Press Statement on Declaring end of Typhoid Outbreak in Kampala

23rd June 2015

Dr. Jane Ruth Aceng        
Director General of Health Services      

                                    MINISTRY OF HEALTH
                                    P. O.  BOX 7272,
                                    KAMPALA - UGANDA

Press Statement on end of Typhoid outbreak in Kampala  

The Ministry of Health and Kampala Capital City Authority (KCCA) informs the public that the Typhoid outbreak that hit Kampala 3 months ago has been controlled. The outbreak was declared on the 19th February 2015 after numerous cases were reported and confirmed in the central business district of Kampala and neighbouring districts of Wakiso and Mukono.
The declaration of an end to the outbreak comes after 4 weeks of the treatment centres reporting cases below the baseline typhoid outbreak thresholds.  
During the outbreak, a total of 14,304 suspected cases were registered. Of these, 10,230 (4,735 Females and 5495 Males) met the case definition for typhoid and were treated in the six designated treatment centers that were set up. The total number of confirmed cases was 1,090. Of these 52 cases were confirmed by blood culture and 1,038 by Tubex.  
The outbreak which started in the city centre spread to all the divisions of Kampala but the most affected areas were Rubaga and Makindye Divisions. Eventually, the outbreak also spread to some areas in Wakiso and Mukono districts.
Six  treatment centres i.e. Kisenyi HC IV, Kitebi HC III, Kisugu HC III, Kawaala HC III, Komamboga HC III and  Kiswa HC IV were set up to receive, screen and treat all suspected typhoid cases. Health workers were mobilized by KCCA from health facilities across Kampala and boosted up by 50 UPDF health personnel to offer care and treatment during the peak of the outbreak. Medicines, health supplies and necessary equipment were delivered by National Medical Stores on a timely basis; hence patients received good quality health care.

The Ministry of Health, KCCA, and partners constituted teams of Epidemiologists and Surveillance Officers to investigate the outbreak.   From the findings, it was established that the outbreak was due to consumption of contaminated water majorly from underground sources and springs, and vended locally made juices prepared with contaminated water.
Government Measures to avert any more outbreaks
1.    The Ministry of Health recommends that there should be only one source of water in the city. This should be water from National Water and Sewerage Corporation (NWSC). Other sources of water used should be the commercialised bottled water that has been approved by the Uganda National Bureau of Standards.
2.    The Ministry of Health recommends that KCCA and NWSC conduct periodic water quality assessments in different locations within the city to monitor safety of the water being used by the population.
3.    Kampala Capital City Authority should strengthen certification of food vendors and prohibit typhoid carriers from vending food.
Appeal to Health workers
Diagnosis of Typhoid - All health workers have been advised against using the Widal testing as a confirmatory test for Typhoid.  It is advisable to use a typhoid case definition for suspected cases and Blood cultures for confirmation of Typhoid. In facilities where it is not possible to carry out blood cultures, blood samples of highly suspected cases should be sent through the national specimen transport network to the Reference Laboratories for appropriate testing.
The Government urges the public to observe the following measures to prevent Typhoid since it remains an endemic disease in the country.

Appeal to the Public

1.    The public should continue to be vigilant to seek medical advice for typhoid symptoms like gradual onset of persistent fever ≥38ºC of 3 or more day’s duration, not responding to anti-malarials with additional symptoms that may include general weakness, headache, abdominal pain, constipation or diarrhoea.
2.     The public is urged to observe personal and community hygiene to avoid possible typhoid infection including hand hygiene, latrine use, keeping drinking water containers clean, regularly cleaning water reservoirs at household levels.
3.    The public is advised to boil drinking water themselves and keep it in clean containers.  
4.    The public is advised to use boiled drinking water for making juices and other local drinks.
5.    The public is further advised to avoid eating unwashed fruits and Vegetables, and to as much as possible eat hot food.
I thank you all

For God and My Country

Dr. Jane Ruth Aceng