Typhoid fever vaccines.

An outbreak of cholera caused by Vibrio cholerae 01, biotype El Tor, serotype Inaba, phage type 4, occurred in an institution for the aged in Singapore in August and September 1984. 96 inmates were infected (21 symptomatic and 75 asymptomatic) and 5 died. The index case was a 72-year-old male inmate who continued to assist in food preparation in the kitchen from the time of onset of diarrhoea until he was seriously ill and hospitalized 4 days later. Another kitchen helper was found to have asymptomatic V. cholerae 01 infection. The infection rate for males was significantly higher than that for females (P less than 0.025), associated with the use of unsanitary toilets. The main mode of transmission was through food contaminated by the 2 kitchen helpers who probably accounted for most of the infections, while poor personal hygiene of the inmates helped to sustain person-to-person spread. The outbreak was confined within the institution as the result of the prompt and effective implementation of control measures.

Epidemiological characteristics of an institutional outbreak of cholera

An outbreak of typhoid caused by Salmonella typhi of the same Vi-phage type (D1) and of the same antibiogram was reported in a large psychiatric institution in Singapore. A total of 95 (4.8%) of the 1965 inmates were infected, 47 with symptoms and 48 asymptomatic. Transmission was through close person-to-person contact and not through contaminated food or water. The source of infection could not be established. The outbreak was brought under control by maintaining a high standard of environmental sanitation, active search for fever and diarrhoeal cases, identification of asymptomatic cases by rectal swabbing, and isolation of those found to be infected. Mass immunization with two doses of heat-phenol inactivated typhoid vaccine was also carried out concurrently. The vaccine was found to have an efficacy of 65.8% in preventing clinical illness.

/pdf/epidemiology-and-control-of-an-outbreak-of-typhoid-in-a-uxzwfhttox.pdf

Epidemiology and control of an outbreak of typhoid in a psychiatric institution.

Typhoid Fever Vaccines

Anaphylactoid reaction after typhoid vaccination

agglutinating antibodies could be detected against the isolated strain, but by the time the enteritis was over the titre had risen to 1/1280. When we saw the patient in our outpatient clinic the titre had declined to 1/160. After the arthritis had disappeared no antibodies could be detected. Radiological examination of the sacroiliac and ankle joints showed no abnormalities. Tissue typing showed HLA-A 2,28; B 12,27. Eight weeks after the onset of the arthritis all signs and symptoms had disappeared.

https://www.bmj.com/content/bmj/1/6160/381.2.full.pdf

Acute renal failure after TAB and cholera vaccination.

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Acute renal failure after TAB and cholera vaccination.