[Spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in 3 provinces in southwestern China, 2001-2012].

Objective: To analyze the spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in Yunnan, Guizhou and Guangxi provinces in southwestern China in recent years. Methods: The incidence data of typhoid and paratyphoid fever cases at county level in 3 provinces during 2001-2012 were collected from China Information System for Diseases Control and Prevention and analyzed by the methods of descriptive epidemiology and geographic informatics. And the map showing the spatial and temporal clustering characters of typhoid and paratyphoid fever cases in three provinces was drawn. SaTScan statistics was used to identify the typhoid and paratyphoid fever clustering areas of three provinces in each year from 2001 to 2012. Results: During the study period, the reported cases of typhoid and paratyphoid fever declined with year. The reported incidence decreased from 30.15 per 100 000 in 2001 to 10.83 per 100 000 in 2006(annual incidence 21.12 per 100 000); while during 2007-2012, the incidence became stable, ranging from 4.75 per 100 000 to 6.83 per 100 000 (annual incidence 5.73 per 100 000). The seasonal variation of the incidence was consistent in three provinces, with majority of cases occurred in summer and autumn. The spatial and temporal clustering of typhoid and paratyphoid fever was demonstrated by the incidence map. Most high-incidence counties were located in a zonal area extending from Yuxi of Yunnan to Guiyang of Guizhou, but were concentrated in Guilin in Guangxi. Temporal and spatial scan statistics identified the positional shifting of class Ⅰ clustering area from Guizhou to Yunnan. Class Ⅰ clustering area was located around the central and western areas (Zunyi and Anshun) of Guizhou during 2001-2003, and moved to the central area of Yunnan during 2004-2012. Conclusion: Spatial and temporal clustering of typhoid and paratyphoid fever existed in the endemic areas of southwestern China, and the clustering area covered a zone connecting the central areas of Guizhou and Yunnan. From 2004 to 2012, the most important clustering area shifted from Guizhou to Yunnan. Findings from this study provided evidence for the identifying key areas for typhoid and paratyphoid fever control and prevention and allocate health resources.

[Surveillance data on typhoid fever and paratyphoid fever in 2015, China].

Objective: Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence. Methods: Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method. Characteristics on seasonal, regional and distribution of the diseases were described. Spatial-temporal clustering characteristics were estimated, under the retrospective space-time method. Results: A total of 8 850 typhoid fever cases were reported from the surveillance system, with incidence rate as 0.65/100 000. The number of paratyphoid fever cases was 2 794, with incidence rate as 0.21/100 000. Both cases of typhoid fever and paratyphoid fever occurred all year round, with high epidemic season from May to October. Most cases involved farmers (39.68%), children (15.89%) and students (12.01%). Children under 5 years showed the highest incidence rate. Retrospective space-time analysis for provinces with high incidence rates would include Yunnan, Guangxi, Guizhou, Hunan and Guangdong, indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces. Conclusion: In 2015, the prevalence rates of typhoid fever and paratyphoid fever were low, however with regional high prevalence areas. Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.

Salmonella paratyphi A-infected ovarian cyst in returning traveller--an unusual complication of enteric fever.

We report a case of Salmonella paratyphi A enteric fever in a returned New Zealand traveller complicated by an infected ovarian cyst, which resulted in clinical and microbiological relapse despite appropriate antibiotic treatment. Extraintestinal manifestations of enteric fever are infrequent but should be considered in situations where treatment response to first-line antibiotics for adequate duration is suboptimal.

Enteric fever in Scotland 1975-1990.

In the 16-year period 1975-90, there were 267 cases of acute infection with typhoidal salmonellae reported in Scotland, in addition to which 32 chronic carriers were identified. The overall incidence of disease changed little over this period, but there was a fall in indigenously acquired paratyphoid B and typhoid, and a rise in imported paratyphoid A. The majority, 215 (81%), had a history of recent travel and were considered to have acquired infection overseas. Only six of the indigenously acquired infections were traced to acutely infected persons, illustrating the low risk of transmission associated with acute enteric fever in the UK. Only one death was definitely ascribed to enteric fever, and one person with S. paratyphi B became a chronic carrier. Significant illness was observed in five chronically infected individuals, including one with carcinoma of the gallbladder. UK residents of 'Asian' ethnicity returning from the Indian subcontinent accounted for 63 (46%) of the 137 cases of typhoid, and 34 (64%) of the 53 cases of paratyphoid A. People of 'Asian' ethnicity were more likely to have acquired infection overseas than 'non-Asians': 110 (89%) of 123 persons compared with 105 (73%) of 144 (odds ratio 3.1, 95% confidence interval 1.5-6.6, P = 0.001). Although there seems to be limited scope for preventing indigenously acquired infection, immunisation of travellers could contribute significantly to reducing the incidence of typhoid.