Ghana has just experienced its heaviest monthly rainfall since 1995, with severe flooding across Accra and surrounding communities. While the immediate destruction is visible, health authorities are warning of a more insidious threat that follows in the weeks ahead, such as outbreaks of cholera and typhoid fever.
The CEO of The Accra London Health Centre, Dr Vanessa Apea, has raised the alarm that these waterborne diseases are the next major danger. This warning aligns with official statements from the Ghana Health Service (GHS), which has identified an increased risk of cholera, typhoid fever, and dysentery following the recent floods.
The Health Minister, Kwabena Mintah Akandoh, has also been leading assessments in affected communities, emphasising the need for vigilance.
The Twin Threats: Cholera and Typhoid
Both cholera and typhoid are bacterial infections spread through contaminated water and food. The primary danger arises because floodwater mixes with sewage, refuse, and human waste, contaminating drinking water and food supplies.
Cholera, caused by the bacterium Vibrio cholerae, can strike suddenly and violently. It produces severe watery diarrhoea and vomiting, leading to fatal dehydration within hours if not treated. A key warning sign is a “rice water” stool. Typhoid, caused by Salmonella Typhi, progresses more slowly. Its symptoms include a prolonged high fever, weakness, headache, and abdominal pain that build over one to three weeks.
A Perfect Storm for Disease
Flooding creates ideal conditions for the spread of these infections:
· Contaminated Water Sources: Broken pipes and open wells become contaminated with faecal matter.
· Food Contamination: Sachet water and street food can be exposed to dirty water, and vegetables grown near flooded water bodies carry contamination onto plates.
· Stagnant Water: Stagnant water left behind breeds mosquitoes, adding malaria, yellow fever, and dengue fever to the list of post-flood risks.
· Displacement: Overcrowding in shelters can make the spread of disease easier.
Diagnosis and Urgent Care
Diagnosis for these infections often starts with clinical judgement, as treatment cannot wait for lab results.
Cholera is suspected from sudden, profuse watery diarrhoea, especially during an outbreak. A stool sample can confirm it, but clinicians assess dehydration through physical signs like sunken eyes, skin elasticity, and blood pressure to guide urgent care.
Typhoid is suspected from a fever that climbs over several days, along with headache and abdominal pain. The Widal test is commonly used in Ghana as a point-of-care option for a rapid result. However, it has limitations, including the potential for false positives and the risk of missing early-stage infections. A blood culture remains the reference standard for confirmation.
Warning Signs That Need Urgent Care:
· Cholera: Profuse watery diarrhoea, vomiting, sunken eyes, extreme thirst, or little to no urination.
· Typhoid: A fever that persists or worsens daily, alongside severe headache and abdominal pain.
Both conditions are treatable with oral rehydration, IV fluids, and antibiotics. The difference between recovery and death is how quickly someone seeks care.
Protecting Households During and After Flooding
Prevention is critical in the days and weeks after floodwater recedes. The Health Minister has announced plans to deploy public health nurses and community health workers to affected areas to intensify health education. Residents are urged to follow these essential habits:
· Drink Safe Water: Boil drinking water, or use bottled or sachet water from a trusted source. Doctor Aminarh warns that even borehole water is at risk of contamination, stating, “The only safe drinking water is to get water and boil it to drink”.
· Eat Safe Food: Only eat hot, freshly cooked food. Avoid raw salads and uncooked vegetables unless you are certain they were not exposed to floodwater.
· Practice Good Hygiene: Wash hands with soap under running water before eating and after using the toilet.
· Avoid Contact: Avoid wading through floodwater where possible. Wash and dry feet and legs thoroughly if exposed.
· Maintain Sanitation: Dispose of waste properly, keep it away from water sources, and clear blocked drains and stagnant water around the home.
