7 March 2008

Clinical Update: Typhoid fever in the Philippines

Between 19 February and 3 March 2008, 1,041 cases of typhoid were reported in Calamba City, Laguna province; approximately 30 miles south of Manila [1]. Subsequent media reports have indicated that as many as 1,477 cases have occurred with 37 of them confirmed [2]. The outbreak follows a series of floods in the area. Increased surveillance has been initiated as has an information campaign about food and water hygiene.

Advice for Travellers

Typhoid fever, caused by Salmonella enterica serotype Typhi, is known to occur in the Philippines and is most commonly transmitted though contaminated water or food. Travellers who are at higher risk for infection include those visiting friends and relatives, young children, long-term travellers, and those exposed to conditions of poor sanitation. In 2006 approximately 95,000 UK residents travelled to the Philippines; 60% were visiting friends and relatives and 30% were on holiday [3].

Travellers should practice strict food, water and personal hygiene precautions. Typhoid vaccine should be given to travellers whose planned activities put them at higher risk, and should currently be considered for all travellers to the Calamba City area. Current vaccines against Salmonella Typhi are only 50-80% protective and do not protect against Salmonella Paratyphi, a related bacterium that causes a similar clinical syndrome to typhoid fever.

Additional travel health recommendations for the Philippines can be found on the NaTHNaC Country Information Page for this country.

References

1. Philippine Information Agency. PGMA acts on rising incidence of typhoid cases in 10 Calamba barangays, 4 March 2008. Accessed 7 March 2008. Available at: http://pia.gov.ph/?m=11&sec=archive&r=ALL&sp=2&fi=p080303

.htm&no=57

2. ProMED-mail. Typhoid fever update 2008 (04): Philippines, 5 March 2008. Accessed 7 March 2008. Available at: http://apex.oracle.com/pls/otn/f?p=2400:1202:81396618477193

9::NO::F2400_P1202_CHECK_DISPLAY,F2400_P1202_PUB_M

AIL_ID:X,71691   

3. Office for National Statistics. International Passenger Survey 2006.  

Links

NaTHNaC Health Information Sheet: Typhoid and Paratyphoid.