Emergence of resistant Shigella dysentriae bacteria in the IDP camps

The World Health Organization (WHO) office in Eritrea would like to inform all UN staff, (resident and visiting), None overnmental Organizations, and other !artners that the "inistr# of Health of the $tate of Eritrea has notified an out%reak of %lood# diarrhoea in one &'( cam! namel# Harena cam!) This information was disclosed at the eighteenth emergenc# Health and Nutrition meeting, which was held on $e!tem%er *+, ,*** and at the Emergenc# coordination !lenar# meeting on $e!tem%er *-, ,***) The causative agents were identified to %e Shigella dysentriae and Escherichia coli %acteriae) $higella d#sentriae is from the genus of non.lactose fermenting, non motile gram.negative %acilli %elonging to the famil# Entero%acteriaceae, that contains a num%er of s!ecies that cause digestive tract distur%ances ranging from mild diarrhoea to a severe and often fatal bacillary dysentery (a term which is a!!lied to a num%er of intestinal disorders characterized %# inflammation of the mucous mem%rane of the intestinal tract, es!eciall# the colon)) The %acilli, which cause shigellosis, %elongs to the genus $higella of which there are three !athogenic grou!s namel# Shiga, Flexner and Sonnei the last two having man# 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 /acillar# d#senter# in endemic form is found all over the world) &t occurs in e!idemic form whenever there is a crowded !o!ulation with !oor sanitation, and thus has %een a constant accom!animent of wars and natural catastro!hes) $!read ma# occur %# contaminated food or drinks %# direct contact or through vectors like flies %ut contact through unwashed hands after defecation is %# far the most im!ortant factor) Out%reaks are not uncommon in mental hos!itals, residential schools and other closed institutions) !linical Features The s#m!toms of $higellosis are a%dominal !ain, tenesmus (s!asmodic contraction of the anal s!hincter with !ain and !ersistent desire to em!t# the %owel with involuntar# ineffectual straining effort) and diarrhoea with !assage of mucous or %lood or %oth) The %acteria ($higellae), which were identified from the !atients in the &'( cam!s, were found to %e resistant to the commonl# used first line drugs, which are Trimetho!rim sulfametho0azole (1o.trimo0azole or /actrim) and 2m!icillin) However, according to the "OH the out%reak has not reached an e!idemic !ro!ortion and measures to contain it

have %een taken, which include !rovision of the a!!ro!riate drugs (Nalidi0ic acid and Nitrofuratoin) to which the %acteriae are sensitive, and environmental sanitation and education to the !eo!le living in the cam!s) Meanwhile The World health Organization Office in Eritrea recommends that all U personnel! "Os! other partners and the people in the camps and s#rro#nding areas ta$e all preca#tionary meas#res to pre%ent themsel%es from ac&#iring the disease'

"ips for preventing food#borne diseases

3ood %orne diseases are diseases, which are transmitted from an infected !erson to another via food (meal and drinks) through oro.fecal contamination of the food or drink either %# direct contact or via a vector like fl# or cockroach) To avoid such contamination and avoid %eing infected the following measures should %e taken4. $eep clean wash hands regularl# after contacting a diseased !erson, after visiting a toilet, handling raw or uncooked food, dirt# materials or contacting with animals) $eep food at safe temperature kee! hot food reall# hot (a%ove 5* *1) and cold food cold (%elow 6* *1)) 'o not leave food at room tem!erature as this favours the multi!lication of %acteria, which causes disease like $higellosis) Separate ra% and cooked food $e!arate cooked food from raw and read# to eat food at all times, raw food es!eciall# meat, !oultr# and fish can contain dangerous micro. organisms, which cannot %e seen with naked e#es) !ook thoroughly 1ook food thoroughl#, es!eciall# meat, !oultr# egg and fish) Thorough cooking kills almost all dangerous microorganisms) &se safe %ater Use safe water) To do this #ou have to drink either !re.treated or self treated water or %oil the water first then cool and drink it) Water sources should %e !rotected from getting contaminated) The other o!tion is drinking %ottled water) Unsafe water can act as a vehicle for harmful microorganisms) 2lwa#s drink !asteurised milk or %oiled milk) &se of latrine Human wastes (faeces) should %e dis!osed in latrines) 2fter defecation the !it (hole) should %e covered as this will !revent flies from getting access to the faeces and contaminate food or drinks) Washing hands after visiting toilet should not %e forgotten at an# time)