Informing the public health management of typhoid and paratyphoid: The Australian context
MetadataShow full item record
Objective: To examine outcomes of public health management of notified enteric fever cases in South-East Queensland over the past five years. Methods: Notification records of typhoid and paratyphoid infection in South-East Queensland 2008–2012 (inclusive) were reviewed to determine likelihood of cases and contacts adhering to present or previous recommendations for faecal clearance/screening, duration of infectiousness of cases and extent of local transmission to contacts. Results: Sixty-nine of 85 cases and 218 of 265 contacts submitted at least one faecal specimen. Cases were 2.7 (95%CI 1.2–6.0) and contacts were 4.4 (95%CI 3.0–6.4) times more likely to complete recommended faecal clearance/screening under previous compared to present guidelines (requiring more specimens). In ten cases with positive post-treatment specimens, last recorded infectiousness was 19 days to six months after notification. The documented rate of local transmission of infection was 18/1,000 contacts submitting at least one faecal specimen (95%CI 6–48/1,000). Conclusions: Local transmission risk of enteric fever in South-East Queensland is low, although small numbers of cases may have prolonged bacilli excretion post-treatment. More complex clearance/screening regimens are associated with decreased compliance. Implications: Pursuing extensive faecal clearance/screening regimens is unlikely to be effective in terms of public health management of enteric fever in South-East Queensland. We suggest a unified national approach focussing on cases/contacts at high risk of disease transmission.
Australian and New Zealand Journal of Public Health
© 2015 Public Health Association of Australia. This is the peer reviewed version of the following article: Informing the public health management of typhoid and paratyphoid: The Australian context, Australian and New Zealand Journal of Public Health, [39(6), 577–581, 2015 which has been published in final form at http://doi.org/10.1111/1753-6405.12387. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)