Guidelines for the public health management of typhoid and paratyphoid in England : Practice guidelines from the National Typhoid and Paratyphoid Reference Group - 04/08/12

Doi : 10.1016/j.jinf.2012.05.005

S. Balasegaram ^a,^⁎,^{^{r
The first two authors contributed equally to this work and should be regarded as joint First Authors.},}^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}} , A.L. Potter ^a,^b,^{^{r
The first two authors contributed equally to this work and should be regarded as joint First Authors.},}^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, D. Grynszpan ^c,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, S. Barlow ^d,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, R.H. Behrens ^e,^f,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, L. Lighton ^g,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, L. Booth ^h,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, L. Inamdar ^i,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, K. Neal ^j,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, K. Nye ^k,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, J. Lawrence ^l,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, J. Jones ^l,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, I. Gray ^m,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, D. Tolley ^n,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, C. Lane ^o,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, B. Adak ^p,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, A. Cummins ^q,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}, S. Addiman ^b,^{^{s
On behalf of the Typhoid and Paratyphoid Reference Group.}}
^a South East Regional Epidemiology Unit, Health Protection Agency (HPA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK
^b North East and North Central London HPU, HPA, 151 Buckingham Palace Road, London, SW1W 9SZ, UK
^c North West London HPU, HPA, 61 Colindale Avenue, London, NW9 5EQ, UK
^d Wolverhampton City Council, 1st Floor, Civic Centre, St Peters Square, Wolverhampton, WV1 1DA, UK
^e London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
^f Hospital for Tropical Diseases, Mortimer Market, Capper Street, London WC1E 6JB, UK
^g Greater Manchester HPU, HPA, Floor 7b, Sentinel House, Albert Street, Eccles, Manchester, M30 0NJ, UK
^h Hampshire and Isle of Wight HPU, HPA, Unit 8, Fulcrum 2, Solent Way, Whiteley, Fareham, Hampshire, PO15 7FN, UK
ⁱ Yorkshire & the Humber HPU, HPA, West Yorkshire Health Protection Unit, Bridle Path, York Road, Leeds, LS15 7TR, UK
^j East Midlands HPU, HPA, Institute of Population Health, City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK
^k HPA West Midlands Public Health Laboratory, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, B9 5SS, UK
^l Travel and Migrant Health Section, HPA, 61 Colindale Avenue, London, NW9 5EQ, UK
^m Chartered Institute of Environmental Health, Chadwick Court, 15 Hatfields, London, SE1 8DJ, UK
ⁿ London Borough of Tower Hamlets, Anchorage House, 5 Clove Crescent, London, E14 1BY, UK
^o Salmonella Surveillance, Gastrointestinal Emerging and Zoonotic Infections Department, HPA, 61 Colindale Avenue, London, NW9 5EQ, UK
^p Gastrointestinal Infections, Gastrointestinal Emerging and Zoonotic Infections Department, HPA, 61 Colindale Avenue, London, NW9 5EQ, UK
^q Essex HPU, HPA, 8 Collingwood Road, Witham, Essex, CM8 2TT, UK

Corresponding author. South East Regional Epidemiology Unit, Health Protection Agency (HPA), 151 Buckingham Palace Road, London, SW1W 9SZ, UK. Tel.: +44 (0) 20 7811 7251; fax: +44 (0) 20 7811 7757.

Summary

Objectives

The Typhoid and Paratyphoid Reference Group (TPRG) was convened by the Health Protection Agency (HPA) and the Chartered Institute of Environmental Health (CIEH) to revise guidelines for public health management of enteric fever. This paper presents the new guidelines for England and their rationale.

Methods

Methods include literature reviews including grey literature such as audit data and case studies; analysis of enhanced surveillance data from England, Wales and Northern Ireland; review of clearance and screening schedules in use in other non-endemic areas; and expert consensus.

Results

The evidence and principles underpinning the new guidance are summarised. Significant changes from previous guidance include: • Algorithms to guide risk assessment and management, based on risk group and travel history; • Outline of investigation of non-travel cases; • Simplified microbiological clearance schedules for cases and contacts; • Targeted co-traveller screening and a “warn and inform” approach for contacts; • Management of convalescent and chronic carriers.

Conclusions

The guidelines were launched in February 2012. Feedback has been positive: the guidelines are reported to be clear, systematic, practical and risk-based. An evaluation of the guidelines is outlined and will add to the evidence base. There is potential for simplification and consistency between international guidelines.

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Keywords : Typhoid, Paratyphoid, Enteric fever, Guidelines

Plan

Introduction

Epidemiology of enteric fever

Rationale for revised guidelines

Methods

Public health guidelines for the management of enteric fever

Principles underlying this guidance

CASES: consideration of the risks of transmitting infection

CONTACTS: consideration of the risk of acquiring infection

Investigation of SOURCE: Subdivision of cases into travel-related or unlikely travel-related; further investigation of unlikely travel-related cases for source

Algorithm 1: public health management of enteric fever

Public health management of PROBABLE and CONFIRMED cases

Public health management of contacts

Algorithm 2: public health management of those with positive samples or previous history of enteric fever

Primary prevention

Consultation process

Teaching case studies and launch of the guidelines

Evaluation of the guidelines

Applicability to other countries

Export

Vol 65 - N° 3

P. 197-213 - septembre 2012 Retour au numéro

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Guidelines for the public health management of typhoid and paratyphoid in England : Practice guidelines from the National Typhoid and Paratyphoid Reference Group - 04/08/12

Summary

Objectives

Methods

Results

Conclusions

Plan

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