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. 2011 Aug;139(8):1239-45.
doi: 10.1017/S0950268810002207. Epub 2010 Sep 28.

Molecular Epidemiological Investigation of a Typhoid Fever Outbreak in South Africa, 2005: The Relationship to a Previous Epidemic in 1993

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Molecular Epidemiological Investigation of a Typhoid Fever Outbreak in South Africa, 2005: The Relationship to a Previous Epidemic in 1993

K H Keddy et al. Epidemiol Infect. .

Abstract

In 2005, over 600 clinically diagnosed typhoid fever cases occurred in South Africa, where an outbreak had been previously described in 1993. Case-control and molecular investigations, including Salmonella enterica serovar Typhi (S. Typhi) isolates from that area from 1993, 2005 and later, were undertaken. Controls were significantly older than cases (P=0·003), possibly due to immunity from previous infection, and a significantly larger proportion had attended a gathering (P=0·035). Exposure to commercial food outlets and person-to-person transmission was not significant. Pulsed-field gel electrophoresis and multi-locus tandem repeat analysis revealed common clusters of S. Typhi strains identified in 1993 and 2005 as well as in 2007 and 2009. This outbreak probably occurred in a non-immune population due to faecally contaminated water. S. Typhi strains appeared to be related to strains from 1993; failure to address unsafe water may lead to further outbreaks in the area if the current population immunity wanes or is lost.

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