Poor hygiene in Trivandrum eateries gives rise to typhoid fears

Source:http://www.thehindu.com

The district has had an explosion of typhoid cases this year, including two suspected typhoid deaths, pointing to poor levels of food safety. The district health administration, which went on an intensive drive across the district on Tuesday as part of the SAFE Trivandrum initiative, examining eateries, bakeries, juice shops and ice factories, found that hardly 25 per cent of the food handlers in these outlets had health certificates.All those who eat out regularly are at serious risk of contracting the infection, health officials said.Typhoid fever is a bacterial infection caused by Salmonella typhi, transmitted directly through contaminated food and water and at times, through someone who is infected or is a chronic typhoid bacilli carrier. Sewage contamination of drinking water in poor sanitary conditions is a clear risk.

“Last year, the district reported 411 cases of typhoid. But this year so far, we have had 857 cases and two deaths (one confirmed), following which we have put our entire health field staff on alert. This should serve as a warning to all those running food businesses because the way food is handled in their eateries and the hygiene habits and the medical fitness of all the food handlers are seriously under question,” District Medical Officer K.M. Sirabuddin said.

In Tuesday’s inspections, health officials examined 1,783 institutions. Of the 2,197 food handlers in these institutions, only 431 had health cards. Of the 315 migrant workers employed as food handlers, only 71 had health cards.

No follow-up

“All of these institutions, except 222, had FSSA licences. But given the unhygienic conditions in which food is handled in many of these eateries, it is clear that there have been no follow-up measures after the issue of licences. We issued closure notice to six shops – in one of these, we found the cook with a major, festering burn on his hand continuing to handle food,” a health official said.

The district has been reporting at least eight to 10 cases of typhoid every day. There have been no outbreaks and all the cases are scattered. This makes it all the more difficult to identify a common source of infection.

Chronic carriers

Typhoid can lead to dangerous complications if it is not treated early. Though it is curable through the use of antibiotics, a certain percentage of people continue to harbour the typhoid bacilli even after they recover and are fully free of any symptoms. These people remain chronic typhoid carriers because the bacilli are present in their intestinal tract and are shed through stools.

Health officials said such healthy carriers were more dangerous than those with active typhoid fever as there was no way to recognise a typhoid carrier except by culturing their blood or stool samples.

“This is why it is so very important that all food handlers should have health cards, which should be renewed every six months after proper medical investigation. A healthy but chronic typhoid carrier engaged as a food handler can give typhoid to several people if he handles food with unwashed hands after using the toilet,” a public health official said.