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[Outbreak of typhoid fever in a family]
H O Fjaerli1, B Heger, S G Gundersen
1Infeksjonsmedisinsk avdeling, Ullevål sykehus, Oslo.
Insights
A family experienced a typhoid fever outbreak due to poor hygiene and inadequate treatment of the initial case. This highlights the need for strict guidelines in managing contagious diseases.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Typhoid fever is a significant global health concern, particularly in regions with limited sanitation.
- Salmonella Typhi, the causative agent, can lead to severe illness and complications.
Observation:
- A cluster of six typhoid fever cases occurred within a single family over nine days.
- The index case, an 18-month-old girl, suffered a relapse after initial antibiotic treatment.
- The family originated from Pakistan, suggesting potential travel-related exposure or endemic factors.
Findings:
- The rapid intrafamilial spread indicates transmission likely resulted from insufficient hygienic practices.
- Inadequate antibiotic management of the index case may have contributed to the outbreak's severity and spread.
- Factors such as poor housing conditions and cultural barriers potentially exacerbated the situation.
Implications:
- This outbreak underscores the critical importance of stringent hygiene protocols in preventing typhoid fever transmission.
- Effective antibiotic stewardship and patient follow-up are crucial for managing infectious disease relapses and preventing secondary spread.
- There is a clear need for enhanced public health interventions, including education and support, for vulnerable populations to control contagious diseases.
Abstract:
We describe a small epidemic of typhoid fever in a family who came originally from Pakistan. In 1992 six members (mother and five children) of a family of ten were admitted to our department with typhoid fever within a nine-day period. The index case was an 18 months old girl who had been hospitalized and treated elsewhere for typhoid fever. Two weeks after completing antibiotic treatment she was admitted to our hospital with a relapse. The source of her first infection is unknown. The rapid spread of typhoid fever in the family was most likely due to insufficient hygienic precautions and inadequate antibiotic treatment of the index case. Several coexisting factors such as poor housing conditions and cultural barriers may also have influenced the outcome. There is obviously a need for strict guidelines and proper coordination of treatment and follow-up of this and other similar contagious diseases.