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Malawi sees spike in cholera and typhoid cases

An Anglican nursing school in Malawi has reopened after health officials gave it a clean bill of health following an outbreak of typhoid in early July.

On 15 July 2016 district health officials ordered St Luke’s College of Nursing and Midwifery in Zomba closed after 40 nursing students were hospitalized for typhoid. Students were permitted to return to classes on r 4 Sept 2016.

The Zomba District Health Officer Dr. Gift Kawaladzira told Malawi24 the source of the infection was an improperly maintained water system. “The college uses the water which is direct from Malosa Mountain through a water system installed by the Anglican Church. This system is parallel to the Southern region water system and has several flaws,” he explained.

An antibiotic-resistant strain of typhoid bacterium is driving a previously unrecognized epidemic in Africa, researchers reported in the 11 May 2015 issue of Nature Genetics. The new strain of typhoid, which is caused by a variant of Salmonella known as Typhi, is resistance to older antibiotics, such as penicillin or drugs based on sulfonamide. In Blantyre 782 cases of typhoid were identified in 2014, up from an average of just 14 per year between 1998 and 2010. The proportion of infections that were resistant to multiple antibiotics jumped from 7 per cent to 97 per cent over the same period.

In the 2015 article in Nature Genetics, Dr. Vanessa Wong, an infectious-disease specialist at the Wellcome Trust Sanger Institute noted the drug-resistant strain was most common in areas where older antibiotics are frequently used against typhoid, suggesting that overuse of such drugs has helped to drive the epidemic in Africa.

The increase in typhoid in Malawi has been accompanied by a sharp jump in cholera. In June the Norwegian Red Cross reported 1,300 confirmed cases of cholera with 35 reported deaths. Epidemiologists believe the cholera outbreaks, which have been reported throughout the country, are tied to the prolonged drought affecting Southern and Central Africa. The disease appears to be concentrated around the great lakes of Central Africa.

The lack of rainfall has led to a drop in water levels in the lakes. With no fresh water entering the lakes, bacteria levels have spiked. “The water situation is quite bad due to the lack of rain. In some communities, the water  is contaminated, and when people drink the water they get infected. They get acute diarrhoea or even cholera,” says Michael Charles, acting regional representative for the International Federation of Red Cross and Red Crescent Societies (IFRC) in southern Africa.

Malawi is in the midst of a severe drought brought on by the  strongest El Nino in 30 years is causing erratic and low rainfall, affecting up to 8 million people in Malawi alone. The bacteria levels in Lake Malawi and Lake Chilwa will drop once large amounts of freshwater flow. However, the rainy season does not begin until November.

Speaking to Capital FM, Lewis Tukala of the District Environmental Health Office in Karonga urged lakeside communities not to drink lake water.  “Cholera virus can live for two years in water so the only way to prevent the outbreak is by refraining from drinking or using untreated water and start using safe water from the tap or borehole,” he said, adding: “For those who live along the lake and do not have any other source of potable water, they should make sure that they treat the water from those sources with water guard or chlorine.”

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