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By Giff Johnson

MAJURO, Marshall Islands (Marianas Variety, June 29) – At least 22 cases of typhoid fever have been confirmed here in the Marshall Islands capital, and health authorities have issued repeated warnings to local residents in an effort to halt further spread of the potentially deadly illness.

Doctors from the U.S. Centers for Disease Control arrived here earlier this week to assist the Ministry of Health in identifying the source of the typhoid.

The first case of typhoid was confirmed in mid-March. But in June, the number of cases began a sharp increase. There are typically one or two cases of typhoid a year in the Marshall Islands, but the outbreak of at least 22 confirmed cases has been a great concern to health officials.

Public Health’s Dr. Zackraias Zackraias said so far, the ministry has been unable to identify the cause of the typhoid. Patients coming to Majuro Hospital with typhoid have ranged in age from young children to adults and from many different parts of the island with no common source of exposure, he said.

"We have cases from downtown to the airport (a nine mile stretch of the island) and we have not been able to find a single connection between any of them," said Zachraias. "They are all different ages from seven months to thirty years old. Four are students, but they don’t go to the same school."

"Typhoid is a severe, contagious and life-threatening disease," the ministry said Tuesday in its warning that is now being aired repeatedly on the radio and in the local newspaper. "It is caused by contaminated food, drinks and water by bacteria called Salmonella typhi, which may result in fever with severe complications."

"All of their cases were acute, but the symptoms are easy to treat with antibiotics," said Zachraias. "The follow-up visit, though, is essential to ensure that the typhoid does not remain in the system. Even though the symptoms go away, people can remain carriers, which means they are still contagious. They also face more serious complications, including bleeding and ruptures of the intestines or cancer of the intestine, all of which are life threatening."

Zachraias said that ongoing testing of food handlers was continuing, but restaurants do not appear to be the source so far.

Health Secretary Justina Langidrik said health officials are working with the Environmental Protection Authority to implement strict requirements for individuals who serve food to the public to have updated health certificates and regular monitoring of the public water systems.

Symptoms of typhoid include high fever, persistent headache, abdominal discomfort, constipation, diarrhea, nasal bleeding, weakness, dizziness and nausea, and variable degrees of unconsciousness in the later stages of illness.

June 29, 2006

Marianas Variety: www.mvariety.com

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