Salmonella gastroenteritis in Hong Kong--a clinical review of 200 patients.

A sudden increase in Salmonella gastroenteritis affecting infants and children in Hong Kong in 1971 prompted a clinical review of 200 such patients seen over a 6 year period. It showed unprecedented prevalence of Salmonella johannesburg infections and unusually protracted diarrhoea. Only 3.5 per cent of patients were breast fed. Factors causing this chronicity are discussed. All 8 fatal cases were under 7 1/2 months old, with protracted diarrhoea starting within 1 month after birth in 7. The invasiveness of Salmonella johannesburg is low although its infectivity high. Bacteraemia occurred in only 1 patient and focal infections other than gastroenteritis in none. Antibiotics did not improve diarrhoea nor eliminate faecal excretion in the majority of those treated. Prolonged and intermittent faecal excretion of Salmonella was common. Nineteen per cent of patients acquired diarrhoea in hospital; some after a course of antibiotics given for other infections. Experience from this series does not recommend administration of antibiotics to patients with uncomplicated Salmonella johannesburg gastroenteritis. As chronicity of diarrhoea seemed to be the major prognostic factor with regard to mortality and morbidity in this series, further search for causes and control measures of this chronicity is required.