The Significance of Waterborne Typhoid Fever Outbreaks, 1920–1930

Wolman, Abel; Gorman, Arthur E.

doi:10.1002/j.1551-8833.1931.tb17814.x

Cited by 22 publications

(15 citation statements)

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“…Improvement of sanitation, hygiene and clean water supply around the world could avert ≥90% of diarrheal disease episodes annually [32]. In North America and Europe, typhoid fever caused large-scale outbreaks from the late 19 th through the early 20 th century [33, 34]. After improvement of municipal water and sanitation systems in the early 20 th century, waterborne outbreaks of communicable diseases including typhoid fever drastically decreased [35–37].…”

Section: Discussionmentioning

confidence: 99%

A large and persistent outbreak of typhoid fever caused by consuming contaminated water and street-vended beverages: Kampala, Uganda, January – June 2015

et al. 2017

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BackgroundOn 6 February 2015, Kampala city authorities alerted the Ugandan Ministry of Health of a “strange disease” that killed one person and sickened dozens. We conducted an epidemiologic investigation to identify the nature of the disease, mode of transmission, and risk factors to inform timely and effective control measures.MethodsWe defined a suspected case as onset of fever (≥37.5 °C) for more than 3 days with abdominal pain, headache, negative malaria test or failed anti-malaria treatment, and at least 2 of the following: diarrhea, nausea or vomiting, constipation, fatigue. A probable case was defined as a suspected case with a positive TUBEX® TF test. A confirmed case had blood culture yielding Salmonella Typhi. We conducted a case-control study to compare exposures of 33 suspected case-patients and 78 controls, and tested water and juice samples.ResultsFrom 17 February–12 June, we identified 10,230 suspected, 1038 probable, and 51 confirmed cases. Approximately 22.58% (7/31) of case-patients and 2.56% (2/78) of controls drank water sold in small plastic bags (ORM-H = 8.90; 95%CI = 1.60–49.00); 54.54% (18/33) of case-patients and 19.23% (15/78) of controls consumed locally-made drinks (ORM-H = 4.60; 95%CI: 1.90–11.00). All isolates were susceptible to ciprofloxacin and ceftriaxone. Water and juice samples exhibited evidence of fecal contamination.ConclusionContaminated water and street-vended beverages were likely vehicles of this outbreak. At our recommendation authorities closed unsafe water sources and supplied safe water to affected areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-4002-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A large and persistent outbreak of typhoid fever caused by consuming contaminated water and street-vended beverages: Kampala, Uganda, January – June 2015

et al. 2017

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“…Not to despair, typhoid fever also serves as an example of how a single change in infrastructure can rapidly and markedly diminish the incidence of enteric infections (22)(23)(24).…”

Section: Industrialized World Ecdgmentioning

confidence: 99%

“…In most large cities of Western Europe and North America in the last quarter ofthe 19th century typhoid fever was highly endemic with incidence rates of 200-500 cases per 100,000 population being common (23,24). In the late 19th and early 20th centuries, the introduction of a single intervention, treatment of municipal water supplies (with chlorine, sand filtration, or both) drastically and precipitously reduced the incidence oftyphoid fever wherever these interventions were applied (22)(23)(24).…”

Section: Industrialized World Ecdgmentioning

confidence: 99%

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Changes in human ecology and behavior in relation to the emergence of diarrheal diseases, including cholera.

Levine

1994

Proc. Natl. Acad. Sci. U.S.A.

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Human po s throughout the world can be found in diverse codis. A proportion of the population of developing countries lves in deprived conditions characterized by r a housing, lack of piped water and sanitation, and widespread fecal contamition of the environment. Enteric infections, particularly due to bacterial pathogens, are readily trnsitted under these drcumstances. In contrast, the majority of nhbitats of idurilized countries live in a sanitary environment that generally discourages the transmission of enterc pathogens, particularly bacteria. In both these ecologic niches, i human ecology and behavior are leading to the emergence of certain enteric infections. Relevant factors in developing areas indude urbanization (leading to periurban slums), diminished breastfeeding, and political upheaval that results in population migrations. In indus d areas, large-scale food production (e.g., enormous poultry farms), distribution, and rtailing (e.g., fast-food chains) create opportunities where widespread and extensive outbreaks of food-borne enteric infection can ensue if a breakdown in food hygiene occurs.In a broad sense, one can divide the world into two distinct ecologies with respect to the occurrence of enteric diseases, with a developing country ecology at one extreme and an industrialized world ecology at the other. Between these extremes, one encounters gradations and exceptions. In each ofthese settings, changes in human ecology and behavior are having an impact on enteric infections. In developing areas, some of the sweeping changes in demographics and population distribution that are underway are creating environments of amplified transmission of enteric pathogens or are attenuating the protective features ofsome traditional practices. In industrialized areas, the changes underway to meet the ever-increasing demands of consumption-based economies are creating opportunities for the importation of pathogens that improvements in infrastructure were believed to have eliminated. Finally, even the gains in infrastructure and commercialization of food production, food distribution, and food retailing, with all oftheir positive impact on health, have by their very nature created environments in which we have seen the emergence of enteric pathogens.Developing World Ecology

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“…Many enteric diseases caused by bacteria are water-dispersed; cholera, typhoid, and anthrax are examples (Wolman andGorman 1931, Diesch 1970). Many enteric diseases caused by bacteria are water-dispersed; cholera, typhoid, and anthrax are examples (Wolman andGorman 1931, Diesch 1970).…”

Section: A Andowmentioning

confidence: 99%