the other on 21 Jul 2017," said the minister. She explained that the 1st death occurred due to a complication of pancreatitis and the 2nd case was a patient who was transferred from his house to the hospital in Izabal but died on the way.
Hernandez explained that the other 58 cases have been taken care of by the health department. "The epidemiological investigation of case identification, as well as prevention measures are being implemented," she said. The minister asked the population, particularly of Dolores, Peten, to consult a health centre when presenting with fever and abdominal pain.
"We have seen a reduction in the number of registered cases, but we still cannot say that the outbreak is contained; we hope to do so in the coming weeks," said the official.
The Ministry of Health indicates that they have done an analysis of the water consumed in the sector but there is still no conclusive report of what caused the outbreak of the disease. "We suspect this is a problem of food handling. Typhoid fever can be asymptomatic, that is they do not show the disease, but the infected person can still spread it," said Hernandez. Because of this health authorities ask the population to reinforce hygiene measures when handling food and chlorinate or boil water. [Byline: Carlos Alvarez]
[Typhoid fever, so-called enteric fever caused by _Salmonella enterica_ serotype Typhi, has a totally different presentation from that of the commoner 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 diarrhoea 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. Diarrhoea may develop but usually does not. Many patients develop hepatosplenomegaly [both liver and spleen enlarged]. After the 1st week or so, many cases develop a maculopapular rash on the upper abdomen. These lesions ("rose spots") are about 2 cm [0.78 in] in diameter and blanch on pressure. They persist for 2-4 days and may come and go. Mild and atypical infections are common.
The word typhoid (as in typhus-like) reflects the similarity of the louse-borne rickettsial disease epidemic typhus and that of typhoid fever; in fact, in some areas, typhoid fever is still referred to as abdominal typhus. - ProMED Mod.LL]
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