East London experience with enteric fever 2007-2012

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Enteric fever, caused by Salmonella Typhi and Paratyphi, poses a significant public health challenge, particularly in travelers.
• Understanding the clinical presentation and epidemiological factors of enteric fever is crucial for effective disease management and prevention.

Purpose of the Study:

• To describe the clinical presentation and epidemiology of enteric fever in East London between 2007-2012.
• To identify opportunities for prevention and reduce treatment costs associated with enteric fever.

Main Methods:

• A retrospective analysis of 98 microbiologically confirmed enteric fever cases (Salmonella Typhi and Paratyphi) was conducted.
• Data collected included clinical presentation, travel history, demographics, laboratory results, treatment, outcomes, and vaccination status.

Main Results:

• Nearly half of enteric fever cases were initially missed in emergency departments, leading to readmissions.
• The majority of UK patients with enteric fever were residents who had traveled abroad, with low documented typhoid vaccination rates.
• The total cost of managing enteric fever over the study period was substantial, highlighting the economic burden of the disease.

Conclusions:

• Enhanced traveler education and vaccination are essential for preventing enteric fever.
• Improved recognition of enteric fever by emergency medicine clinicians, especially for patients with travel history to South Asia, is required.
• Interventions aimed at early diagnosis and appropriate management can reduce healthcare costs and improve patient outcomes.