Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2025-01-05T16:11:06.937Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of typhoid fever in Singapore

Published online by Cambridge University Press:  15 May 2009

F. S. Yew ,
K. T. Goh  and
Y. S. Lim
F. S. Yew
Affiliation:
Quarantine and Epidemiology Department. Ministry of the Environment, Singapore, 40 Scotts Road, Singapore 0922
K. T. Goh
Affiliation:
Quarantine and Epidemiology Department. Ministry of the Environment, Singapore, 40 Scotts Road, Singapore 0922
Y. S. Lim
Affiliation:
Enteric Bacteriology Laboratory, Department of Pathology, Singapore General Hospital, Singapore
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A total of 1452 cases of typhoid fever was notified in Singapore from 1980–9. The morbidity rates of indigenous cases showed a steady decline from 5.9 per 100000 population in 1980 to 1.2 per 100000 population in 1989. The mean case fatality was 0.8%. Children, adolescents and young adults were most susceptible to typhoid fever. There was no significant difference in morbidity rates between the major ethnic groups. The vast majority of indigenous cases were sporadic while outbreaks accounted for almost one third of them. Food was the main vehicle of transmission. The commonest indigenous phage types were B1, D1 and A. Antimicrobial resistance was infrequently seen. The proportion of imported cases rose from 32% in 1980 to 72% in 1989. Almost half (48.5%) of all imported cases were local residents who contracted typhoid fever while travelling in endemic countries. As imported cases assume greater importance in the epidemiology of typhoid fever in Singapore, further drop in typhoid fever incidence would require reduction of travel-related cases through greater awareness of food hygiene and effective vaccination.

Type
Research Article
Information
Epidemiology & Infection , Volume 110 , Issue 1 , February 1993 , pp. 63 - 70
Copyright
Copyright © Cambridge University Press 1993

References

REFERENCES

1.Cvjetanovie, B. Typhoid fever and its prevention. Pub Hlth Rev 1973; 2: 230–43.Google Scholar
2.Rice, PA. Baine, WB, Gangarose, EJ. Salmonella typhi infections in the United States. 1967–1972: increasing importance of international travellers. Am J Epidemiol 1977; 106: 160–6.CrossRefGoogle Scholar
3.Ryan, CA, Hargrett, BNT. Blake, PA. Salmonella typhi infections in the United States. 1975–1984: increasing role of foreign travel. Rev Infect Dis 1989; 11: 1–8.CrossRefGoogle ScholarPubMed
4. Seamic. Seamic Health Statistics 1986. International Medical Foundation of Japan 1987: 48.Google Scholar
5.Sharp, JCM. Heymann, CS. Enteric fever in Scotland. 1967–1974. J Hyg 1976; 76: 83–9.CrossRefGoogle ScholarPubMed
6.Public Health Laboratory Service Standing Sub-Committee on Bacteriological Examination of water Supplies. Waterborne infections disease in Britain. J Hyg 1978; 81: 139–49.Google Scholar
7.Levine, MM. Black, RE, Lanata, C. Chilean Typhoid Committee. Precise estimation of the numbers of chronic carriers of Salmonella typhi in Santiago, Chile, an endemic area. J Infect Dis 1982; 146: 724–6.CrossRefGoogle Scholar
8.Somerville, PC, Notelovitz, J, Alberts, M. Typhoid fever in the Northern Transvaal national states. An approach to an epidemiological quandry. S Afr Med J 1981; 60: 491–5.Google Scholar
9.Ng, SY. Leong, KW. Typhoid fever in Singapore. Proceedings of the Alumni Association, Malaya 1955; 8: 183–9.Google Scholar
10.Koh, TS. Goh, KT. Enteric fever surveillance in Singapore. Sing Med J 1976; 17: 32–7.Google ScholarPubMed
11.Goh, KT. Enteric infections in Singapore with special reference to typhoid. Southeast Asian J Trop Med Pub Hlth 1978; 9: 433–8.Google ScholarPubMed
12.Committee on Epidemic Diseases. Epidemiology of typhoid fever in Singapore 1980–1989.Epidemiol News Bull 1990; 16: 3–5.Google Scholar
13.Cragie, J. Felix, A. Typing of typhoid bacilli with Vi bacteriophage. Lancet 1947; i: 823–7.CrossRefGoogle Scholar
14.Anderson, ES, Williams, REO. Bacteriophage typing of enteric pathogens and staphylococci and its use in epidemiology. J Clin Pathol 1956; 9: 94–127.CrossRefGoogle ScholarPubMed
15.Bauer, AW, Kirby, WMM, Sherris, JC, Turck, M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45: 493–6.CrossRefGoogle ScholarPubMed
16. Singapore, Ministry of the Environment. Annual report of Ministry of the Environment. 1976–1990.Google Scholar
17. Singapore, Ministry of Culture. Singapore, 1984.Google Scholar
18.Cvjetanovic, B. Control of enteric fever. Sing Med J 1976; 17; 38–9.Google ScholarPubMed
19.Moore, B, Perry, EL, Chard, ST. A survey by the sewage swab method of latent enteric infection in an urban area. J Hyg 1952; 50: 137–56.CrossRefGoogle Scholar
20.Shinohara, N, Tanaka, H, Saito, T, et al. Detection of carriers of typhoid bacilli by sewerage-tracing surveillance in Matsuyama City. Jpn J Med Sci Biol 1981; 34: 385–92.CrossRefGoogle ScholarPubMed
21.Christie, AB. Typhoid and paratyphoid fevers. In: Christie, AB, ed. Infections diseases: epidemiology and clinical practice, 3rd edn. Edinburgh: Churchill Livingston. 1980: 47–102.Google Scholar
22.Gilman, RH, Islam, S, Rabbani, H, Ghosh, H. Identification of gallbladder typhoid carriers by a string device. Lancet 1979; i: 795–6.CrossRefGoogle Scholar
23.Nolan, CM. White, PC Jr. Vi serology in the detection of typhoid carriers. Lancet 1981; i: 583–4.CrossRefGoogle Scholar
24.Chau, PY, Tsang, RSW. Vi serology in screening of typhoid carriers: improved specificity by detection of Vi antibodies by counterimmunophoresis. J Hyg 1982; 89: 261–7.CrossRefGoogle Scholar
25.Engleberg, NC, Barrett, TJ, Fisher, H, et al. Identification of a carrier by using Vi enzyme-linked immunosorbent assay serology in an outbreak of typhoid fever on an Indian reservation. J Clin Microbiol 1983; 18: 1320–2.CrossRefGoogle Scholar
26.Lanata, CF, Ristori, C, Jimenez, L, et al. Vi serology indetection of chronic Salmonella typhi carriers in an endemic area. Lancet 1983; ii: 441–3.CrossRefGoogle Scholar
27.Losonsky, GA, Ferreccio, C, Kotloff, KL, Kaintuck, S, Robbins, JB, Levine, MM. Development and evaluation of an enzyme-linked immunosorbent assay for serum Vi antibodies for detection of chronic Salmonella typhi carriers. J Clin Microbiol 1987; 25: 2266–8.CrossRefGoogle ScholarPubMed
28.Lin, FYC, Becke, JM, Groves, C, et al. Restaurant-associated outbreak of typhoid fever in Maryland: identification of carrier facilitated by measurement of serum Vi antibodies. J Clin Microbiol 1988; 26: 1194–6.CrossRefGoogle ScholarPubMed
29.Lam, S, Goh, KT. Vi phage types in Singapore. Sing Med J 1978; 19: 3–8.Google ScholarPubMed
30.Jegathesan, M. Phage types of Salmonella typhi in Malaysia over the 10-year period 1970–1979. J Hyg 1983; 90: 91–7.CrossRefGoogle ScholarPubMed
31.Sanborn, WR, Vieu, JF, Komalarini, S, et al. Salmonellosis in Indonesia: phage type distribution of Salmonella typhi. J Hyg 1979; 82: 143–53.CrossRefGoogle ScholarPubMed
32.Colquhoun, J, Weetch, RS. Resistance to chloramphenicol developing during treatment of typhoid fever. Lancet 1950; ii: 621.CrossRefGoogle Scholar
33.Kontomichalou, P. Studies on resistance transfer factors. Pathol Microbiol 1967; 30: 71–93.Google ScholarPubMed
34.Sompolinsky, D, Ben-Yakov, M, Aboud, M, Bolbur, I. Transferable resistance factors with mutator effect in Salmonella typhi. Mutat Res 1967; 4: 119–27.CrossRefGoogle Scholar
35.Njoku-Obi, AN, Njoke-Obi, JC. Resistance of Salmonella typhosa to chloramphenicol. J Bacteriol 1965; 90: 552–3.CrossRefGoogle ScholarPubMed
36.Murti, B, Rajyalakshmi, K, Bhaskaran, CS. Resistance of Salmonella typhi to chloramphenicol. J Clin Pathol 1962; 15: 544–51.CrossRefGoogle ScholarPubMed
37.Paniker, CKJ, Vimala, KN. Transferable chloramphenicol resistance in Salmonella typhi. Nature 1972; 239: 109–10.CrossRefGoogle ScholarPubMed
38.Brown, JD, Mo, DH, Rhoades, ER. Chloramphenicol-resistant Salmonella typhi in Saigon. JAMA 1975; 231: 162–6.CrossRefGoogle ScholarPubMed
39.Lampe, RM, Mansuwan, P, Duangmani, C. Chloramphenicol-resistant typhoid. Lancet 1974; i: 623–4.CrossRefGoogle Scholar
40.Sanborn, WR, Lesmana, M, Dennis, DT. et al. Antibiotic-resistant typhoid in Indonesia. Lancet 1975; ii: 408–9.CrossRefGoogle Scholar
41.Jegathesan, M, Khor, SY. First isolates of chloramphenicol resistant S. typhi in Malaysia. Malaysia Med J 1980; 34: 395–7.Google ScholarPubMed
42.Yew, FS. Chew, SK, Goh, KT, Monteiro, EHA. Typhoid fever in Singapore: a review of 370 cases. J Trop Med Hyg 1991; 94: 352–7.Google Scholar
43. Center for Disease Control. Typhoid immunization: Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1990; 39 (RR-10): 1–5.Google Scholar
44.Levine, MM. Modern vaccines: enteric infections. Lancet 1990; 335: 958–61.CrossRefGoogle ScholarPubMed
45.Acharya, IL, Lowe, CU. Thapa, R. et al. Prevention of typhoid fever in Nepal with the Vi capsular polysaccharide of Salmonella typhi. N Eng J Med 1987; 317: 1101–4.CrossRefGoogle ScholarPubMed
46.Klugman, KP. Gilbertson, IT, Koornhof, HJ, et al. Protective activity of Vi capsular polysaccharide vaccine against typhoid fever. Lancet 1987; i: 1165–9.CrossRefGoogle Scholar
47.Wahdan, MH, Serie, C, Cerisier, Y, Sallam, S, Germanier, R. A controlled field trial of live Salmonella typhi strain Ty 21a oral vaccine against typhoid: three-year results. J Infect Dis 1982; 145: 292–5.CrossRefGoogle ScholarPubMed
48.Levine, MM. Ferreccio, C. Black, RE. et al. Large-scale field trial of Ty21a live oral typhoid vaccine in enteric-coated capsule formulation. Lancet 1987; i: 1049–52.CrossRefGoogle Scholar