Guidelines for the public health management of typhoid and paratyphoid in England

Balasegaram, Sooria; Potter, Amanda; Grynszpan, Delphine; Barlow, Sarah E.; Behrens, Ron H; Lighton, Lorraine; Booth, Linda; Inamdar, Leena; Neal, Kevin M.; Nye, K.; Lawrence, J; Jones, Jane; Gray, I. P.; Tolley, David A.; Lane, Christianne J.; Adak, B; Cummins, Amelia; Addiman, S.

doi:10.1016/j.jinf.2012.05.005

Cited by 23 publications

(16 citation statements)

References 22 publications

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“…Many participants were stool culture positive in the days preceding the development of bacteremia and fever, a period that did coincide with the initial onset of symptoms (headache, abdominal discomfort, etc). This prepatent period may represent a period of heightened transmission risk, for example, to household contacts caring for a sick relative, and supports renewed national recommendations for contact screening [38]. …”

Section: Discussionmentioning

confidence: 76%

An Outpatient, Ambulant-Design, Controlled Human Infection Model Using Escalating Doses of Salmonella Typhi Challenge Delivered in Sodium Bicarbonate Solution

Waddington¹,

Darton²,

Jones³

et al. 2014

Clinical Infectious Diseases

129

253

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Section: Discussionmentioning

confidence: 76%

An Outpatient, Ambulant-Design, Controlled Human Infection Model Using Escalating Doses of Salmonella Typhi Challenge Delivered in Sodium Bicarbonate Solution

Waddington¹,

Darton²,

Jones³

et al. 2014

Clinical Infectious Diseases

129

253

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“…Occupational history was recorded in the medical notes for 31 patients (32%). Nine adult patients (29%) were considered to be at high risk of transmitting infection [ 1 ]. Of these seven were food handlers and two worked with children.…”

Section: Resultsmentioning

confidence: 99%

“…The organisms were cultured on selective media and identified by API 20E (BioMerieux) or MALDI-TOF MS (Bruker Corporation) and serology. Data from Public Health England enteric fever enhanced surveillance [ 1 , 11 ] were used to determine the vaccination status and travel history in each case. Clinical correlates with isolate antibiotic susceptibilities will be the subject of a further report.…”

Section: Methodsmentioning

confidence: 99%

“…Typhi), and Salmonella enteric serovar Paratyphi ( S . Paratyphi) A, B, or C and is acquired by ingestion of contaminated food and water [ 1 ]. Early recognition and public health interventions for enteric fever are important for high risk cases such as those working within the food industry or attending nursery to prevent onward transmission.…”

Section: Introductionmentioning

confidence: 99%

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East London Experience with Enteric Fever 2007-2012

et al. 2015

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PurposeThe clinical presentation and epidemiology for patients with enteric fever at two hospitals in East London during 2007–2012 is described with the aim to identify preventive opportunities and to reduce the cost of treatment.MethodsA retrospective analysis of case notes from patients admitted with enteric fever during 2007 to 2012 with a microbiologically confirmed diagnosis was undertaken. Details on clinical presentation, travel history, demographic data, laboratory parameters, treatment, patient outcome and vaccination status were collected.ResultsClinical case notes were available for 98/129 (76%) patients including 69 Salmonella enterica serovar Typhi (S. Typhi) and 29 Salmonella enterica serovar Paratyphi (S. Paratyphi). Thirty-four patients (35%) were discharged from emergency medicine without a diagnosis of enteric fever and then readmitted after positive blood cultures. Seventy-one of the 98 patients (72%) were UK residents who had travelled abroad, 23 (23%) were foreign visitors/new entrants to the UK and four (4%) had not travelled abroad. Enteric fever was not considered in the initial differential diagnosis for 48/98 (49%) cases. The median length of hospital stay was 7 days (range 0–57 days). The total cost of bed days for managing enteric fever was £454,000 in the two hospitals (mean £75,666/year). Median time to clinical resolution was five days (range 1–20). Seven of 98 (7%) patients were readmitted with relapsed or continued infection. Six of the 71 (8%) patients had received typhoid vaccination, 34 (48%) patients had not received vaccination, and for 31 cases (44%) vaccination status was unknown.ConclusionsFurther interventions regarding education and vaccination of travellers and recognition of the condition by emergency medicine clinicians in travellers to South Asia is required.

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“…To improve detection of domestically acquired typhoid fever outbreaks, we recommend that state and local health departments investigate and report all domestically acquired typhoid fever cases and identified outbreaks. Although the United States does not have national guidelines, detailed guidelines for management and investigation of typhoid and paratyphoid cases are outlined in a document published in England [30, 31]. We recommend CDC continue to explore the use of space–time scan statistics using different parameters and settings or use of the retrospective space–time permutation scan statistic [8] for identification of domestically acquired typhoid fever clusters that may represent undetected outbreaks retrospectively and for prospective real-time or periodic disease surveillance.…”

Section: Discussionmentioning

confidence: 99%

Typhoid fever acquired in the United States, 1999–2010: epidemiology, microbiology, and use of a space–time scan statistic for outbreak detection

et al. 2014

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SUMMARY Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space–time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space–time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space–time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection.

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Guidelines for the public health management of typhoid and paratyphoid in England

Cited by 23 publications

References 22 publications

An Outpatient, Ambulant-Design, Controlled Human Infection Model Using Escalating Doses of Salmonella Typhi Challenge Delivered in Sodium Bicarbonate Solution

An Outpatient, Ambulant-Design, Controlled Human Infection Model Using Escalating Doses of Salmonella Typhi Challenge Delivered in Sodium Bicarbonate Solution

East London Experience with Enteric Fever 2007-2012

Typhoid fever acquired in the United States, 1999–2010: epidemiology, microbiology, and use of a space–time scan statistic for outbreak detection

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