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Source: http://www.canada.com/topics/news/national/story.html?id=7bb18e1a-f907-48dc-b753-09faf9365f9f
Typhoid fever on track to break B.C. record
Pamela Fayerman , Canwest News Service
Published: Monday, May 26
VANCOUVER - Typhoid and paratyphoid fever cases in B.C. are on pace to shatter all previous incidence rates of the past several years as 44 cases of both have already been diagnosed so far this year, nearly all in the Fraser health region among Indo-Canadians who have visited family and friends in India.
"In view of the increased number of cases of Salmonella typhoid infections in B.C., we strongly recommend travellers to endemic countries such as India get vaccinated prior to travel and avoid drinking untreated water or eating uncooked, unpeeled foods while there," said Dr. Eleni Galanis, a physician epidemiologist at the B.C. Centre for Disease Control.
"No one has long-term immunity to this disease but it is preventable through such simple precautions."
In the Fraser health region, which has B.C.'s highest population of Indo-Canadians, typhoid rates have increased threefold since 2000. More than 80 per cent of cases are connected with travel to India, especially to the Punjab state.
"We've definitely seen an increase in these infections and we're concerned about that because it is a preventable disease. But we are unclear as to whether the increase is due to an increase in the travelling population or to people going to more high-risk areas or even whether the risk in the destinations is increasing," said Galanis.
Typhoid fever (Salmonella typhi) and Paratyphoid (Salmonella paratyphi) are potentially fatal diseases caused by bacteria that multiply in the gut and gallbladder after an individual has ingested contaminated (by human waste) food or water. The Public Health Agency of Canada says that 16 per cent of those who get Typhoid fever die if antibiotic treatment is not given but fatality rates are reduced to one per cent with the correct therapy.
However, of increasing concern to doctors is that some strains are becoming resistant to commonly used antibiotics, especially for those infections acquired on the Indian subcontinent.
Typhoid fever is different from other salmonella infections because it infects only humans. The greatest risk of acquiring the disease is exposure to food and water from market stalls, street vendors, and home-based restaurants according to the Public Health Agency.
In the past five and a half years, B.C. has recorded nearly 400 cases of both but it is not known how many cases resulted in death.
There is a $40 injectable vaccine or tablets. But the vaccine and pills can only be used to protect against typhoid fever, not against the less serious paratyphoid fever. Protection varies with different vaccines but immunity, generally, does not persist beyond two to four years.
People can acquire either of these infections by travelling overseas in such developing countries as Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan and Sri Lanka but most B.C. cases are in people who have travelled to India, said Galanis.
"People from those countries may have had immunity but once they live here, they will lose any immunity they had in as quickly as a few months," she said, adding that children born in Canada who visit the Indian subcontinent have no natural protection.
The Fraser health region is trying to counter misconceptions about immunity and target prevention messages to the audience most affected so public health advertising is being done in various languages and in various mediums.
Jason Stone, a communicable disease practitioner with the Fraser Health Authority, said travellers should book an appointment with a travel medicine clinic as soon as they know they will be travelling.
Galanis said some research has been done to see whether travel agents are effective tools at conveying the vaccine message but it was inconclusive as to whether they are a good conduit of information.
"I think the outcome of that research was that there was a barrier because it is one more thing travel agents are being asked to do that they are not paid to do," she said.
While typhoid fever is transmissible, the so called "secondary attack" rates in B.C. are small as evidence shows that almost all cases are acquired by travellers. When the infections are diagnosed in food workers, day care employees and health care workers, patients are told not to go to work until their antibiotic treatment is effective to the point that three stool samples are tested as negative. Symptoms of the infections include fever, headache, appetite loss, slowed heartbeat, enlarged spleen, and spots on the skin.
? Vancouver Sun 2008
Typhoid fever on track to break B.C. record
Pamela Fayerman , Canwest News Service
Published: Monday, May 26
VANCOUVER - Typhoid and paratyphoid fever cases in B.C. are on pace to shatter all previous incidence rates of the past several years as 44 cases of both have already been diagnosed so far this year, nearly all in the Fraser health region among Indo-Canadians who have visited family and friends in India.
"In view of the increased number of cases of Salmonella typhoid infections in B.C., we strongly recommend travellers to endemic countries such as India get vaccinated prior to travel and avoid drinking untreated water or eating uncooked, unpeeled foods while there," said Dr. Eleni Galanis, a physician epidemiologist at the B.C. Centre for Disease Control.
"No one has long-term immunity to this disease but it is preventable through such simple precautions."
In the Fraser health region, which has B.C.'s highest population of Indo-Canadians, typhoid rates have increased threefold since 2000. More than 80 per cent of cases are connected with travel to India, especially to the Punjab state.
"We've definitely seen an increase in these infections and we're concerned about that because it is a preventable disease. But we are unclear as to whether the increase is due to an increase in the travelling population or to people going to more high-risk areas or even whether the risk in the destinations is increasing," said Galanis.
Typhoid fever (Salmonella typhi) and Paratyphoid (Salmonella paratyphi) are potentially fatal diseases caused by bacteria that multiply in the gut and gallbladder after an individual has ingested contaminated (by human waste) food or water. The Public Health Agency of Canada says that 16 per cent of those who get Typhoid fever die if antibiotic treatment is not given but fatality rates are reduced to one per cent with the correct therapy.
However, of increasing concern to doctors is that some strains are becoming resistant to commonly used antibiotics, especially for those infections acquired on the Indian subcontinent.
Typhoid fever is different from other salmonella infections because it infects only humans. The greatest risk of acquiring the disease is exposure to food and water from market stalls, street vendors, and home-based restaurants according to the Public Health Agency.
In the past five and a half years, B.C. has recorded nearly 400 cases of both but it is not known how many cases resulted in death.
There is a $40 injectable vaccine or tablets. But the vaccine and pills can only be used to protect against typhoid fever, not against the less serious paratyphoid fever. Protection varies with different vaccines but immunity, generally, does not persist beyond two to four years.
People can acquire either of these infections by travelling overseas in such developing countries as Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan and Sri Lanka but most B.C. cases are in people who have travelled to India, said Galanis.
"People from those countries may have had immunity but once they live here, they will lose any immunity they had in as quickly as a few months," she said, adding that children born in Canada who visit the Indian subcontinent have no natural protection.
The Fraser health region is trying to counter misconceptions about immunity and target prevention messages to the audience most affected so public health advertising is being done in various languages and in various mediums.
Jason Stone, a communicable disease practitioner with the Fraser Health Authority, said travellers should book an appointment with a travel medicine clinic as soon as they know they will be travelling.
Galanis said some research has been done to see whether travel agents are effective tools at conveying the vaccine message but it was inconclusive as to whether they are a good conduit of information.
"I think the outcome of that research was that there was a barrier because it is one more thing travel agents are being asked to do that they are not paid to do," she said.
While typhoid fever is transmissible, the so called "secondary attack" rates in B.C. are small as evidence shows that almost all cases are acquired by travellers. When the infections are diagnosed in food workers, day care employees and health care workers, patients are told not to go to work until their antibiotic treatment is effective to the point that three stool samples are tested as negative. Symptoms of the infections include fever, headache, appetite loss, slowed heartbeat, enlarged spleen, and spots on the skin.
? Vancouver Sun 2008