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Recently, concerns over the ­potential contamination of municipal water prompted advice against the use of unboiled tap ­water on social media. This followed after the National Institute for Communicable Diseases (NICD) notified the public of surges in enteric fever (an infection that includes typhoid fever) cases reported in the Western Cape and North West on 16 February. Investigations into the source of trans­missions were subsequently launched.

For fourth-year BSc (Food ­Science) student Kgalalelo ­Koloti, news of the possible Typhoid outbreak was received with  great caution. “I was alarmed. What I had assumed was a mere stomach bug turned out to be an enteric ­opportunistic pathogen of major concern.”

During this year’s Welcoming period, several Stellenbosch University (SU) students fell ill, citing a wide-spreading stomach bug as the cause. Dr Jo Barnes—­epidemiologist and senior lecturer at SU’s Faculty of Medicine and Health Sciences—said, “A student ­population reflects the health risks present in their environment, just as any other community does, and poor personal hygiene can hugely contribute to the spread of a wide range of organisms that can cause diarrhoea.”

She added that in spaces of close contact between large groups of people, such as a university, this risk is further amplified.

As a distinct gastrointestinal disorder, typhoid fever is caused by the organism Salmonella Typhi and is primarily carried by human and animal faeces. According to Barnes, “Typhoid is spread by eating or drinking food or water contaminated with the faeces of an infected person. 

“Symptoms usually begin 6–30 days after exposure to the ­organism, with a gradual onset of a high fever lasting several days.” 

Other symptoms associated with typhoid, according to Barnes, are weakness, headaches, ­abdominal pain, constipation, vomiting, and the development of a skin rash with rose-coloured spots. In severe cases, typhoid can lead to confusion and even death. 

With persistent challenges of improper water and ­sanitation ­services, the presence of ­typhoid in South Africa is certainly not unheard of. Despite this,
Dr Jantjie Taljaard—Infectious ­Diseases ­Physician at ­Tygerberg Academic Hospital—provides that cases per year over the past 10 years have rested around the 100-case mark.  He added that while sharp increases have been noted in both the Western Cape and North West this year, “no cases of typhoid have been diagnosed in the Stellenbosch area”. 

“Contamination of common water sources [is] being ­investigated, but tests are all negative up to date,” Taljaard said. This was confirmed by the Stellenbosch Municipality in communication posted on 23 February. Updates from the municipality through Twitter indicate that water samples have been sent to laboratories for full spectrum testing as an additional safety measure.

In Barnes’s expert advice, common practices of good hygiene such as regular hand washing and the cleaning of shared ­spaces ­remain just as relevant to ­preventing the spread of typhoid as it does to curbing the common stomach bug. In cases of uncertainty or a display of symptoms, one can contact a nearby hospital, clinic or private doctor for diagnosis.

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