Epidemiology of an Unusually Prolonged Outbreak of Typhoid Fever in Terrassa, Spain

Sohn, Sohee; Xercavins, Mariona; Llovet, Teresa; Navarro, Ferrán; Morera, M.; More, Judy; Bella, Febriani Dwi; Freixas, N.; Simó, Mercé De; Echeita, A.; Coll, Pere; Garau, Javier; Prats, G

doi:10.1093/clinids/24.3.506

Cited by 19 publications

(1 citation statement)

References 11 publications

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“…The prolonged nature of the outbreak is likely due to the presence of acutely ill persons [ 25 ] and possibly chronic carriers [ 26 , 27 ] working and living in the shafts, continually shedding the bacteria in their feces and leading to ongoing contamination of the groundwater sources within the shafts. Prolonged outbreaks of enteric fever have been associated with the presence of chronic carriers [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

A Prolonged Outbreak of Enteric Fever Associated With Illegal Miners in the City of Matlosana, South Africa, November 2020–September 2022

Sekwadi,

Smith,

Maruma

et al. 2024

Open Forum Infectious Diseases

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Background In South Africa, the annual incidence of enteric fever averaged 0.1 per 100 000 persons between 2003 and 2018. During 2021 an increase in the number of enteric fever cases was observed. An outbreak investigation was conducted to determine the magnitude and source of the outbreak. Methods We performed a cross-sectional descriptive study. Data were collected through telephonic or face-to-face interviews with cases or proxies using a standardized case investigation form. Whole Genome Sequencing (WGS) was performed on all Salmonella Typhi isolates. Drinking water samples were collected, tested and analysed. Descriptive analysis was performed using Microsoft Excel. Results Between January 2020 and September 2022, a cluster of 53 genetically highly related Salmonella Typhi isolates were identified from five different provinces in South Africa. Isolates associated with the cluster showed ≤5 allelic differences as determined following core-genome multilocus sequence typing analysis. Most (60%; 32/53) of the cases were in the North West Province. Males comprised 68% (36/53). Of these, 72% (26/36) were within age group 15-49 years with median age of 31 years. And where occupation was known within this age group 78% (14/18) were illegal gold miners. Illegal miners reported illness onset while working underground. Five municipal tap water samples were tested and showed no evidence of fecal contamination. Conclusion This outbreak predominantly affected illegal gold miners, likely due to the consumption of contaminated groundwater while working in a gold mine shaft. In addition, this investigation highlights the value of WGS to detect clusters and support epidemiological investigation of enteric fever outbreaks.

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Section: Discussionmentioning

confidence: 99%

A Prolonged Outbreak of Enteric Fever Associated With Illegal Miners in the City of Matlosana, South Africa, November 2020–September 2022

Sekwadi,

Smith,

Maruma

et al. 2024

Open Forum Infectious Diseases

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Outbreak of typhoid fever in vaccinated members of the French Armed Forcesin the Ivory Coast

et al. 2005

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In 2001, an outbreak of typhoid fever occurred among the members of the French Armed Forces. All had received a typhoid vaccination as per the immunization schedule practiced in the Armed Forces (every 5 years). A retrospective cohort study was conducted in 94 personnel. The objectives were to confirm the diagnosis, determine the source of contamination and identify the factors associated with defective vaccinal efficacy. Twenty-four cases were clinically identified. A cucumber salad was identified as the contaminating dish (Risk Ratio = 3.6; 95%CI 1.5-8.9). Only one factor was related to defective vaccinal efficacy; the risk of typhoid fever was two-fold higher in people vaccinated more than 3 years previously (Risk Ratio = 2.2; 95%CI, 1.1-4.2). Compliance with food hygiene rules could have prevented 24 cases of typhoid fever. Nevertheless, repeat vaccination against typhoid fever is now conducted every 3 years in the French Forces, in compliance with the manufacturers' recommendations.

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

Balasegaram¹,

Potter

Grynszpan

et al. 2012

Journal of Infection

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Epidemiology of an Unusually Prolonged Outbreak of Typhoid Fever in Terrassa, Spain

Cited by 19 publications

References 11 publications

A Prolonged Outbreak of Enteric Fever Associated With Illegal Miners in the City of Matlosana, South Africa, November 2020–September 2022

A Prolonged Outbreak of Enteric Fever Associated With Illegal Miners in the City of Matlosana, South Africa, November 2020–September 2022

Outbreak of typhoid fever in vaccinated members of the French Armed Forcesin the Ivory Coast

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

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