BACKGROUND: Typhoid fever incidence in Spain, and particularly in Catalonia has decreased significantly since 1985. Water borne outbreaks can affect large numbers of people. These two reasons make specially interesting to study all suspected typhoid fever outbreaks, like the one that happened in March 1994 in Bages county (Barcelona). METHODS: Epidemiological questionnaires were conducted to investigate the origin of the outbreak, the presence of related cases in the same area, and the household contacts of cases S. typhi isolates were characterized by serotyping, biotyping, phage-typing, ribotyping and pulsed field gel electrophoresis analysis of DNA. RESULTS: Nine cases were identified. All cases were treated with antibiotics, with clinical success. There were not secondary cases. The possible origin was a drinking fountain. All the strains had the same epidemiological marker patterns. CONCLUSIONS: Breaking of the sewer pipes near to the drinking fountain was probably the origin of the contamination. It can be concluded the importance of keeping a good epidemiological control system to investigate and prevent outbreaks. It is also important to control the drinking fountains to prevent its contamination. Finally it is necessary to highlight the utility of epidemiological markers to fully characterized the involved strains.
BACKGROUND:Typhoid fever incidence in Spain, and particularly in Catalonia has decreased significantly since 1985. Water borne outbreaks can affect large numbers of people. These two reasons make specially interesting to study all suspected typhoid fever outbreaks, like the one that happened in March 1994 in Bages county (Barcelona). METHODS: Epidemiological questionnaires were conducted to investigate the origin of the outbreak, the presence of related cases in the same area, and the household contacts of cases S. typhi isolates were characterized by serotyping, biotyping, phage-typing, ribotyping and pulsed field gel electrophoresis analysis of DNA. RESULTS: Nine cases were identified. All cases were treated with antibiotics, with clinical success. There were not secondary cases. The possible origin was a drinking fountain. All the strains had the same epidemiological marker patterns. CONCLUSIONS: Breaking of the sewer pipes near to the drinking fountain was probably the origin of the contamination. It can be concluded the importance of keeping a good epidemiological control system to investigate and prevent outbreaks. It is also important to control the drinking fountains to prevent its contamination. Finally it is necessary to highlight the utility of epidemiological markers to fully characterized the involved strains.