Mathieu J J, Henning K J, Bell E, Frieden T R
Division of Community Medicine, Mount Sinai School of Medicine, New York, NY.
Arch Intern Med. 1994 Aug 8;154(15):1713-8.
Although typhoid fever incidence decreased in the 1960s and 1970s in New York City and elsewhere, it did not disappear. In this article, trends associated with various modes of transmission of Salmonella typhi in New York City patients are described.
Typhoid fever surveillance reports from 1980 to 1990 were reviewed for clinical, demographic, and epidemiologic characteristics. Cases of typhoid fever were classified as travel related or domestically acquired.
In all, 479 typhoid cases were identified, of which 67% were travel related. The age groups most frequently affected were children and adolescents. Cases more than doubled in the decade, and the ratio of travel-related cases to domestically acquired cases increased steadily from 63% to 80%. Travelers to Southeast Asia were at three times higher risk than those visiting South America and eight times higher than those visiting the Caribbean. The case-fatality proportion was 1.5%.
The trends of S typhi infection in New York City followed the trends observed in the United States since 1978, which demonstrates the importance of international travel. Although food and water precautions may be effective for short-term travelers, selective use of oral antityphoid vaccines for New York City travelers to high-risk endemic countries should be encouraged.
尽管20世纪60年代和70年代纽约市及其他地区的伤寒热发病率有所下降，但并未消失。本文描述了纽约市患者中伤寒杆菌各种传播方式相关的趋势。
回顾了1980年至1990年伤寒热监测报告的临床、人口统计学和流行病学特征。伤寒热病例分为与旅行相关或国内感染。
共识别出479例伤寒病例，其中67%与旅行相关。受影响最频繁的年龄组是儿童和青少年。十年间病例增加了一倍多，与旅行相关的病例与国内感染病例的比例从63%稳步上升至80%。前往东南亚的旅行者感染风险是前往南美洲旅行者的三倍，是前往加勒比地区旅行者的八倍。病死率为1.5%。
纽约市伤寒杆菌感染趋势与1978年以来美国观察到的趋势一致，这表明国际旅行的重要性。尽管食品和水预防措施可能对短期旅行者有效，但应鼓励纽约市前往高风险流行国家的旅行者选择性使用口服伤寒疫苗。
