Misra S, Diaz P S, Rowley A H
Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Clin Infect Dis. 1997 May;24(5):998-1000. doi: 10.1093/clinids/24.5.998.
To examine the epidemiology of typhoid fever in children in an area that was not endemic, we analyzed 55 cases of typhoid fever in children and adolescents who were < or = 18 years and whose cases were reported to the Chicago and suburban Cook County Health Departments over 7 years. Cases had positive blood and/or stool cultures for Salmonella typhi. The ethnic distribution of the patients was as follows: 25% Asian, 22% Hispanic, 15% African American, 9% Caucasian, 18% other, and 11% unknown. Of the 55 cases, 35% were aged 0-5 years, 25% were aged 6-10 years, 31% were aged 11-15 years, and 9% were aged 16-18 years. Twelve patients did not have a history of travel. All patients recovered; none became carriers. Symptoms in 41 patients whose charts were available for review included fever (100%), diarrhea (77%), vomiting (50%), and dehydration (30%). Bacteremia was documented in 27 (66%) of 41 cases. In 17 of 41 cases, the household contacts were food handlers or health care workers. Eight (31%) of 26 isolates were resistant to both ampicillin and trimethoprim-sulfamethoxazole. The findings in our study were as follows: typhoid fever occurred frequently in children aged 0-5 years (in contrast with reports from areas of endemicity), approximately 20% of patients did not have a history of travel, and multidrug-resistant strains were prevalent.
为了研究非伤寒流行地区儿童伤寒热的流行病学情况，我们分析了55例儿童和青少年伤寒热病例，这些病例年龄小于或等于18岁，在7年期间向芝加哥及库克县郊区卫生部门报告。病例的血液和/或粪便培养结果显示伤寒杆菌呈阳性。患者的种族分布如下：25%为亚洲人，22%为西班牙裔，15%为非裔美国人，9%为白种人，18%为其他种族，11%种族不明。在55例病例中，35%年龄在0至5岁，25%年龄在6至10岁，31%年龄在11至15岁，9%年龄在16至18岁。12名患者无旅行史。所有患者均康复，无人成为带菌者。41例病历可供查阅的患者症状包括发热（100%）、腹泻（77%）、呕吐（50%）和脱水（30%）。41例中有27例（66%）记录有菌血症。41例中有17例，其家庭接触者为食品处理人员或医护人员。26株分离菌中有8株（31%）对氨苄青霉素和甲氧苄啶-磺胺甲恶唑均耐药。我们的研究结果如下：伤寒热在0至5岁儿童中频繁发生（与流行地区的报告相反），约20%的患者无旅行史，且多重耐药菌株普遍存在。
