Key facts

Transmission: Faecal-oral route

Unwashed hands
Food or water contaminated by human waste
Fruits and vegetables/food washed or prepared with contaminated water
Close contact with a sick person (especially contact with their vomit or faeces)

Most vulnerable to severe consequences

Children under five years old
Malnourished people, especially children
People with weakened immune systems (for example, people living with HIV/AIDS)

Most vulnerable to contracting the disease

People living in areas that have poor water, sanitation and hygiene facilities and services

Symptoms

Prolonged high fever
Tiredness (sometimes)
Headache (sometimes)
Nausea (sometimes)
Abdominal pain (sometimes)
Constipation (sometimes)
Diarrhoea (sometimes)
Rash (sometimes)
Confusion (sometimes)
Bleeding (sometimes)

What can you do to prevent and control an epidemic?

Monitoring the community and identifying sick people

Identify community members with community case definition for suspected typhoid

Treatment and management

Refer suspected cases to health facilities
Provide psychosocial support to the sick person and their family members

Sanitation and waste management

Promote use of appropriate sanitation and waste facilities (toilets/latrines)
- No open defecation
- Promote use of appropriate sanitation facilities (sound, clean latrines that are well maintained and have proper faecal sludge management)

Hand hygiene

Promote good hand hygiene (handwashing with soap)
- BEFORE: preparing food; eating; feeding a child; treating wounds; or caring for sick people
- AFTER: using the toilet or cleaning a baby; touching garbage or waste; touching or feeding animals; blowing nose, coughing or sneezing; treating wounds; or caring for sick people

Food and water hygiene and safety

Encourage household water treatment for safe drinking water
- Store water in clean, covered water container
Promote thorough cleaning, cooking and storage of food
- Cover and store food safely (protected from insect/animal contamination)
- Use clean utensils and storage containers
- Encourage exclusive breastfeeding for the first six months of life, and complementary breastfeeding until the age of two years (especially when a child is sick)

Social mobilization and behaviour change

Find out the specific advice being given by health and other relevant authorities
Model following this advice and inform community members of current health practice advice
Offer support and encouragement to follow the advice
- Try to gain understanding about if and why health practice advice is not being followed
- With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices

Immunization

Support routine and mass vaccination campaigns

Mapping and community assessment

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with typhoid fever? Where?
- How many people have died? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
- Where do people obtain their drinking water?
Record the following information on the back of the map:
- When did people start to fall sick with typhoid fever?
- How many people live in the affected community? How many are children under five years?
- Are children in the community generally well-nourished?
- Is the water source safe?
- Do people know how to treat water?
  - How do they do it?
- What sanitation facilities are available? (put communal toilets/latrines on map)
  - Do people use them?
- What handwashing facilities are available? (put communal handwashing stations on map)
  - Do they have soap?
- What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between women and men.
  - When babies and infants are sick, do women continue to breastfeed them?
- Is a social mobilization or health promotion programme in place?
  - Is a vaccination programme planned or in place?
- What are the roles, responsibilities, specific needs and priorities of women and girls, men and boys, and people with disabilities in handling, storing and treating water? Make sure you think about cultural and social traditions and perceptions, household decision-making, livelihoods such as agriculture and livestock raising etc.
- What are the barriers people face in accessing water points and sanitation and hygiene facilities, of all gender identities, ages, disabilities and backgrounds?
- Which sources do people use/trust the most for information?
  - Are there rumours or misinformation about typhoid fever? What are the rumours?

Volunteer actions

01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 07. Assessment of dehydration 12. Managing fever 13. Breastfeeding 19. Psychosocial support 24. Routine vaccinations 25. Mass vaccination campaigns 29. Hygiene promotion 30. Clean, safe household water 31. Good food hygiene 32. Sanitation 33. Encouraging the use and maintanace of latrines 34. Handwashing with soap 43. Social mobilization and behaviour change