When Jane Moraa who works at the fish eateries along Lwang'ni beach in Kisumu developed a fever, she assumed it was malaria and bought over-the-counter anti-malarial drugs without medical tests.
Moraa was later found to be suffering from typhoid fever whose symptoms- fever, headache, weakness and fatigue, muscle ache, sweating, dry cough, loss of appetite, weight loss and stomach pain- are easy to confuse with those of malaria.
Typhoid fever is common around the lake region and urban slums. Water shortages in some parts of the country only increase the cases of typhoid and other water-borne diseases.
The disease infects up to 10 percent of the population resulting in some fatalities, but it can be controlled using preventive measures starting with food handlers in kiosks, restaurants and hotels since they're among the high risks groups.
Other risk groups include slum dwellers, beach settlers, fisher folk and school children, who are not only at risk due to their tender ages but because they eat anything including soil and chalk.
"Food handlers are exposed to contaminated food products or containers", says Prof Charles Chunge an expert on tropical and travel diseases.
Dr Chunge, who also chairs the Typhoid Advisory Committee, says once food handlers are contaminated by food-borne disease pathogens, they can easily transmit it to their co-workers, friends, relatives and customers.
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Also at risk are people whose immune systems have been compromised by HIV and other chronic diseases and thus require protection against typhoid and other immuno-compromise diseases like Hepatitis A and B.
Experts say that pathogens causing food-borne diseases like typhoid are highly contagious meaning "food is one major cause of a typhoid outbreak besides water in Kenya," says Prof Chunge.
He adds that many typhoid cases result from a decline in proper management of public and environmental health.
The majority of food handlers in kiosks are slum dwellers. They live in areas with poor sanitation and hygiene, water shortages, poor broken sewers all which contribute to outbreaks and the spread of disease.
This calls for good hygiene practices, food safety, safe water and sanitation and "it is a requirement by law that before a food handler gets statutory medical certificate to work in a hotel, a restaurant or a food kiosk, they must be immunised", says Prof Chunge.
Others who should be immunised by county and sub-country public health officers every three years include school children, beach dwellers, fisher folk and slum dwellers as surveys show them as high risk.
A cross-sectional survey along the beaches of Lake Victoria found 50 per cent of food handlers positive for typhoid.
Besides immunisation, there are also home-based preventive measures: washing hands with hot water and soap, especially after visiting the toilet, boiling drinking water, using pit latrines in rural areas, maintaining good hygiene, cooking foods properly and keeping the environment clean.