1997 - Typhoid fever in Tadjikistan
28 February 1997
Disease Outbreak Reported
On 13 February WHO was informed of a new outbreak of typhoid fever in Tadjikistan. It is estimated that at least 3,000 cases have occurred in the capital city Dushanbé. Other reports indicate this to be a low estimate and that the disease has also spread outside the capital. Case fatality rates have been recorded as around 1%. Salmonella typhi has been confirmed by local and international laboratories. While the results of antibiotic sensitivity tests have been contradictory, in view of the current low case fatality rates WHO recommends the continued use of chloramphenicol and co-trimoxazole pending further investigations. Those who do not respond and high-risk groups (infants and the elderly) should be given ciprofloxacin. Weekly specimens should be examined to monitor antibiotic resistance patterns.
In response to a WHO appeal launched on 21 February, Sweden has committed Sw.Kr. 500,000, and other countries (Denmark, Italy and Japan) have also expressed interest. The funds will be used for laboratory kits and the proposed second line antibiotics to supplement the supply of chloramphenicol provided by other agencies. As soon as current security restrictions are lifted, an expert from the WHO Office for the European Region will be made available to the Government of Tadjikistan to help coordinate the technical expertise and supply of drugs and equipment in close collaboration with the agencies in place (IFRC, MSF, Pharmaciens sans frontières, etc.).