A typhoid fever outbreak in a slum of South Dumdum municipality, West Bengal, India, 2007: Evidence for foodborne and waterborne transmission

Bhunia, Rama; Hutin, Yvan; Ramakrishnan, Ramachandran; Pal, Nishith; Sen, Tapas; Murhekar, Manoj
January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p1
Academic Journal
Background: In April 2007, a slum of South Dumdum municipality, West Bengal reported an increase in fever cases. We investigated to identify the agent, the source and to propose recommendations. Methods: We defined a suspected case of typhoid fever as occurrence of fever for ≥ one week among residents of ward 1 of South Dumdum during February - May 2007. We searched for suspected cases in health care facilities and collected blood specimens. We described the outbreak by time, place and person. We compared probable cases (Widal positive >= 1:80) with neighbourhood-matched controls. We assessed the environment and collected water specimens. Results: We identified 103 suspected cases (Attack rate: 74/10,000, highest among 5-14 years old group, no deaths). Salmonella (enterica) Typhi was isolated from one of four blood specimens and 65 of 103 sera were >= 1:80 Widal positive. The outbreak started on 13 February, peaked twice during the last week of March and second week of April and lasted till 27 April. Suspected cases clustered around three public taps. Among 65 probable cases and 65 controls, eating milk products from a sweet shop (Matched odds ratio [MOR]: 6.2, 95% confidence interval [CI]: 2.4-16, population attributable fraction [PAF]: 53%) and drinking piped water (MOR: 7.3, 95% CI: 2.5-21, PAF-52%) were associated with illness. The sweet shop food handler suffered from typhoid in January. The pipelines of intermittent non-chlorinated water supply ran next to an open drain connected with sewerage system and water specimens showed faecal contamination. Conclusion: The investigation suggested that an initial foodborne outbreak of typhoid led to the contamination of the water supply resulting in a secondary, waterborne wave. We educated the food handler, repaired the pipelines and ensured chlorination of the water.


Related Articles

  • Enteric fever in two vaccinated travellers to Latin America. Beaulieu, Andre-Anne; Boggild, Andrea K. // CMAJ: Canadian Medical Association Journal;10/18/2011, Vol. 183 Issue 15, p1740 

    The article presents case studies of a 24-year-old woman and her 25-year-old partner who were diagnosed of enteric fever after travelling in Latin America. It says that the patients received vaccinations for typhoid fever, yellow fever, hepatitis A, and malaria prophylaxis prior to their trip....

  • Multiplex PCR for the concurrent detection and differentiation of Salmonella spp., Salmonella Typhi and Salmonella Typhimurium. Chai Fung Pui; Woan Chwen Wong; Lay Ching Chai; Hai Yen Lee; Ahmad Noorlis; Tuan Chilek Tuan Zainazor; John Yew Huat Tang; Farinazleen Mohamad Ghazali; Yoke Kqueen Cheah; Yoshitsugu Nakaguchi; Mitsuaki Nishibuchi; Son Radu // Tropical Medicine & Health;Mar2011, Vol. 39 Issue 1, p9 

    Salmonellosis outbreaks involving typhoid fever and human gastroenteritis are important diseases in tropical countries where hygienic conditions are often not maintained. A rapid and sensitive method to detect Salmonella spp., Salmonella Typhi and Salmonella Typhimurium is needed to improve...

  • Regulatory T Cell Suppressive Potency Dictates the Balance between Bacterial Proliferation and Clearance during Persistent Salmonella Infection.  // PLoS Pathogens;Aug2010, Vol. 6 Issue 8, p1 

    No abstract available.

  • Typhoid Fever.  // JAMA: Journal of the American Medical Association;8/26/2009, Vol. 302 Issue 8, p914 

    The article offers clinical information on typhoid fever, a disease caused by Salmonella enterica serotype Typhi. Typhoid is characterized with fever that can reach up to 104 degrees Fahrenheit, stomach pain, headache and weakness. It can be transmitted through food or drinks that were handled...

  • The rising tide of foodborne and waterborne infections. Buchanan, Robert L.; Ericsson, Charles D. // Patient Care;5/15/1997, Vol. 31 Issue 9, p30 

    Examines the efforts toward eradicating foodborne and waterborne diseases in the United States. Prevalence of foodborne and waterborne diseases; Risk factors; Clinical management; Strategies in preventing transmission of foodborne and waterborne diseases. INSET: The Seattle model: What...

  • Diarrhoea dos and don'ts. MATHAI, GITA // Telegraph (Calcutta, India);10/19/2015, p13 

    The article offers information on diarrhoea, a food or water borne bacteria, viruses or parasites, its symptoms and management.

  • Diagnostic utility of a single Widal test in the diagnosis of typhoid fever at Aga Khan University Hospital (AKUH), Nairobi, Kenya. Omuse, Geoffrey; Kohli, Ruchika; Revathi, Gunturu // Tropical Doctor;Jan2009, Vol. 40 Issue 1, p43 

    Typhoid fever is a systemic illness caused by Salmonella enterica serovar typhi (S. typhi) and is endemic in Kenya, where a single Widal test done on an acute phase serum is the most commonly used test. Using a cut-off value of 1:320 for both O and H agglutinins as being diagnostic of S. typhi,...

  • Imported Fruit Blamed For Rare Typhoid Outbreak. Henkel, John // FDA Consumer;Jul/Aug99, Vol. 33 Issue 4, p36 

    Reports that the tropical mamey fruit popular in Hispanic American homes was the source of the rare outbreak of typhoid fever in the United States (US) between December 1998 and February 1999. Investigation of the Florida Health Department and US Centers for Disease Control and Prevention into...

  • A Critical Survey of Water-Health Problems in the Tertiary Institutions of Nigeria. Ojiegbe, R. U. // Journal of Environmental Systems;2003-2004, Vol. 31 Issue 2, p169 

    Water-related health problems were assessed in a survey of four prominent tertiary institutions in Owerri, Imo State, Nigeria, using hospital data on water-related diseases from 2000 to 2004. The most prevalent disease was malaria, followed by diarrhea diseases and enteric fevers. The causes...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics