Guidelines for the public health management of typhoid and paratyphoid in England. Practice guidelines from the National Typhoid and Paratyphoid Reference Group.

S. Balasegaram*, A. L. Potter, D. Grynszpan, S. Barlow, R. H. Behrens, L. Lighton, Linda Booth, L. Inamdar, K. Neal, K. Nye, J. Lawrence, J. Jones, I. Gray, D. Tolley, C. Lane, B. Adak, A. Cummins, S. Addiman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Objectives: The Typhoid and Paratyphoid Reference Group (TPRG) was convened by the Health Protection Agency (HPA) and the Chartered Institute of Environmental Health (CIEH) to revise guidelines for public health management of enteric fever. This paper presents the new guidelines for England and their rationale. Methods: Methods include literature reviews including grey literature such as audit data and case studies; analysis of enhanced surveillance data from England, Wales and Northern Ireland; review of clearance and screening schedules in use in other non-endemic areas; and expert consensus. Results: The evidence and principles underpinning the new guidance are summarised. Significant changes from previous guidance include: • Algorithms to guide risk assessment and management, based on risk group and travel history; • Outline of investigation of non-travel cases; • Simplified microbiological clearance schedules for cases and contacts; • Targeted co-traveller screening and a " warn and inform" approach for contacts; • Management of convalescent and chronic carriers. Conclusions: The guidelines were launched in February 2012. Feedback has been positive: the guidelines are reported to be clear, systematic, practical and risk-based. An evaluation of the guidelines is outlined and will add to the evidence base. There is potential for simplification and consistency between international guidelines.

Original languageEnglish
Pages (from-to)197-213
Number of pages17
JournalJournal of Infection
Volume65
Issue number3
DOIs
Publication statusPublished - Sep 2012

Bibliographical note

Funding Information:
• Full guidance document http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317132464189 • National “Warn and Inform” information (template letter and factsheet) http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1317132464469 • Enhanced Surveillance questionnaire (ESQ) http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1199451954499 • Teaching case studies http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1317132464469 Typhoid and Paratyphoid Reference Group membership Amelia Cummins Consultant in Communicable Disease Control, Essex HPU, HPA Amy Potter (Secretariat) Public Health Specialty Registrar, North East and North Central London Health Protection Unit (HPU)/South East Regional Epidemiology Unit, HPA Bob Adak Head of Gastrointestinal Infections, Gastrointestinal Emerging and Zoonotic Infections Department, HPA Chris Lane Head of Salmonella Surveillance, Gastrointestinal Emerging and Zoonotic Infections Department, HPA Dave Tolley Environmental Health Commercial and Corporate Health and Safety Service Manager, London Borough of Tower Hamlets Delphine Grynszpan (Secretariat) Consultant in Communicable Disease Control, North West London HPU, HPA Ian Gray Principal Policy Officer, Chartered Institute of Environmental Health Jane Jones Consultant Epidemiologist, Travel and Migrant Health Section, HPA Joanne Lawrence Surveillance Scientist, Travel and Migrant Health Section, HPA Kathy Nye Consultant Microbiologist and Clinical lead for Gastrointestinal infections for HPA Microbiology services, HPA Keith Neal Consultant in Health Protection, East Midlands HPU, HPA Leena Inamdar Consultant in Communicable Disease Control/Regional Epidemiologist, Yorkshire & the Humber HPU, HPA Linda Booth Consultant in Communicable Disease Control, Hampshire and Isle of Wight HPU, HPA Lorraine Lighton Consultant in Communicable Disease Control, Greater Manchester HPU, HPA Ron Behrens Tropical Medicine Consultant, London School of Hygiene and Tropical Medicine, & Hospital for Tropical Diseases Sarah Addiman (Secretariat) Nurse Consultant, North East and North Central London HPU, HPA Sooria Balasegaram (Chair) Regional Epidemiologist, South East Regional Epidemiology Unit, HPA Steve Barlow Team Leader, Food and Environmental Safety, Wolverhampton City Council

Keywords

  • Enteric fever
  • Guidelines
  • Paratyphoid
  • Typhoid

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