Clinico-epidemiological study of an outbreak of typhoid in North India

INTRODUCTION: Typhoid fever is endemic in India. There have been various outbreaks of typhoid fever reported from different parts of India. Considering the outbreak potential of typhoid, the present study was undertaken wherein an outbreak of typhoid occurred in a city in northern India. METHODOLOGY: The study design used was a cross-sectional descriptive study. Detailed information was obtained from each reported case. Active case finding surveys were conducted. Case definitions for suspect, probable, and confirmed case taken for our study, have already been validated by the World health organisation (WHO). All patients were subjected to requisite investigations. A sanitary survey was carried out to locate defects in water supply and sewage disposal. Record of bacteriological survey of water samples from the area was scrutinized. Descriptive epidemiology of cases was carried out. RESULTS: Attack rate was 16.1% and 17.4% among men and women, respectively. Fever was present in 52 (69.3%) cases. The epidemic curve displayed a sudden peak and an abrupt fall of cases. This is suggestive of a common point source outbreak. There were no fatalities. Sanitary survey teams found a sewage leak in the locality where maximum cases were reported. Lab reports tested positive for salmonella species in water. The outbreak was promptly controlled after repair of the leaking sewage pipeline; and provision of alternative source of water supply. CONCLUSION: This study reemphasises the requirement of a basic public health measure and infrastructure, that is, water quality monitoring by concerned authorities to break the chain of transmission of typhoid fever.