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Restaurant-associated outbreak of Salmonella Typhi in Nauru: an epidemiological and cost analysis

Published online by Cambridge University Press:  05 February 2002

S. J. OLSEN ,
B. KAFOA ,
N. S. S. WIN ,
M. JOSE ,
W. BIBB ,
S. LUBY ,
G. WAIDUBU ,
M. O'LEARY  and
E. MINTZ
S. J. OLSEN
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Mailstop A-38, Atlanta GA 30333, USA Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, CDC
B. KAFOA
Affiliation:
Fiji School of Medicine, Suva, Fiji
N. S. S. WIN
Affiliation:
Nauru General Hospital, Nauru
M. JOSE
Affiliation:
Nauru General Hospital, Nauru
W. BIBB
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Mailstop A-38, Atlanta GA 30333, USA
S. LUBY
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Mailstop A-38, Atlanta GA 30333, USA
G. WAIDUBU
Affiliation:
Nauru General Hospital, Nauru
M. O'LEARY
Affiliation:
Western Pacific Region of the World Health Organization, Suva, Fiji
E. MINTZ
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Mailstop A-38, Atlanta GA 30333, USA
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Abstract

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Typhoid fever is endemic in the South Pacific. We investigated an outbreak in Nauru. Through interviews and medical records, we identified 50 persons with onset between 1 October 1998 and 10 May 1999, of fever lasting [ges ]3 days and one other symptom. Salmonella Typhi was isolated from 19 (38%) cases. Thirty-two (64%) patients were school-aged children, and 17 (34%) were in four households. Case-control studies of (a) culture-confirmed cases and age- and neighbourhood-matched controls; and (b) household index cases and randomly selected age-matched controls implicated two restaurants: Restaurant M (matched OR [MOR] = 11, 95% confidence interval [CI] = 1·3–96) and Restaurant I (MOR = 5·8, 95% CI = 1·2–29). Food-handlers at both restaurants had elevated anti-Vi antibody titres indicative of carrier state. The annual incidence was 5·0/l000 persons. Outbreak-associated costs were $46000. Routine or emergency immunization campaigns targeting school-aged children may help prevent or control outbreaks of typhoid fever in endemic disease areas.

Type
Research Article
Information
Epidemiology & Infection , Volume 127 , Issue 3 , December 2001 , pp. 405 - 412
Copyright
2001 Cambridge University Press