Indonesia tops typhoid league

Indonesia tops typhoid league

JAKARTA (JP): Indonesia is among the countries in the world
with the highest prevalence of typhoid fever, statistics say.

A survey conducted recently found the disease afflicts between
800,000 and 1.6 million people in Indonesia every year, killing
one percent to five percent of them.

The endemic disease is prevalent among children and teenagers
the most, as 80 percent to 90 percent of Indonesians afflicted
with the fever are aged between two years old and 19 years old.

The research also showed that the most frequent cases of
typhoid fever were found in the age group of between 10 years old
and 14 years old.

Narain H. Punjabi, a medical research scientist for a U.S.
Navy laboratory, told a seminar here on Saturday that children
were more vulnerable to the disease than adults because a child's
immune system has not yet fully developed.

"Most children also don't realize the importance of good
hygiene and sanitation. So they merely depend on adults to
provide them with food," he said.

What people consume is the key to typhoid fever because
Salmonella typhi bacteria, the disease's causative agent, is
transmitted by the ingestion of contaminated food or water.

The bacteria travels to the digestive system where it
multiplies.

It then causes bleeding and perforation of the small
intestine. If it stays there long enough, it will get in the
bloodstream and move to the liver and the rest of the body,
causing other complications.

The bacteria, which is discharged in feces, will survive and
become contagious to other human beings.

Even patients who have recovered can become a carrier and
spread the disease as salmonella can stay in their intestines for
a long time.

The number of carriers in the country total one percent to
four percent, Narain said.

Clinical symptoms of the disease include a high fever, a
coated tongue, stomach ache, diarrhea and a headache.

"But sometimes the symptoms are not clear and can be confused
with other illnesses, especially in children. So it takes several
tests and comparison diagnoses," said Narain.

The problem is the test takes time, money and it is not always
provided in small cities.

To make matters worse, the research found that the bacteria
was immune to several antibiotics.

There are vaccines that can prevent the fever, providing
resistance for three years. But it is relatively expensive,
costing around Rp 72,000 per person.

"So it's best just to keep good habits. Always wash your hands
before eating, eat food which has been washed properly and keep
the bathroom clean," said Soedjatmiko, a pediatrician at Cipto
Mangunkusumo Hospital, Central Jakarta, who also spoke at the
seminar.

The bacteria, he said, is not killed unless the food is boiled
for more than 12 minutes. (09)