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Typhoid fever hits city

By Flavia Nassaka

How to stay safe amidst the scare

Do you or anyone you know have a fever, diarrhea, headache, stomach pains, joints pains, and poor appetite?  Those could be symptoms of several known ailments. But they could also be a sign of typhoid fever.

Typhoid fever is an acute illness associated with fever caused by the Salmonella typhi bacteria. It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness.

Starting from the city center a few weeks ago, the disease associated with consumption of foods or drinks contaminated with faeces and urine has spread quickly throughout the three districts of Kampala, Wakiso, and Mukono. It has become a public health concern.

Dr. Ben Adupet, of Mulago National Referral Hospital in Kampala explains that from contaminated food, typhoid causing bacteria invade the digestive system and are carried by blood cells to the liver, spleen, and bone marrow, where they multiply and re-enter the bloodstream leading to symptoms.

By Feb. 26, the number of people showing symptoms of typhoid fever at Kisenyi Health Center IV, a designated typhoid treatment center in Kampala had increased to 560 from 142 on Feb. 19 when the disease outbreak was confirmed claiming two lives.

Sister Rose Achan, who is in- charge of the center, told The Independent that numbers had been increasing. She said on Feb.26 alone they received more than 50 cases. Sister Achan said the patients at Kisenyi are being administered with antibiotics and even advised on adopting a healthier lifestyle.

Dr. David Serukka Kampala City Council Authority (KCCA) Director of Public Health says typhoid is being reported mostly among the cities working class. He said such people eat in restaurants and buy fruits and snacks from road side sellers and vendors whose hygiene practices cannot be guaranteed.

“It’s about what you eat,” he said, “People who eat in restaurants can’t be sure of how the food they eat is prepared.”

He said, however, getting the disease does not mean that one is dirty as it does not discriminate against the high end or low end population.

He said although attention has been focused on those seeking treatment from Kisenyi, a low income part of the city, there are cases being reported in private clinics and hospitals.

Recommended dietary and lifestyle changes

Serukka said typhoid is one of the conditions with high rates of relapse whereby about 5% of the sufferers become carriers of the bacteria after and become sources of new outbreaks after a certain period of time. He therefore says while on antibiotics treatment and shortly after completing the dose, it is important to consider a typhoid diet.

He breaks it down as follows:

Avoid high fiber whole grains and raw vegetables as these can place additional stress on your digestive system. When you have typhoid, foods to avoid also include vegetables like cabbage for they cause bloating and gas. Avoid all spices especially hot seasonings such as pepper, Cayenne and chili powder.

Avoid milk as it is tougher to digest and is likely to aggravate diarrhea but rather consider juices and carbohydrate rich items. Animal products should be restricted because meat is tough to digest and can aggravate diarrhea, gas, and other similar digestive problems. However, Dr. Adupet recommends modest quantities of poultry meats, as they are an excellent source of protein.

Because of the gastrointestinal conditions involved, foods that are easy to digest are recommended. These foods will also help your immune system recover as quickly as possible. Slightly overcooked rice along with porridge should be included in a diet for typhoid patients as rice contains a small amount of fiber that helps to regulate the digestive system while porridge contains healthy cultures that reduce the severity of stomach flu.

He explains that too much sweating associated with the fever results in a drastic loss of fluids, vitamins, and electrolytes such as sodium and potassium. It is important to include a variety of fruits and vegetables in the patient’s typhoid diet and treatment plan.

After typhoid, diet that includes low fiber soft foods that are easy on the digestive system should be continued for it is a vital part of the recovery stage.

For children, Dr. Adupet says since they tend to succumb to typhoid the most, they should be constantly given fluids, boiled eggs and thick broths to replace the lost electrolytes and minerals. For adults, they should ensure to take more than a litre of drinks every day.

To be safe, medics advise we seek restaurants with a reputation for safety and always ensure we are served with food that is hot to the touch.  We should also beware of raw or sliced fruits that may have been washed in contaminated water.

KCCA and Ministry of Health officials are sensitizing food vendors and juice sellers in downtown Kampala where the disease has been mostly reported. They are passing on better hygiene practices to prevent further spread of the disease.

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