Amoebic Dysentery Causes Diarrhea Outbreak In America Samoa

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161 cases, including 14 hospitalizations, in May

By Fili Sagapolutele

PAGO PAGO, American Samoa (The Samoa News, May 23, 2014) – The American Samoa Department of Health has revealed that a diarrhea outbreak in the territory that began early this month with more than 150 confirmed cases, includes cases which tested positive for ‘amoeba entamoeba histolytica’, which is a parasite.

The revelation was made by DoH official Dr. Mark Durrand during a news conference yesterday morning at the department’s main office in Fagaalu. The media conference was called by Health director Motusa Tuileama Nua for an update on the presence of amoebic dysentery in the territory.

Durrand said that since early this month there has been an increase in diarrhea cases in American Samoa.

The upsurge started in the first week of May, but really "accelerated on May 10th", he said, adding that there have been 161 cases so far with 14 of them serious enough to be admitted to LBJ Medical Center.

Of the total cases, 56 of them "have been positive for ‘amoeba entamoeba histolytica’, which is a parasite [and] six of the cases have been positive for ‘shigella’ which is a bacteria," he explained.

"There is a little bit of uncertainty about amoeba" he said, but added that samples have been sent to off island reference-labs to confirm the organism that is responsible for the outbreak."

Further, the "epidemiology so far does not show any common source for the outbreak. It doesn’t show a particular store, particular eating place, particular event, a particular part of the island, a school, a work place, [or] a food source," Durrand said and noted that they are still investigating the source.

The DoH doctor also said that there are no cases from Manu’a and there is an "unofficial report" that there is a "diarrhea outbreak in Samoa" and there may be deaths associated with that outbreak.

"No matter which organism is responsible for this outbreak, these kinds of diseases — what we call a fecal-oral spread — means the germs that cause diarrhea like this — are spread from human waste. And when a person swallows or gets that waste in their body then they can get sick with this kind of disease," he said.

Durrand gave examples of the ways this kind of disease can spread, such as through water supplies that are contaminated with human waste or food handlers who aren’t washing their hands before they prepare the food.

He said the disease can also spread if fruits and vegetables that are consumed are washed in contaminated water.

So the measures that are recommended to protect the public from this diarrhea, include the following, the doctor noted:

He also said the public is recommended to protect their food from insects — especially house files, and drinking water should either be boiled before drinking, or bottled water from the store should be used for drinking.

Fruits and vegetables should be washed in clean water from a reliable source as well.

"This can be a dangerous sickness. A lot of these cases — severe cases with blood in the stool, can cause dehydration and death— especially, for young children, and the elderly, and people who have other chronic diseases," Durrand stated. "So if it's more than a mild case of diarrhea, if there is fever, or blood in the diarrhea, then it’s highly recommended to get medical care.


Samoa News notes that the DoH Medical Director, Tamasoali’i John Tufa had speculated that it’s contaminated water that is causing the spread of the amoebic dysentery infection being seen at the hospital, because, he noted, the cases are scattered all over the island, not just from one village.

This caused ASPA CEO Utu Abe Malae to respond that "LBJ and Public Health must take this matter seriously and assign a can-do team to determine the source of the amoebiasis outbreak and solve the problem."

He later told Samoa News that on Tuesday (this week) he had received a report from AS-EPA of the water quality tests of 17 locations or homes of victims associated with the outbreak of amoebiasis, and that "sixteen of the 17 tested negative for two kinds of indicator bacteria: Total Coliform and Fecal Coliform. Fecal coliform is associated with fecal contamination of the water."

Utu pointed out however, "Public Health has to take more samples and perform the standard epidemiological protocol," to find the real source of the outbreak and solve the problem.

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