A Clinical and Epidemiological Analysis on an Outbreak of Typhoid Fever During 1996 Summer Through Autumn in Chunju Area / 감염

ABSTRACT

BACKGROUND: We experienced an outbreak of typhoid fever in Chunju area which manifested as severe symptoms and signs, and variable complications. To chracterize the epidemic and to identify a possible source of infection, the clinical findings of patients from the outbreak were analyzed, and the patterns of antimicrobial susceptibility and phage typing of Salmonella Typhi isolates were determined. METHODS: We analyzed a total of 232 patients from the outbreak who admitted to Chunju Presbyterian Medical Center during 1996 August through October. The medical records of the patients were reviewed retrospectively. All isolates of S. Typhi from the outbreak were analyzed for serotyping, antibiogram, and phage typing. Phage typing were performed using Vi- phages for 50 strains isolated from the patients who showed atypical clinical manifestations and unusal complications. RESULTS: The outbreak attacked mainly young femalegroup. The complications observed were 155 casesof hepatitis, 47 pancytopenia, 20 acute pancreatitis, 13 urinary tract infection, 12 intestinal hemorrhage, 5 disseminated intravascular coagulation, 4 meningitis, 3 septic shock, 2 sensorineural hearing loss, 2 myocardial ischemia, 2 pneumonia, 1 stillbirth, and 1 death. S. Typhi were isolated in 129 cases including 111 from blood, 17 stool and 1 urine. All isolates were susceptible to all antimicrobial agents tested. All 50 isolates from severe patients with unusal complications were identified as Salmonella, serogroup D1, serotype Typhi, phage type D1. CONCLUSIONS: We experienced an outbreak of typhoid fever associated with severe, atypical symptoms and unusual complications, caused by Salmonella, serogroup D1, serotype Typhi, phage type D1.