[Typhoid fever in school children: by what measures is the modification of the clinical course due to oral vaccination?]. / Fiebre tifoidea en escolares: en que medida la clinica es modificada por el uso de una vacuna oral?

The clinical course of infection by Salmonellae was compared between patients who had been vaccinated against typhoid fever using the Ty21a vaccine and those who had not. Of 2566 bacteriological confirmed cases 84% were infected with S typhi, 14% with S paratyphi B and 2% with S paratyphi A. Among patients with typhoid fever, 34% were treated in hospital, 3.5% had relapses, 5.4% developed complications and 1 patient died (0.05%). Among patients with paratyphoid fever, 18% were treated in hospital, 0.6% had relapses, 1.4% developed complications and there were no deaths. These figures were similar among vaccinated and non-vaccinated cases. A slightly greater proportion of vaccinated cases were treated in hospital (38 vs 30%). Thus, use of oral vaccination against typhoid fever does not alter the clinical course of infection with Salmonellae.

A population-based retrospective assessment of the disease burden resulting from invasive Haemophilus influenzae in infants and young children in Santiago, Chile.

Clinical discharge and laboratory records were reviewed in the seven government hospitals that provide care for 93% of the pediatric population of Santiago, Chile, to detect cases of meningitis and other invasive (bacteremia-associated) infections caused by Haemophilus influenzae. infections that occurred in children less than five years of age from January, 1985, through December, 1987, were recorded and matched with census data to calculate incidence rates. The incidence of meningitis and non-meningitis syndromes peaked in the 6- to 11-month age group and tapered sharply after 12 months of age. The city-wide incidence (ca. 21.6 cases/10(5) children less than 5 years of age) is one-third to one-half that reported for the general pediatric population in the United States. However, there is much evidence for under-reporting in Santiago. In Area Norte, served by Roberto del Rio Children's Hospital where H. influenzae has been a subject of research by pediatricians for years, the incidence of invasive H. influenzae infections (42.5/105) is approximately two-fold higher than the rest of Santiago. The cumulative proportions of episodes of H. influenzae disease occurring in successively older age groups closely parallel the pattern seen in the general United States pediatric population. Although only ca. 20% of all episodes occur during the first 6 months of life, nearly 80% of episodes are seen by 18 months of age. Based on the observed incidence rates, the apparent underreporting and the high city-wide case fatality of Hib meningitis (16%), invasive H. influenzae infections represent an important public health problem in Santiago, Chile.

[The detection of chronic Salmonella typhi carriers: a practical method applied to food handlers]. / Detección de portadores crónicos de Salmonella typhi: método práctico aplicado a manipuladores de alimentos.

We evaluated the anti Vi test to detect S typhi carriers in 1006 food handlers of 65 locations in central Santiago (Chile): 710 males and 296 females, age range 17 to 67. Positive reactions were found in 27 subjects, titers varying from 1/40 in 9 to 1/160 in 1 subject. Culture of feces, along with urine and bile cultures in those with very high titers allowed isolation of S typhi in 2 subjects, one with a 1/40 titer, the other 1/160. None had clinical history of typhoid fever, both had received parenteral vaccination. These results compare favorably with the classic technique which would have required 3018 fecal cultures (vs 108 in the present study) and a total cost of US$ 1730 vs US$ 364. In addition, anti-Vi detection is readily accepted by the subjects. Therefore, we recommend this technique as a screening prior to culture techniques in the identification of chronic S typhi carriers.