Статья

A Massive Epidemic of Multidrug‐Resistant Typhoid Fever in Tajikistan Associated with Consumption of Municipal Water

Jonathan MerminFoodborne and Diarrheal Diseases Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. [email protected]Rodrigo VillarDushanbe Sanitary and Epidemiology Service and Microbiology Laboratory, Hospital Number 2, Dushanbe, TajikistanJoe CarpenterFoodborne and Diarrheal Diseases Branch, Biostatistics and Information Management Branch, and Hospital Infections Program, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Refugee Health Unit, National Center for Environmental Health, and Epidemic Intelligence Service and Division of International Health, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GeorgiaLes RobertsDushanbe Sanitary and Epidemiology Service and Microbiology Laboratory, Hospital Number 2, Dushanbe, TajikistanAliev SamariddenDushanbe Sanitary and Epidemiology Service and Microbiology Laboratory, Hospital Number 2, Dushanbe, TajikistanLarissa GasanovaFoodborne and Diarrheal Diseases Branch, Biostatistics and Information Management Branch, and Hospital Infections Program, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Refugee Health Unit, National Center for Environmental Health, and Epidemic Intelligence Service and Division of International Health, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GeorgiaSvetlana LomakinaFoodborne and Diarrheal Diseases Branch, Biostatistics and Information Management Branch, and Hospital Infections Program, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Refugee Health Unit, National Center for Environmental Health, and Epidemic Intelligence Service and Division of International Health, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GeorgiaCheryl A. BoppFoodborne and Diarrheal Diseases Branch, Biostatistics and Information Management Branch, and Hospital Infections Program, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Refugee Health Unit, National Center for Environmental Health, and Epidemic Intelligence Service and Division of International Health, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GeorgiaLori HutwagnerFoodborne and Diarrheal Diseases Branch, Biostatistics and Information Management Branch, and Hospital Infections Program, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, and Refugee Health Unit, National Center for Environmental Health, and Epidemic Intelligence Service and Division of International Health, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GeorgiaPaul S. MeadDushanbe Sanitary and Epidemiology Service and Microbiology Laboratory, Hospital Number 2, Dushanbe, TajikistanB C RossDushanbe Sanitary and Epidemiology Service and Microbiology Laboratory, Hospital Number 2, Dushanbe, TajikistanEric D. MintzDushanbe Sanitary and Epidemiology Service and Microbiology Laboratory, Hospital Number 2, Dushanbe, Tajikistan

1999en

ABI

Аннотация

From 1 January through 30 June 1997, 8901 cases of typhoid fever and 95 associated deaths were reported in Dushanbe, Tajikistan. Of 29 Salmonella serotype Typhi isolates tested, 27 (93%) were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. In a case-control study of 45 patients and 123 controls, Salmonella Typhi infection was associated with drinking unboiled water (matched odds ratio, 7; 95% confidence interval, 3-24; P<.001). Of tap water samples, 97% showed fecal coliform contamination (mean level, 175 cfu/100 mL). Samples taken from water treatment plants revealed that fecal coliform contamination occurred both before and after treatment. Lack of chlorination, equipment failure, and back-siphonage in the water distribution system led to contamination of drinking water. After chlorination and coagulation were begun at the treatment plants and a water conservation campaign was initiated to improve water pressure, the incidence of typhoid fever declined dramatically.

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Идентификаторы

DOI: 10.1086/314766

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Цитирований: 2Использованных источников: 0

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