Egoz N, Shihab S, Leitner L, Lucian M
Haifa District Health Department, Ministry of Health, Israel.
Isr J Med Sci. 1988 Nov;24(11):640-3.
An outbreak of typhoid fever followed a large outbreak of dysentery in northern Israel. Both outbreaks resulted from contamination of a drilled well that supplied water to the municipal water system. The well was contaminated with sewage from a broken main-pipe coming from Shefaram (an Arab town). The outbreak of typhoid involved 77 persons, of whom 75 were hospitalized. In 67, phage-type C1 (the phage type dominant in Shefaram since the 1950s) was isolated. The incubation period was relatively long, between 12 and 40 days (median 22) following exposure. Over 50% of the cases were children aged 0 to 14, and only two patients were older than 35 years; the sex ratio among the patients was 1:1. The incidence rate in Shefaram was 2.3 times higher than in the Krayot (outlying suburbs of Haifa). This difference was due mainly to the high incidence in young females in Shefaram. The opposite was observed during the outbreak of dysentery, when the attack rates of the disease were higher in the Krayot. Relapses occurred in 12% (9 cases). This outbreak demonstrates the potential that still exists for serious outbreaks due to contamination of the municipal water supply.
在以色列北部，伤寒热疫情紧随痢疾大爆发之后出现。这两次疫情均源于一口为城市供水系统供水的钻井受到污染。该井被来自谢法拉姆（一个阿拉伯城镇）的一条破裂主管道中的污水污染。伤寒疫情涉及77人，其中75人住院治疗。在67人的样本中，分离出了C1型噬菌体（自20世纪50年代以来在谢法拉姆占主导地位的噬菌体类型）。潜伏期相对较长，暴露后为12至40天（中位数为22天）。超过50%的病例为0至14岁的儿童，只有两名患者年龄超过35岁；患者的性别比为1:1。谢法拉姆的发病率比克雷奥（海法的外围郊区）高2.3倍。这种差异主要是由于谢法拉姆年轻女性的发病率较高。而在痢疾疫情期间观察到的情况则相反，当时该病在克雷奥的发病率更高。12%（9例）出现了复发。这次疫情表明，城市供水污染仍有可能引发严重疫情。
