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Clinical Infectious Diseases : An... Nov 2005The incidence of enteric (typhoid) fever in travelers is estimated to be approximately 3-30 cases per 100,000 travelers to developing countries. Recently, it is become... (Review)
Review
The incidence of enteric (typhoid) fever in travelers is estimated to be approximately 3-30 cases per 100,000 travelers to developing countries. Recently, it is become clear that travelers who are visiting friends and relatives, especially travelers to the Indian subcontinent, seem to be the most vulnerable to enteric fever and require special attention for prevention. Recent concerns are the increasing incidence of paratyphoid fever in Asia, which is not covered by available typhoid vaccines, and the emergence of infections caused by antibiotic-resistant strains (including strains resistant to fluoroquinolones). Typhoid vaccination is recommended for most travelers to moderate- to high-risk countries. Because of the nonspecific clinical presentation of enteric fever, a high index of suspicion is important in febrile travelers who have traveled to areas of endemicity.
Topics: Bacterial Vaccines; Drug Resistance, Multiple, Bacterial; Humans; Paratyphoid Fever; Risk Factors; Travel; Typhoid Fever
PubMed: 16231259
DOI: 10.1086/497136 -
The Journal of the Egyptian Public... 1996Twenty eight positive blood culture paratyphoid A fever cases were studied. Forty two positive blood culture typhoid cases were taken as controls. Cases and controls... (Comparative Study)
Comparative Study
Twenty eight positive blood culture paratyphoid A fever cases were studied. Forty two positive blood culture typhoid cases were taken as controls. Cases and controls were subjected to: 1) careful history, 2) thorough clinical examination, 3) two blood cultures for salmonella, 4) Widal agglutination test, 5) total and differential white blood count, 6) urine and stool cultures following therapy. There was no significant difference in the clinical picture between acute paratyphoid A fever and acute typhoid fever except the significant decrease of anorexia (57%), toxic look (54%), coated tongue (64%) in acute paratyphoid A cases when compared to acute typhoid cases. The prevalence of extraintestinal symptoms in paratyphoid A cases may mimic viral infections. Three of the 4 classical signs namely; toxic look (54%), bronchitic chest (50%), splenomegaly (72%) and tympanitis (64%) were good bed side suggestive clinical diagnostic aids in paratyphoid A cases. Blood culture was the cornerstone of diagnosis of paratyphoid A cases. In 6 (21%), only the second blood sample was positive stressing the value of multiple cultures. Significant Widal antibody titre was elicited in only about half (57%) of paratyphoid A cases which was significantly lower than typhoid cases (83%). Leucopenia was found in only 25% of paratyphoid A cases. Eosinopenia was constant and is considered as a diagnostic and prognostic aid. No correlation was elicited between either the height of antibody titre or the height of leucocytic count and the severity of illness. There was no significant difference in the response to therapy or the occurrence of complications between paratyphoid A cases and typhoid cases. Up to the current knowledge, this is the first report on comparative study between acute paratyphoid A fever and acute typhoid fever in Egypt from clinical, diagnostic, therapeutic and prognostic points of view.
Topics: Acute Disease; Adolescent; Adult; Agglutination Tests; Anti-Bacterial Agents; Bronchitis; Case-Control Studies; Child; Chloramphenicol; Diagnosis, Differential; Egypt; Endemic Diseases; Female; Fever; Humans; Leukopenia; Male; Middle Aged; Paratyphoid Fever; Prognosis; Salmonella paratyphi A; Serotyping; Severity of Illness Index; Splenomegaly; Typhoid Fever
PubMed: 17214195
DOI: No ID Found -
Zhonghua Liu Xing Bing Xue Za Zhi =... May 2014This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever, in Guizhou province, from 2007 to 2012, to...
OBJECTIVE
This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever, in Guizhou province, from 2007 to 2012, to provide evidence for the improvement of related programs.
METHODS
Data on typhoid fever and paratyphoid including information on epidemics, individual, cases, measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province, from 2007 to 2012. Information related to the average annual incidence, nature of outbreaks, time span before confirmed diagnosis was made, unit which carried the case report, proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excel and EpiInfo software were used for data analysis.
RESULTS
In the period of 2007-2009, a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012, 2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former, data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ² = 0.08, P = 0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47% . The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in, input and audited showed increase of 8.44%, 6.76% and 2.40% respectively.
CONCLUSION
Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province, but the potential risk of outbreaks still existed in some areas, suggesting that health education and surveillance programs including laboratory diagnosis, should be strengthened.
Topics: China; Communicable Disease Control; Humans; Paratyphoid Fever; Typhoid Fever
PubMed: 25059366
DOI: No ID Found -
Archives of Internal Medicine Dec 1976Previous descriptions of paratyphoid fever (PTF) are of limited value to the clinician who has had no experience with Salmonella enteric fevers. Sixty-two cases of PTF...
Previous descriptions of paratyphoid fever (PTF) are of limited value to the clinician who has had no experience with Salmonella enteric fevers. Sixty-two cases of PTF occurred in a healthy, homogeneous population. Findings supported by the literature included a seasonal incidence, initially seen symptoms of gastroenteritis and spiking fevers, and a high percentage of positive blood cultures. Unusual findings included the rarity of rose spots, patients with fever as their only symptom, two patients with transient papilledema, and two others with peripheral blood smears suggestive of acute leukemia. The findings of this study are compared with previous reports. Likely causes for divergent and contradictory information are inclusion of data from non-PTF states and study of populations with altered states of health.
Topics: Adolescent; Adult; Ampicillin; Carrier State; Child; Chloramphenicol; Female; Hemagglutination Tests; Humans; Leukocyte Count; Male; Paratyphoid Fever
PubMed: 826229
DOI: 10.1001/archinte.136.12.1422 -
Clinical Infectious Diseases : An... Mar 2019Typhoid and paratyphoid remain the most common bloodstream infections in many resource-poor settings. The World Health Organization recommends typhoid conjugate vaccines...
BACKGROUND
Typhoid and paratyphoid remain the most common bloodstream infections in many resource-poor settings. The World Health Organization recommends typhoid conjugate vaccines for country-specific introduction, but questions regarding typhoid and paratyphoid epidemiology persist, especially regarding their severity in young children.
METHODS
We conducted enteric fever surveillance in Bangladesh from 2004 through 2016 in the inpatient departments of 2 pediatric hospitals and the outpatient departments of 1 pediatric hospital and 1 private consultation clinic. Blood cultures were conducted at the discretion of the treating physicians; cases of culture-confirmed typhoid/paratyphoid were included. Hospitalizations and durations of hospitalizations were used as proxies for severity in children <12 years old.
RESULTS
We identified 7072 typhoid and 1810 paratyphoid culture-confirmed cases. There was no increasing trend in the proportion of paratyphoid over the 13 years. The median age in the typhoid cases was 60 months, and 15% of the cases occurred in children <24 months old. The median age of the paratyphoid cases was significantly higher, at 90 months (P < .001); 9.4% were in children <24 months old. The proportion of children (<12 years old) hospitalized with typhoid and paratyphoid (32% and 21%, respectively) decreased with age; there was no significant difference in durations of hospitalizations between age groups. However, children with typhoid were hospitalized for longer than those with paratyphoid.
CONCLUSIONS
Typhoid and paratyphoid fever are common in Dhaka, including among children under 2 years old, who have equivalent disease severity as older children. Early immunization with typhoid conjugate vaccines could avert substantial morbidity, but broader efforts are required to reduce the paratyphoid burden.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bangladesh; Child; Child, Preschool; Epidemiological Monitoring; Hospitalization; Humans; Infant; Infant, Newborn; Middle Aged; Paratyphoid Fever; Severity of Illness Index; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vaccination; Young Adult
PubMed: 30845325
DOI: 10.1093/cid/ciy1124 -
Journal of Travel Medicine 2001Enteric fever remains a major cause of fever in travelers. We evaluated new trends in enteric fever.
BACKGROUND
Enteric fever remains a major cause of fever in travelers. We evaluated new trends in enteric fever.
METHODS
We reviewed the epidemiological, clinical, biological, bacteriological data, and outcome of all cases of typhoid and paratyphoid fever seen in our department over the last decade. The inclusion criteria were the presence of signs compatible with enteric fever and isolation of Salmonella typhi or Salmonella paratyphi A, B, or C from blood or stool cultures or any other site.
RESULTS
Among the 41 patients, 38 (93%) had travel-associated enteric fever. The main geographic source of contamination was the Indian subcontinent. One patient had been vaccinated with parenteral Vi vaccine 1 year previously. Fever and headaches were the only signs which were present in more than 80% of patients. The Widal test at inclusion was positive in 27%, and a second serological test was found to be positive in 50% of evaluated cases. Blood cultures and stool cultures were positive in 34 cases and 10 cases, respectively. Salmonellae spp were isolated in both hemocultures and stool cultures in 4 cases and in urine in 1 case. Two strains of S. typhi were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. One strain of S. typhi and one of S. paratyphi B were nalidixic acid resistant. All evaluable patients were cured with the exception of 2 patients (1 failure, 1 relapse). We observed 3 toxic reactions. No patients died.
CONCLUSION
The diagnosis and outcome of enteric fever are hampered by the lack of specificity of clinical and biological signs, the increasing rates of antimicrobial resistance, and the occurrence of toxic reactions during treatment.
Topics: Adolescent; Adult; Drug Resistance, Microbial; Feces; Female; Humans; Male; Medical Records; Middle Aged; Paratyphoid Fever; Paris; Retrospective Studies; Salmonella paratyphi A; Salmonella typhi; Travel; Typhoid Fever
PubMed: 11726293
DOI: 10.2310/7060.2001.22378 -
Nihon Rinsho. Japanese Journal of... Mar 2007
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Lancet (London, England) Jul 1970
Topics: Child; Humans; Infant; Paratyphoid Fever; Salmonella; Salmonella paratyphi A; United Kingdom
PubMed: 4193370
DOI: No ID Found -
American Journal of Diseases of... Aug 1987From 1977 to 1984, Salmonella typhi was isolated from 85% and Salmonella paratyphl A was isolated from 15% of 192 Thai children with enteric fever at Children's...
From 1977 to 1984, Salmonella typhi was isolated from 85% and Salmonella paratyphl A was isolated from 15% of 192 Thai children with enteric fever at Children's Hospital, Bangkok. Children with enteric fever presented with sudden onset of fever and gastrointestinal symptoms. of fever presented with sudden onset Diarrhea occurred in 62% of children with paratyphoid fever and 36% of children with typhoid fever. Rose spots were seen in 15% of patients with typhoid and 7% of patients with paratyphoid fever. There were no deaths. Bronchitis and pneumonia occurring in 11% of patients were the most common complications. Acute hemolysis occurred in 3% of the patients with typhoid fever who had thalassemia or glucose-6-phosphate dehydrogenase deficiency. Chloramphenicol-resistant S typhi, which accounted for 70% of the isolates in 1977, has since 1982 accounted for less than 2% of isolates.
Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Infant; Male; Paratyphoid Fever; Salmonella paratyphi A; Thailand; Typhoid Fever
PubMed: 3115088
DOI: 10.1001/archpedi.1987.04460080048025 -
Journal of the Formosan Medical... Dec 2022Previous studies had showed that indigenous clones of Salmonella Typhi and S. Paratyphi were originally imported from other countries in Taiwan. We presented the...
Previous studies had showed that indigenous clones of Salmonella Typhi and S. Paratyphi were originally imported from other countries in Taiwan. We presented the clinical manifestations and laboratory findings of indigenous and imported enteric fever cases in Taiwan in the current decade. We retrospectively reviewed typhoid and paratyphoid fever cases in two medical centers of Chang Gung Memorial Hospitals in 2010-2020. A total of 37 enteric fever cases including 24 typhoid fever and 13 paratyphoid fever were recorded. There were 20 indigenous cases, 16 imported cases, and one indetermined case. Splenomegaly and hepatitis were more frequent in typhoid fever than in paratyphoid fever (P < 0.05). Imported cases had more ciprofloxacin non-susceptibility rate (8/16, 50.0%) than indigenous cases (2/20, 10%). Indigenous ciprofloxacin non-susceptible S. Typhi isolates were found in 2018. One indigenous S. Paratyphi B isolate was multi-drug resistant (MDR) to chloramphenicol, ampicillin, and trimethoprim/sulfamethoxazole.
Topics: Humans; Typhoid Fever; Paratyphoid Fever; Salmonella paratyphi A; Retrospective Studies; Taiwan; Anti-Bacterial Agents; Ciprofloxacin
PubMed: 35871037
DOI: 10.1016/j.jfma.2022.06.010