TY - JOUR
T1 - A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water
AU - Mermin, Jonathan H.
AU - Villar, Rodrigo
AU - Carpenter, Joe
AU - Roberts, Les
AU - Samaridden, Aliev
AU - Gasanova, Larissa
AU - Lomakina, Svetlana
AU - Bopp, Cheryl
AU - Hutwagner, Lori
AU - Mead, Paul
AU - Ross, Bruce
AU - Mintz, Eric D.
PY - 1999
Y1 - 1999
N2 - 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.
AB - 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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U2 - 10.1086/314766
DO - 10.1086/314766
M3 - Article
C2 - 10228063
AN - SCOPUS:0033064569
SN - 0022-1899
VL - 179
SP - 1416
EP - 1422
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -