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Stefan Hagmann, Murli Purswani, When to Suspect Typhoid Fever in Children When There Is No History of International Travel, Journal of Travel Medicine, Volume 16, Issue 6, 1 November 2009, Pages 442–443, https://doi.org/10.1111/j.1708-8305.2009.00367_1.x
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To the Editor‐in‐Chief:
Byers and Peterson state in their case discussion that in industrialized countries locally acquired cases of typhoid fever (TF) are commonly diagnosed in non‐citizen immigrants or occur through the consumption of imported contaminated food products. 1 They further emphasize the importance of eliciting a travel history among patients as well as family members when considering a diagnosis of TF. 1 However, we recently diagnosed two children with TF (due to Salmonella enterica serotype Typhi), who were US born. The diagnosis of TF was not entertained by the treating physicians because of the absent travel history and no sick contacts. There was also no indication of any unusual dietary habits, or consumption of any imported food, thus delay from onset of symptoms to diagnosis was 7 and 10 days, respectively. In case 1 the grandfather had frequently traveled between Bangladesh and New York but had denied any recent illness and might have been a chronic carrier of S. typhi, regardless of his recent travel activity. Up to 5% of individuals may continue to shed S. typhi for >1 year. 2 In case 2 none of the reported contacts in the family had traveled to their country of origin, the Ivory Coast, or reported a recent illness. Therefore, our experience illustrates that healthcare professionals taking care of children whose parents or grandparents have emigrated from TF endemic countries should include TF in the differential diagnosis even when there is no obvious travel activity in the examined child or among the family contacts.
