The Suspicious Stool Sample

Sixty-year-old housewife B.T. from Valjevo traveled by train to go shopping in Turkey at the end of October. Her stomach began to hurt at the Bulgarian-Yugoslav border during her return trip (it is assumed that she drank bad water). She called the doctor two days after she returned to Valjevo. The physician at the Health Center was prepared - he had the September publication explaining which measures were necessary to prevent the transmission and spread of cholera issued by the Federal Ministry for Work, Health and Social Policy in front of him. When told about the patient's stomach pains and travels, he took a stool sample and had her hospitalized. The patient did not think her disease was serious and did not show up at the hospital until two days later. The Health Protection Institute of Serbia confirmed the finding. They were able to isolate bacteria which showed that this was a more benign type of cholera. The patient's state quickly stabilized, but, because of the risk of spreading the bacteria, she is still in the hospital.

After B.T.'s hospitalization, the members of her household (husband, daughter and two grandchildren) and three of her fellow travelers on the train were put under medical supervision. This means that during the incubation period, which last five days for cholera, they must give stool samples at the epidemiological lab every morning. Unaccustomed to medical treatment, those who were put under supervision say that (19th century Serbian king) Milos Obrenovic, who solved outbreaks of infection by burning down entire villages, was "more human". This is because interest in their stool samples was not just confined to the epidemiological lab in Valjevo. Interest was also expressed by the employees of the Regional Health Protection Institute in Sabac, as well as the medical staff at the Military Medical Academy (VMA), because the infected woman's husband works at the military catering service.

Even the television was "on top of things" - the infected woman's first and last names were mentioned during the "Serbia today" program. The situation grew more and more unpleasant; the catering establishment where the husband works has already been given the new name of "Cholera's Place"; the unlucky caterer was told not to come to work until further notice. Pointing to the negative results of the stool sample tests was useless. Such treatment of those who were in contact with the infected woman caused those who are thought to be infected to avoid cooperation. A thirty-eight-year-old patient who called her doctor because of diarrhea after a trip to Turkey was immediately hospitalized. However, she escaped from the hospital "so that she would not be on television". The police had to bring her back. The measures taken and the consequences of the "struggle" against cholera were so shocking that the daughter of the infected woman (who has not been going to work out of shame) suspects that the entire affair "was in the service of politics and propaganda", because "her mother did not have the type of stomach pains that have been ascribed to her, and we all know how severe the symptoms of cholera are".

Branka Miholjcic, the republican sanitary inspector who coordinates the work in the Kolubara district (where Valjevo is located), says that everything is under control - the water supply is being controlled, as is all food production; this is also true for the outdoor markets. All Health Centers have received directions which state that all cases of diarrhea are suspicious. Travel agencies have been ordered to present lists of all people who are traveling abroad - no one will be allowed to leave without permission from the epidemiological lab. All of those who were under medical supervision and did not adhere to the regulations will receive a summons from the judge for this violation. Doctor Miholjcic stated that we have furthermore been lucky in all of this, because individual cases of cholera were all imported. This brings up the question of whether things will remain this way, since the sewer system is an ideal environment for the cholera bacteria, which can easily enter the water supply system from there. The only precautionary measure that can be taken is regular chlorine treatment of drinking water. The only preventive steps that could be taken would be to prohibit travel to risky countries or to have travelers vaccinated prior to departure. The head of the infectious disease wing at the Valjevo hospital, Dr. Zoran Jankovic, has been asking why these preventative measures are not being taken and has not received any response. He adds that travelers could pay the cost of the vaccine themselves if necessary. Otherwise, if cholera makes itself at home here, the costs could be embarrassing.