Enteric fever in Scotland, 1967-1974.

A review of 194 cases of enteric infection in Scotland during 1967-74, is reported. Diagnosis was confirmed by the laboratory isolation of Salmonella typhi (64 cases), S. paratyphi A (3) and S. paratyphi B (127), from blood or faeces; 174 persons were clinically ill and 20 were symptomless infections. Most patients (81-0%) were under 35 years of age, with the highest incidence occurring among young adults of 15-24 years, many of whom had been travelling overseas. One-third of all cases (65) were imported infections; the remaining 129 patients had not been outside the United Kingdom. A significantly greater proportion of typhoid infection (54-7%) was contracted overseas, in contrast to paratyphoid B with only one-fifth of cases (21-2%) being imported; all three cases of paratyphoid A were imported. The geographic distribution of origin of imported infections is discussed, along with the frequency of organisms belonging to different phage types. Two deaths occurred, one of which was the result of complications of paratyphoid fever. All other patients responded well to treatment, although two persons continued to excrete and became chronic carriers. A few examples are given of episodes of particular epidemiological interest. It is expected that in future years there will be a continued increase in the proportion of imported infections as more persons travel overseas, concurrent with the continuing decline in the number of chronic carriers resident in the British Isles.

Water-borne typhoid fever caused by an unusual Vi-phage type in Edinburgh.

Investigation of a small series of cases of typhoid fever infected in a river between 1963 and 1970 revealed that all were caused by a single source, a carrier of a rare phage type of Salmonella typhi. The contamination of the river resulted from an incorrect sewage connexion with a surface water drain outfall into the river.