Published Date: 1999-09-16 23:50:00
Subject: PRO/EDR> Salmonella paratyphi B - Europe ex Turkey (03)
Archive Number: 19990916.1656

SALMONELLA PARATYPHI B - EUROPE EX TURKEY (03)
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Salmonella paratyphi B - Europe ex Turkey 990904225014
Salmonella paratyphi B - Europe ex Turkey (02) 990910194232
Date: Thu, 16 Sep 1999
From: Chan Yow Cheong mailto:chanyowcheong@pacific.net.sg
ProMED Regional Moderator for Asia
Source: Eurosurveillance Weekly, issue 38, 16 Sep 1999
<http://www.eurosurv.org/update/>

Two hundred and seventy-three confirmed and suspected cases of _Salmonella
paratyphi_ B have now been identified among travellers returning to eight
European countries from the Antalya region of Turkey (1,2,3). There are 78
cases in Sweden, 59 in Norway, 49 in Denmark, 30 in Finland, 30 in Germany,
16 in England and Wales, ten in the Netherlands, and one in Switzerland.
Almost all the cases have stayed in or near the town of Alanya.
The dates on which cases became ill range from 13 July to 5 September 1999.
>From these dates and the dates of stay in Alanya, it can be concluded that
transmission within the town continued for at least five weeks between
mid-July and mid-August. It is too early to know whether transmission has
stopped, but the current rate of case ascertainment suggests that
transmission has diminished.
Twenty cases are known to have become ill within seven days of arriving in
Alanya. For those who became ill after leaving Alanya, an average of six
days (range 1 to 19) elapsed between departure from the town and onset of
illness onset. The Enter-net surveillance network (4) is continuing active
surveillance of all cases of _S. paratyphi_ B in collaborating countries.
Cases known to have travelled to Turkey are being interviewed promptly to
establish the dates on which they became ill, whether they travelled to or
near Alanya, the name of any accommodation they used in the town, and the
dates of their arrival and departure. A detailed case control study of
around 100 of the cases in six countries has begun.
Doctors should continue to consider the diagnosis of paratyphoid fever and
arrange for the microbiological examination of specimens from all patients
who present with diarrhoea, septicaemia, or high fever after returning from
Turkey.
References:
Hasseltvedt V. Salmonella paratyphi B phage type Taunton in travellers to
south west Turkey. Eurosurveillance Weekly 1999; 3: 990826
(http://www.eurosurv.org/1999/990826.html)
Lieftucht A, Mølbak K. Paratyphoid fever after travel to Turkey - update 2
September 1999. Eurosurveillance Weekly 1999; 3: 990902.
(http://www.eurosurv.org/1999/990902.html)
Fisher I, Lieftucht A, Mølbak K. Paratyphoid fever after travel to Turkey -
update 9 September 1999. Eurosurveillance Weekly 1999; 3: 990909.
(http://www.eurosurv.org/1999/990909.html)
Fisher IST on behalf of the Enter-net participants. The Enter-net
international surveillance network - how it works. Eurosurveillance 1999;
4: 52-5. (http://www.ceses.org/eurosurv/)
Reported by Ian Fisher (ifisher@phls.nhs.uk), Enter-net Coordinator, Alfons
Lieftucht (alieftucht@phls.nhs.uk), European Programme for Intervention
Epidemiology Training, PHLS Communicable Disease Surveillance Centre,
London, England, and Kåre Mølbak (krm@ssi.dk), Statens Serum Institut,
Copenhagen, Denmark.
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