An outbreak of typhoid fever in the Middle East

Abstract

1. An outbreak of typhoid fever in a Royal Air Force camp in the Middle East is discussed.2. A total of 110 cases occurred of which 105 are analysed. The case-fatality rate was 10%.3. Of the 105 cases 59% gave a positive blood culture. The percentages of diagnostic isolations from stools and urine were small.4. Clearance tests of stools and urine showed that 8.4% of patients excretedSalm. typhiduring convalescence.5. Leucocyte counts during the first 2 weeks of the illness showed that only 30% of the patients had a count below 5000 per cu.mm.; 62% of these low figures were encountered in severe cases.6. Autopsies on seven fatal cases showed considerable variability in the macroscopic appearance of the intestinal lesions.7. Serological investigation confirmed that higher percentages of cases with low titres of O agglutinin were found in the severe and mild clinical groups, and that most O titres in the moderately severe cases exceeded 1:200.8. Of the patients 52% showed Vi titres exceeding 1:20 during convalescence.9. The significance of various findings is discussed.