Data
The surveillance system for typhoid and paratyphoid fever established by Santé publique France makes it possible to study the epidemiological trends of these diseases.
A stable incidence of typhoid and paratyphoid fever, with the global COVID-19 pandemic having a significant impact on the number of cases reported in 2020
In 2019, 208 cases of typhoid and paratyphoid fever were reported in France, including 171 (82%) cases of typhoid fever, 23 (11%) cases of paratyphoid fever A, 10 (5%) cases of paratyphoid fever B, and 4 (2%) cases of paratyphoid fever C. The median age of cases was 22 years (min: 1 year, max: 80 years), and 47% were women.
In 2020, the reduction in travel due to the global COVID-19 pandemic had a significant impact on the number of typhoid and paratyphoid fever cases: 73 cases were reported in France, including 63 (86%) cases of typhoid fever, 7 (10%) cases of paratyphoid fever A, 3 (4%) cases of paratyphoid fever B, and no cases of paratyphoid fever C. The median age of cases was 23 years (min: 2 years, max: 75 years), and 44% were women.
Number of cases and deaths from typhoid fever and paratyphoid fevers reported in France from 1999 to 2020, by region of residence.
| 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Salmonella Typhi | ||||||||||||||||||||||
| All of France | 112 | 92 | 84 | 96 | 113 | 112 | 107 | 88 | 84 | 88 | 133 | 135 | 103 | 86 | 108 | 117 | 100 | 117 | 111 | 119 | 171 | 63 |
| Mainland France | 89 | 82 | 74 | 80 | 101 | 87 | 91 | 79 | 76 | 78 | 104 | 114 | 72 | 53 | 66 | 90 | 50 | 71 | 82 | 64 | 96 | 24 |
| Guadeloupe | 3 | 0 | 0 | 1 | 1 | 2 | 0 | 0 | 1 | 4 | 7 | 1 | 2 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| French Guiana | 10 | 7 | 2 | 0 | 0 | 11 | 7 | 2 | 3 | 5 | 8 | 8 | 3 | 5 | 5 | 5 | 3 | 5 | 6 | 5 | 19 | 2 |
| Martinique | 0 | 0 | 4 | 2 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 0 |
| Mayotte | 5 | 6 | 20 | 21 | 31 | 19 | 44 | 39 | 21 | 45 | 53 | 37 | ||||||||||
| Reunion | 3 | 1 | 0 | 6 | 2 | 1 | 1 | 0 | 4 | 0 | 4 | 2 | 5 | 5 | 3 | 0 | 2 | 1 | 2 | 3 | 1 | 0 |
| Foreign* | 7 | 2 | 4 | 7 | 8 | 10 | 7 | 6 | 0 | 1 | 5 | 4 | 1 | 1 | 2 | 2 | 0 | 2 | 0 | 1 | 2 | 0 |
| Salmonella Paratyphi A | ||||||||||||||||||||||
| All of France | 10 | 11 | 7 | 7 | 19 | 37 | 19 | 32 | 35 | 21 | 34 | 30 | 27 | 27 | 34 | 30 | 12 | 23 | 14 | 28 | 23 | 7 |
| Mainland France | 10 | 11 | 7 | 7 | 19 | 37 | 17 | 31 | 33 | 21 | 33 | 30 | 27 | 27 | 34 | 29 | 12 | 23 | 13 | 28 | 23 | 6 |
| Salmonella Paratyphi B | ||||||||||||||||||||||
| All of France | 5 | 8 | 2 | 5 | 10 | 9 | 15 | 5 | 13 | 15 | 26 | 11 | 9 | 7 | 6 | 7 | 3 | 6 | 13 | 8 | 10 | 3 |
| Mainland France | 5 | 7 | 2 | 5 | 10 | 9 | 15 | 3 | 12 | 14 | 26 | 11 | 8 | 6 | 5 | 7 | 3 | 6 | 13 | 8 | 8 | 3 |
| Salmonella Paratyphi C | ||||||||||||||||||||||
| All of France | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 0 | 2 | 2 | 1 | 0 | 2 | 1 | 1 | 0 | 0 | 1 | 0 | 4 | 0 |
| Mainland France | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 2 | 1 | 0 | 2 | 1 | 1 | 0 | 0 | 1 | 0 | 4 | 0 |
| TOTAL (typhoid + paratyphoid) | ||||||||||||||||||||||
| All of France | 127 | 111 | 93 | 108 | 143 | 158 | 142 | 126 | 132 | 126 | 195 | 177 | 139 | 122 | 149 | 155 | 115 | 147 | 139 | 155 | 208 | 73 |
| Mainland France | 104 | 100 | 83 | 92 | 131 | 133 | 123 | 113 | 121 | 114 | 165 | 156 | 107 | 88 | 106 | 127 | 65 | 100 | 109 | 100 | 131 | 33 |
| Number of deaths | 1 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
* Confirmed cases of residents abroad diagnosed in France
Number of reported cases of typhoid fever and paratyphoid fever in France from 1999 to 2020
People of all ages can contract typhoid or paratyphoid fever. Between 1999 and 2020, the 5–44 age group was the most affected, accounting for 75% of reported cases in mainland France.
Distribution by age group of reported cases of typhoid and paratyphoid fever in mainland France from 1999 to 2020, by imported or locally acquired status
Incidence of typhoid and paratyphoid fever, per million inhabitants in France, 1999–2020
Most cases are imported
Of the 2,361 cases of typhoid and paratyphoid fever reported in metropolitan France between 1999 and 2020 for which information is available, 1,962 (83%) occurred within one month of a trip to an endemic area, particularly in a country on the Indian subcontinent, in Southeast Asia, in a sub-Saharan African country, or in the Maghreb.
Nearly 90% of typhoid fever cases occurred in people who had not previously been vaccinated against the disease.
During this period, the proportion of cases imported from Africa steadily decreased, falling from 73% of imported cases in 1999 to 26% in 2020, while the proportion of cases imported from Asia and Latin America steadily increased, rising from 23% to 63% and from 1% to nearly 10%, respectively.
In 2013, the National Reference Center for Escherichia coli, Salmonella, and Shigella, along with Santé publique France, detected an ongoing paratyphoid A fever outbreak in Cambodia based on diagnoses made among travelers returning from that country.¹ This outbreak has since been reported in other countries as well.²⁻³
In 2017, an outbreak of typhoid fever among participants at a “Rainbow” gathering held in Italy in July–August 2017 was also detected based on surveillance data. The identification of this outbreak subsequently led to the identification of 16 cases linked to this event in six European countries and New Zealand4.
Tourdjman M, Le Hello S, Gossner C, et al. Unusual increase in reported cases of paratyphoid A fever among travelers returning from Cambodia, January to September 2013. Euro Surveill 2013; 18(39).
Judd MC, Grass JE, Mintz ED, Bicknese A, Mahon BE. Salmonella enterica Paratyphi A Infections in Travelers Returning from Cambodia, United States. Emerg Infect Dis. 2015 Jun; 21(6):1089-91.
Saitoh T, Morita M, et al. Increase in paratyphoid fever cases among Japanese travelers returning from Cambodia in 2013. Epidemiol Infect. 2015 Jul 14:1-5.
https://ecdc.europa.eu/en/news-events/typhoid-fever-outbreak-linked-rainbow-gathering-northern-italy
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Proportion of imported cases of typhoid fever and paratyphoid fevers among cases reported among residents of metropolitan France from 1999 to 2020, and likely regions of acquisition
A distribution concentrated mainly in the summer
There is a peak in imported cases of typhoid and paratyphoid fever during August and September, corresponding to periods of population movement, particularly tourism, whereas the distribution of locally acquired cases remains stable throughout the year. A reverse distribution was observed in 2020, with an increase in locally acquired cases in June–July (following the lifting of lockdown measures) and the absence of a summer peak in imported cases. These trends, linked to the COVID-19 pandemic, will be monitored in 2021.
The predominantly imported nature of typhoid fever, occurring in over 90% of cases among unvaccinated individuals, underscores the importance of recommendations for travelers planning to stay in endemic areas, particularly regarding typhoid fever vaccination and the practice of personal and food hygiene measures.
Distribution of imported and locally acquired cases of typhoid and paratyphoid fever by month of symptom onset — France, 1999–2020
Distribution of typhoid and paratyphoid fever cases by month of symptom onset — France, 2020
The Unique Situation in Mayotte
Against a backdrop of inadequate access to drinking water and sanitation, typhoid fever remains an endemic disease in Mayotte, and over the past decade, the number of identified cases has been steadily increasing. In 2019, 53 cases of typhoid fever confirmed by blood culture and/or stool culture were reported by the laboratory at the Mayotte Hospital Center to the Health Surveillance, Alert, and Management Unit (CVAGS) of the Indian Ocean Regional Health Agency (ARS). In 2020, 37 cases were reported.
Clusters of cases are regularly identified, most often linked to inadequate sanitation and access to drinking water.
Number of typhoid fever cases - Mayotte, 2009–2020
Learn more
Epidemiological Update, April 16, 2018
In relation to
Vaccination
thematic dossier
Contagious diseases most often affect children at a very young age. Because children are particularly vulnerable, they are a priority target for vaccination programs.
