British infection association guidelines for the diagnosis and management of enteric fever in England

L. E. Nabarro, N. McCann, M. T. Herdman, C. Dugan, S. Ladhani, D. Patel, S. Morris-Jones, S. Balasegaram, R. S. Heyderman, M. Brown, C. M. Parry, G. Godbole*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Enteric fever (EF) is an infection caused by the bacteria called Salmonella Typhi or Paratyphi. Infection is acquired through swallowing contaminated food or water. Most EF in England occurs in people returning from South Asia and other places where EF is common; catching EF in England is rare. The main symptom is fever, but stomach pain, diarrhoea, muscle aches, rash and other symptoms may occur. EF is diagnosed by culturing the bacteria from blood and/or stool in a microbiology laboratory. 

EF usually responds well to antibiotic treatment. Depending on how unwell the individual is, antibiotics may be administered by mouth or by injection. Over the past several years, there has been an overall increase in resistance to antibiotics used to treat enteric fever, in all endemic areas. Additionally, since 2016, there has been an ongoing outbreak of drug-resistant EF in Pakistan. This infection is called extensively drug-resistant, or XDR, EF and only responds to a limited number of antibiotics. 

Occasionally individuals develop complications of EF including confusion, bleeding, a hole in the gut or an infection of the bones or elsewhere. Some people may continue to carry the bacteria in their stool for a longtime following treatment for the initial illness. These people may need treatment with a longer course of antibiotics to eradicate infection. 

Travellers can reduce their risk of acquiring EF by following safe food and water practices and by receiving the vaccine at least a few weeks before travel. 

These guidelines aim to help doctors do the correct tests and treat patients for enteric fever in England but may also be useful to doctors and public health professionals in other similar countries.

Original languageEnglish
Pages (from-to)469-489
Number of pages21
JournalJournal of Infection
Volume84
Issue number4
Early online date14 Jan 2022
DOIs
Publication statusPublished - 8 Apr 2022

Bibliographical note

Funding Information: No funding information.

Open Access: Free-to-read, but no Open Access licence.

Publisher Copyright: Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The British Infection Association. All rights reserved.

Citation: L.E. Nabarro, N. McCann, M.T. Herdman, C. Dugan, S. Ladhani, D. Patel, S. Morris-Jones, S. Balasegaram, R.S. Heyderman, M. Brown, C.M. Parry, G. Godbole, British Infection Association guidelines for the diagnosis and management of enteric fever in England, Journal of Infection, Volume 84, Issue 4, 2022, Pages 469-489, ISSN 0163-4453,

DOI: https://doi.org/10.1016/j.jinf.2022.01.014.

Fingerprint

Dive into the research topics of 'British infection association guidelines for the diagnosis and management of enteric fever in England'. Together they form a unique fingerprint.

Cite this