Korean J Infect Dis.  1998 Feb;30(1):54-60.

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

• Lee DS
• Oh HT
• Han DH
• Ann BY
• Kim SH
• Kim KW
• Kim YS
• Park MS

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.

Keyword

Typhoid fever; Outbreak; Complications; Phage type

MeSH Terms

Anti-Infective Agents
Bacteriophage Typing
Bacteriophages
Disseminated Intravascular Coagulation
Hearing Loss, Sensorineural
Hemorrhage
Hepatitis
Humans
Jeollabuk-do*
Medical Records
Meningitis
Microbial Sensitivity Tests
Myocardial Ischemia
Pancreatitis
Pancytopenia
Pneumonia
Protestantism
Retrospective Studies
Salmonella
Salmonella typhi
Serotyping
Shock, Septic
Stillbirth
Typhoid Fever*
Urinary Tract Infections
Anti-Infective Agents