Leausa Toleafoa Dr. Take Naseri

By Lagi Keresoma

APIA: Friday 5th May 2012: Leausa Toleafoa Dr Take Naseri, Ministry of Health (MOH) Consultant Specialist Physician on Public Health, has confirmed a typhoid outbreak at the Tafa’igata prison where ten prisoners and wardens were under treatment at the Hospital.

More cases are reported and treated at both the Tupua Tamasese Meaole Hospital and the Malietoa Tanumafili 11 Hospital at Savai’i and the danger of the epidemic spreading further is a concern.

Leausa Toleafoa Dr. Take Naseri, told Talamua today that the number of typhoid cases is increasing slowly.

“The number of cases vary from month to month,” said Dr. Naseri.

Health records shows that children are the most affected and Samoa is well into the epidemic status of typhoid, but not an outbreak.

Dr. Naseri clarified clarified that an outbreak is when cases have been confirmed to be confined to one place, as in the case of ten prisoners at Tafa’igata prison.

“Because of the confinement of the place (prison), typhoid spread quickly,” said Dr. Naseri.

Legislate food handling: When one or three cases are reported, it is labeled as in the “endemic” status but when more cases are reported from different parts of the country, it is then placed on the epidemic level.

The last typhoid outbreak, according to Dr. Naseri was in 1998. Before that, outbreaks were also noted in 1994 and 1996 but since 1998, the first known outbreak was two weeks ago at the Tafa’igata prison. He said typhoid may have been controlled back then but not completely wiped out.

Dr. Naseri and his team are spearheading a survey and monitoring data to support a submission to Cabinet, to review the Food Bill. The team hopes to legislate the food handling and processing.

“Whoever is preparing food for public consumption must have a clean medical record and free from any diseases,” explained Dr. Naseri.
“They must be screened before allowing to cook at a hotel, restaurant or anywhere that handle and process food for public consumption,” said Dr. Naseri.

He said the idea behind the screening process is not only for the sake of the consumers, but to identify the carriers of the bacteria.

“Anyone can be a healthy carrier of the bacteria without knowing it,” Dr Naseri explains.

“They may not have the symptoms of typhoid fever but they are another avenue of the bacteria finding new hosts.”

He said humans are the only known host of the typhoid bacteria and so it is human that the typhoid bacteria is preying upon and because of the constant human contact, the bacteria has no problem of finding new preys.

He warned the public to be aware of contaminated water which is another major avenue for the bacteria finding new hosts. Bacteria can be passed on after washing in contaminated water or consuming food washed in contaminated water.

“If the water is contaminated and you are washing your hands in, there is a chance of the bacteria passing on to you,” said Dr. Naseri.
He emphasised good hygiene as the best remedy for any bacterial disease and for people not to take hygiene lightly.

He also warned the public to be wary of spilled septic tanks which is another way of getting the bacteria. When a person complains of diarrhea, constipation and prolong fever, “that’s an indication of typhoid fever.”

MOH is also focusing on street vendors selling food around town including barbeques stalls. Dr. Naseri said MOH is discouraging this and they have visited families providing this service. They are also visiting the Tafa’igata prison randomly to monitor the disease and the condition of the facilities.

Division difficulties: Under the leadership of Dr. Naseri and his team, MOH is continuing the surveillance and monitoring work on typhoid and other diseases.

The work is not easy since the division of the Ministry into two bodies, MOH and the National Health Service (NHS). Since the division, there had been confusion as to the roles played by the two bodies and employees. However, Dr. Naseri said we are slowly getting there.

“The National Health Service provides the service and the Ministry of Health monitors the service being provided,” said Dr. Naseri.

However the difficulty sometimes, is the delay in confirmation from the lab and medical reports on cases. For MOH to speed up the process of finding remedies, they need the data provided by NHS for them to work on and this is crucial in the advice and submission they provide to Cabinet.

While there are effective drugs to counter typhoid, Dr. Naseri is working on finding an appropriate vaccine.