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Peer reviewedOpen accessParatyphoid fever

A Large Outbreak of Salmonella Paratyphi A Infection Among Israeli Travelers To Nepal

Clinical Infectious Diseases·

E. Meltzer, S. Stienlauf, E. Leshem, Y. Sidi, E. Schwartz

DOI
10.1093/cid/cit723
PMID
24198224
PMCID
OpenAlex
W2149640495
Study type
Outbreak investigation
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

The outbreak highlights the risk of paratyphoid fever among travelers to endemic areas in Asia and suggests that combination antibiotic therapy may improve clinical outcomes. The point-source nature and nalidixic acid resistance pattern have implications for travel medicine and outbreak response.

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Structured evidence summary

Research question

The study investigated an outbreak of Salmonella Paratyphi A infection among Israeli travelers returning from Nepal during October–November 2009.

Study design

This was an outbreak investigation using standardized exposure questionnaires, medical chart review, antimicrobial susceptibility testing, and pulsed-field gel electrophoresis typing of isolates.

Population and setting

The study included 37 Israeli travelers who returned from Nepal and were diagnosed with S. Paratyphi A bacteremia between 1 October and 30 November 2009.

Main findings

All 37 case isolates showed an identical PFGE pattern and were nalidixic acid resistant. All cases reported exposure to one common food venue, with peak exposures around the Jewish New Year. Patients treated with combination ceftriaxone-azithromycin defervesced in 3.2 days compared to 6.6 days for ceftriaxone monotherapy.

Public-health relevance

The outbreak highlights the risk of paratyphoid fever among travelers to endemic areas in Asia and suggests that combination antibiotic therapy may improve clinical outcomes. The point-source nature and nalidixic acid resistance pattern have implications for travel medicine and outbreak response.

Important limitations

This summary is based solely on the supplied abstract and metadata. Full assessment of study limitations, including potential biases in outbreak investigation methods, completeness of exposure ascertainment, and comparative treatment effect estimates, requires review of the original article.

GIDS interpretation

This article is discoverable through GIDS classifiers for paratyphoid fever, Nepal, Israel, outbreak investigation, travel medicine, and treatment. The content describes a completed 2009 outbreak investigation and does not represent ongoing surveillance data.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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