Officially the information has not been released, despite the fact that it is one of the communicable diseases of mandatory notification.
However, medical sources reported three suspected cases of typhoid fever in Caracas and Valencia, Carabobo state.
They also said, unofficially, that there are other patients with symptoms associated with the disease yet to be verified. Therefore, doctors recommended boiling drinking water to prevent transmission.
Typhoid fever is a disease transmitted by contaminated food and meals or directly from the patient, caused by the bacteria Salmonella typhi , which causes diarrhea, high temperatures, malaise and prostration and can cause rashes.
Huníades Urbina, secretary of the National Academy of Medicine, explained that it is a fecal-oral transmission, through hands and contaminated utensils. Also because of the very poor quality water that arrives. All of that is part of the chain of transmission, just like hepatitis A.
What is known?
The World Health Organization (WHO) estimated that each year between 11 and 21 million people fall ill with typhoid fever and between 128,000 and 161,000 die.
Communities without access to safe drinking water and adequate sanitation systems and vulnerable groups, particularly children, are most at risk of the disease.
For its prevention, it is necessary to take extreme hygiene measures for food and personnel, since it is associated with poor socio-sanitary conditions or poverty and trips to these areas.
Dr. Patricia Valenzuela, infectious disease doctor and vice president of the Venezuelan Society of Infectious Diseases (SVI), said that there are two preventive vaccines: the inactivated one, that is, the bacteria that is dead and processed, which does not have the reproduction cycle and is injectable . And there is a live attenuated vaccine, whose platform is live or weakened and is for oral application.
Doctors recommend boiling water in suspected cases of typhoid fever
“In Venezuela, remember, we have not had those doses. That immunization is offered to people who travel to areas where there are many cases, to endemic and hyper-endemic places. In general, it is offered on a routine basis. The point is to prevent infection. We would have to take into consideration if it is enough to apply it, because it is not an immunity for life. We have to see what the cost and benefit are, whether to give vaccines or do prevention and sanitize the water?
For the doctor, also attached to the Infectology section of the Institute of Tropical Medicine of the Central University of Venezuela (UCV), the priority is prevention and making water drinkable.
“Guaranteeing it in optimal conditions and quality allows countries sustainability and development over time in a satisfactory manner.”
He also warned that another factor to take into account is the treatment for fever, which can generate bacterial resistance.
Regarding the current situation, the infectologist indicated that it seems that there is no common focus that explains it.
“The last officially documented outbreak of typhoid fever in Caracas was in 2004, in the La Planta prison (now defunct).”
Valenzuela said that, at that time, about 30 patients arrived at the Vargas Hospital Emergency. She was a second-year resident of Infectious Diseases and she had to evaluate them.
“One of the patients arrived with an acute surgical abdomen, was taken to the operating room and the main surgeon was struck by the type of injuries he sustained and commented that it reminded him a lot of typhoid fever.”
At that time (2004), the epidemiologist of the health center made the same approach. Samples were taken from another patient who also arrived at the emergency room in very poor condition and died.
“The analyzes were done, some blood culture samples were sent to the Caracas Medical Center. As well as a rectal swab with feces, and it was in that institute that salmonella typhi was identified . Between three or five died, some had neurological deterioration, because it is one of the complications of this disease. When they checked the plant, they found poor conditions in the storage tanks. This is the last documented outbreak in Caracas,” said the doctor.
Valenzuela said that regarding the water that is consumed in Caracas, the reservoirs must be reviewed, tests must be carried out because in principle it should not have color, smell or taste, “these are fundamental characteristics that must be preserved.”
They include prolonged fever, tiredness, headaches, nausea, abdominal pain, and constipation or diarrhea. Some patients have skin rashes. Severe cases can become complicated and cause death.
Salmonella only lives in humans. Carriers carry the bacteria in their blood and intestines, even after symptoms have resolved, meaning they can pass it on to others through contaminated feces.
Dr. Manuel Figuera Esparza, infectologist, president of the SVI, stressed that the most important thing is prevention. “It is important to guide the population to avoid fecal or orofaecal infection in disasters, rains and problems with the purification of water.”
- Boil the water, even the one that is distributed in bottles, because sometimes at the bottom of these containers there can be solids. That is why it is recommended to boil it, at least for up to 10 minutes. This eliminates possible microorganisms.
- Afterwards, the correct thing is to filter with a white cloth. If there is any residue, it remains in that type of filter.
- Store it in clear glass or light-colored wide-mouth plastic jars, which should be properly washed and disinfected. Then it must be covered.
- You can also add drops of chlorine, depending on the percentage of the concentration:
- One or two drops per liter of water if it is 1%. If it is 0.5%, the dose must be increased to 4 drops. You have to check that the chlorine is pure and has no smell or is soapy.
- Wash the food well with drinking water and take care that the eggs do not have dirty shells.
- Hand washing when handling food, before and after, is basic.
- Use different boards to chop meat, poultry, vegetables, and fish. Clean the surface well.
- Do not eat ice, unless it is with clean water.