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Low and declining attack rates of imported typhoid fever in the Netherlands 1997-2014, in spite of a restricted vaccination policy.
BMC Infect Dis. 2016 12 01; 16(1):731.BI

Abstract

BACKGROUND

Typhoid fever mainly occurs in (sub) tropical regions where sanitary conditions remain poor. In other regions it occurs mainly among returning travelers or their direct contacts. The aim of this study was to evaluate the current Dutch guidelines for typhoid vaccination.

METHOD

Crude annual attack rates (AR) per 100,000 Dutch travelers were calculated during the period 1997 to 2014 by dividing the number of typhoid fever cases by the estimated total number of travelers to a specific country or region. Regions of exposure and possible risk factors were evaluated.

RESULTS

During the study period 607 cases of typhoid fever were reported. Most cases were imported from Asia (60%). Almost half of the cases were ethnically related to typhoid risk regions and 37% were cases visiting friends and relatives. The overall ARs for travelers to all regions declined significantly. Countries with the highest ARs were India (29 per 100,000), Indonesia (8 per 100,000), and Morocco (10 per 100,000). There was a significant decline in ARs among travelers to popular travel destinations such as Morocco, Turkey, and Indonesia. ARs among travelers to intermediate-risk areas according to the Dutch guidelines such as Latin America or Sub-Saharan Africa remained very low, despite the restricted vaccination policy for these areas compared to many other guidelines.

CONCLUSION

The overall AR of typhoid fever among travelers returning to the Netherlands is very low and has declined in the past 20 years. The Dutch vaccination policy not to vaccinate short-term travelers to Latin-America, Sub-Saharan Africa, Thailand and Malaysia seems to be justified, because the ARs for these destinations remain very low. These results suggest that further restriction of the Dutch vaccination policy is justified.

Authors+Show Affiliations

Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. fsuryapranata@ggd.amsterdam.nl. National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands. fsuryapranata@ggd.amsterdam.nl.Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.Department of Infectious Diseases, Public Health Service (GGD) of Amsterdam, Nieuwe Achtergracht 100, PO Box 2200, 1000 CE, Amsterdam, The Netherlands. National Coordination Centre for Travellers' Health Advice (LCR), Nieuwe Achtergracht 100, PO Box 1008, 1000 BA, Amsterdam, The Netherlands. Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27905890

Citation

Suryapranata, F S T., et al. "Low and Declining Attack Rates of Imported Typhoid Fever in the Netherlands 1997-2014, in Spite of a Restricted Vaccination Policy." BMC Infectious Diseases, vol. 16, no. 1, 2016, p. 731.
Suryapranata FS, Prins M, Sonder GJ. Low and declining attack rates of imported typhoid fever in the Netherlands 1997-2014, in spite of a restricted vaccination policy. BMC Infect Dis. 2016;16(1):731.
Suryapranata, F. S., Prins, M., & Sonder, G. J. (2016). Low and declining attack rates of imported typhoid fever in the Netherlands 1997-2014, in spite of a restricted vaccination policy. BMC Infectious Diseases, 16(1), 731.
Suryapranata FS, Prins M, Sonder GJ. Low and Declining Attack Rates of Imported Typhoid Fever in the Netherlands 1997-2014, in Spite of a Restricted Vaccination Policy. BMC Infect Dis. 2016 12 1;16(1):731. PubMed PMID: 27905890.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low and declining attack rates of imported typhoid fever in the Netherlands 1997-2014, in spite of a restricted vaccination policy. AU - Suryapranata,F S T, AU - Prins,M, AU - Sonder,G J B, Y1 - 2016/12/01/ PY - 2016/08/30/received PY - 2016/11/22/accepted PY - 2016/12/2/entrez PY - 2016/12/3/pubmed PY - 2017/6/21/medline KW - Epidemiology KW - Guidelines KW - Travel KW - Typhoid fever KW - Vaccination SP - 731 EP - 731 JF - BMC infectious diseases JO - BMC Infect Dis VL - 16 IS - 1 N2 - BACKGROUND: Typhoid fever mainly occurs in (sub) tropical regions where sanitary conditions remain poor. In other regions it occurs mainly among returning travelers or their direct contacts. The aim of this study was to evaluate the current Dutch guidelines for typhoid vaccination. METHOD: Crude annual attack rates (AR) per 100,000 Dutch travelers were calculated during the period 1997 to 2014 by dividing the number of typhoid fever cases by the estimated total number of travelers to a specific country or region. Regions of exposure and possible risk factors were evaluated. RESULTS: During the study period 607 cases of typhoid fever were reported. Most cases were imported from Asia (60%). Almost half of the cases were ethnically related to typhoid risk regions and 37% were cases visiting friends and relatives. The overall ARs for travelers to all regions declined significantly. Countries with the highest ARs were India (29 per 100,000), Indonesia (8 per 100,000), and Morocco (10 per 100,000). There was a significant decline in ARs among travelers to popular travel destinations such as Morocco, Turkey, and Indonesia. ARs among travelers to intermediate-risk areas according to the Dutch guidelines such as Latin America or Sub-Saharan Africa remained very low, despite the restricted vaccination policy for these areas compared to many other guidelines. CONCLUSION: The overall AR of typhoid fever among travelers returning to the Netherlands is very low and has declined in the past 20 years. The Dutch vaccination policy not to vaccinate short-term travelers to Latin-America, Sub-Saharan Africa, Thailand and Malaysia seems to be justified, because the ARs for these destinations remain very low. These results suggest that further restriction of the Dutch vaccination policy is justified. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/27905890/Low_and_declining_attack_rates_of_imported_typhoid_fever_in_the_Netherlands_1997_2014_in_spite_of_a_restricted_vaccination_policy_ DB - PRIME DP - Unbound Medicine ER -