A new look at typhoid vaccination: information for the practicing physician

Article Abstract:

Typhoid fever is a bacterial infection caused by Salmonella typhi, which is characterized by high fever, headache, delirium, cough, diarrhea, and a rash. It is transmitted through contaminated milk, water, or food, especially in areas where sanitation is poor. Among Americans, the greatest proportion of cases occur among those who have traveled to Peru, India, Pakistan, and Chile, with rates between 58 and 174 cases per million travelers. Other groups at risk include clinical microbiology laboratory workers and household contacts of typhoid carriers. Vaccination is recommended for all three groups. However, prevention of exposure is preferred because the vaccine is not completely effective in preventing the disease. A new oral live vaccine (Ty21a) is available that provides protection equivalent to the older injected version. Several large-scale trials have noted fewer adverse reactions are associated with the new vaccine, which is administered in four doses given over seven days. The recommendations of the Immunization Practices Advisory Committee, including contraindications, are outlined for both the older vaccine, and the new live-attenuated oral vaccine. Travelers should be aware that these vaccines are for typhoid only, and that proper hygienic precautions are still required to prevent other food- and water-borne illnesses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Innovations, Evaluation, Prevention, Typhoid vaccine, Typhoid vaccines

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Proponents gather to discuss practicing evidence-based medicine

Article Abstract:

Physicians discussed the need for evidence-based medicine at a 1997 conference sponsored by the Agency for Health Care Policy and Research (AHCPR). Evidence-based medicine means that medical treatments should not be used unless there is evidence that they are effective. This has been driven partly by cost control and also by the desire for good quality health care. The AHCPR has issued practice guidelines, many of which will be posted on the Internet. In addition, 12 evidence-based practice centers will be created in the US. These centers will also publish reports evaluating specific kinds of evidence.

Conferences, meetings and seminars, Practice, Medical care, Quality management, Medical care quality, Evidence-based medicine, Evidence, Scientific, Scientific evidence (Law)

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Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia

Article Abstract:

A community-based case study is conducted to determine risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. The findings indicate that public health policies for control of typhoid and paratyphoid fever in Jakarta should focus on hygiene education as well as monitoring of the street-food trade.

United States, Science & research, Research, Causes of, Paratyphoid fever

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