South East Regional Epidemiology Unit, Health Protection Agency, 151 Buckingham Palace Road, London SW1W 9SZ, UK.
J Infect. 2012 Sep;65(3):197-213. doi: 10.1016/j.jinf.2012.05.005. Epub 2012 May 23.
The Typhoid and Paratyphoid Reference Group (TPRG) was convened by the Health Protection Agency (HPA) and the Chartered Institute of Environmental Health (CIEH) to revise guidelines for public health management of enteric fever. This paper presents the new guidelines for England and their rationale.
Methods include literature reviews including grey literature such as audit data and case studies; analysis of enhanced surveillance data from England, Wales and Northern Ireland; review of clearance and screening schedules in use in other non-endemic areas; and expert consensus.
The evidence and principles underpinning the new guidance are summarised. Significant changes from previous guidance include: • Algorithms to guide risk assessment and management, based on risk group and travel history; • Outline of investigation of non-travel cases; • Simplified microbiological clearance schedules for cases and contacts; • Targeted co-traveller screening and a "warn and inform" approach for contacts; • Management of convalescent and chronic carriers.
The guidelines were launched in February 2012. Feedback has been positive: the guidelines are reported to be clear, systematic, practical and risk-based. An evaluation of the guidelines is outlined and will add to the evidence base. There is potential for simplification and consistency between international guidelines.
由健康保护署（HPA）和英国环境卫生学会（CIEH）召集的伤寒和副伤寒参考小组（TPRG）修订了肠热病公共卫生管理指南。本文介绍了英格兰的新指南及其基本原理。
方法包括文献综述，包括灰色文献，如审计数据和案例研究；分析英格兰、威尔士和北爱尔兰的强化监测数据；审查在其他非流行地区使用的清除和筛查时间表；以及专家共识。
总结了新指南所依据的证据和原则。与以往的指南相比，有重大变化包括：•基于风险群体和旅行史的风险评估和管理算法；•非旅行病例调查概述；•简化病例和接触者的微生物清除时间表；•针对共同旅行者的筛查和“警告和告知”接触者的方法；•恢复期和慢性携带者的管理。
指南于 2012 年 2 月发布。反馈积极：指南被报告为清晰、系统、实用和基于风险的。概述了对指南的评估，这将增加证据基础。国际指南之间有简化和一致性的潜力。
