The World Health Organization (WHO) office in Eritrea would like to inform all UN staff, (resident and visiting), None Governmental Organizations, and other partners that the Ministry of Health of the State of Eritrea has notified an outbreak of bloody diarrhoea in one IDP camp namely Harena camp. This information was disclosed at the eighteenth emergency Health and Nutrition meeting, which was held on September 07, 2000 and at the Emergency coordination plenary meeting on September 09, 2000.
The causative agents were identified to be Shigella dysentriae and Escherichia coli bacteriae. Shigella dysentriae is from the genus of non-lactose fermenting, non motile gram-negative bacilli belonging to the family Enterobacteriaceae, that contains a number of species that cause digestive tract disturbances ranging from mild diarrhoea to a severe and often fatal bacillary dysentery (a term which is applied to a number of intestinal disorders characterized by inflammation of the mucous membrane of the intestinal tract, especially the colon). The bacilli, which cause shigellosis, belongs to the genus Shigella of which there are three pathogenic groups namely Shiga, Flexner and Sonnei the last two having many strains.
According to the Ministry of Health the outbreak has not reached an epidemic proportion and measures to contain it have been taken, including antibiotic sensitivity.
Epidemiology: Bacillary dysentery in endemic form is found all over the world. It occurs in epidemic form whenever there is a crowded population with poor sanitation, and thus has been a constant accompaniment of wars and natural catastrophes. Spread may occur by contaminated food or drinks by direct contact or through vectors like flies but contact through unwashed hands after defecation is by far the most important factor. Outbreaks are not uncommon in mental hospitals, residential schools and other closed institutions.
Clinical Features: The symptoms of Shigellosis are abdominal pain, tenesmus (spasmodic contraction of the anal sphincter with pain and persistent desire to empty the bowel with involuntary ineffectual straining effort) and diarrhoea with passage of mucous or blood or both.
The bacteria (Shigellae), which were identified from the patients in the IDP camps, were found to be resistant to the commonly used first line drugs, which are Trimethoprim sulfamethoxazole (Co-trimoxazole or Bactrim) and Ampicillin. However, according to the MOH the outbreak has not reached an epidemic proportion and measures to contain it have been taken, which include provision of the appropriate drugs (Nalidixic acid and Nitrofuratoin) to which the bacteriae are sensitive, and environmental sanitation and education to the people living in the camps.
Meanwhile The World health Organization Office in Eritrea recommends that all UN personnel, NGOs, other partners and the people in the camps and surrounding areas take all precautionary measures to prevent themselves from acquiring the disease.
Tips for preventing food-borne diseases:
Food borne diseases are diseases, which are transmitted from an infected person to another via food (meal and drinks) through oro-fecal contamination of the food or drink either by direct contact or via a vector like fly or cockroach. To avoid such contamination and avoid being infected the following measures should be taken:-
Keep clean: wash hands regularly after contacting a diseased person, after visiting a toilet, handling raw or uncooked food, dirty materials or contacting with animals.
Keep food at safe temperature: keep hot food really hot (above 60 0C) and cold food cold (below 10 0C). Do not leave food at room temperature as this favours the multiplication of bacteria, which causes disease like Shigellosis.
Separate raw and cooked food: Separate cooked food from raw and ready to eat food at all times, raw food especially meat, poultry and fish can contain dangerous micro- organisms, which cannot be seen with naked eyes.
Cook thoroughly: Cook food thoroughly, especially meat, poultry egg and fish. Thorough cooking kills almost all dangerous microorganisms.
Use safe water: Use safe water. To do this you have to drink either pre-treated or self treated water or boil the water first then cool and drink it. Water sources should be protected from getting contaminated. The other option is drinking bottled water. Unsafe water can act as a vehicle for harmful microorganisms. Always drink pasteurised milk or boiled milk.
Use of latrine: Human wastes (faeces) should be disposed in latrines. After defecation the pit (hole) should be covered as this will prevent flies from getting access to the faeces and contaminate food or drinks. Washing hands after visiting toilet should not be forgotten at any time.