Cluster of locally acquired typhoid fever cases in Ille-et-Vilaine (France), April 2009
Introduction - On June 10, 2009, the National Reference Center (NRC) for Salmonella identified two strains of S. Typhi from Ille-et-Vilaine that exhibited an antibiotic resistance profile specific to strains from Central and West Africa. The typhoid fever cases had not traveled to Africa, Asia, or Latin America, but had attended the same festive meal on March 28. Method - Active case finding and a cohort-based epidemiological study were conducted. Results - Fifty-five of the 67 guests were interviewed; more than half were under 20 years of age. In addition to the two initially reported cases, one person who presented with persistent headaches and an episode of diarrhea was considered a probable case. The risk of developing typhoid fever was significantly associated with the consumption of chicken (p=0.02) and tiep (an African dish) (p=0.01) after 11:00 PM or the following day. The food had been purchased locally. None of the cooks had a history of typhoid fever. Given the absence of cases among close contacts, microbiological testing for bacterial carriage was not performed. Conclusion - This cluster of three indigenous typhoid fever cases is likely linked to the consumption of food contaminated by a healthy carrier of S. Typhi. It serves as a reminder that the diagnosis should not be systematically ruled out in the absence of travel to an endemic area. (R.A.)
Author(s): Loury P, Tillaut H, Faisant M, Paillereau N, Marquis M, Mari C, Briand A, Demillac R, Delmas G
Publishing year: 2010
Pages: 446-8
Weekly Epidemiological Bulletin, 2010, n° 44, p. 446-8
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