An evidence-based review of current guidelines for the public health control of typhoid in Australia: a case for simplification and resource savings.
BACKGROUND
Although an uncommon disease in Australia, public health control measures for typhoid remain important to prevent further cases, however, they are labour intensive.


METHODS
We reviewed current guidelines from all Australian states and territories, England and the United States to ascertain whether recommended control measures for typhoid are supported by evidence from the medical literature or data from Victorian typhoid notifications.


RESULTS
Guidelines lacked consistency and were overly complex, particularly with reference to the frequency and timing of faecal specimens required to demonstrate eradication of typhoid from cases and contacts. Data from the medical literature are limited and do not support the superiority of any one approach, or multiple approaches based on risk groups of cases or contacts. Victorian data suggest that a general approach, with a reduction in the number of specimens collected and duration of follow-up is reasonable.


CONCLUSIONS
Potential exists for simplification and improved consistency between guidelines for the public health control of typhoid, with associated resource savings.
Skull
S A
SA
Victorian Infectious Diseases Service, Royal Melbourne Hospital. saskull@unimelb.edu.au
Tallis
G
G
D000890:Anti-Infective Agents / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002353:Carrier State; D002939:Ciprofloxacin / Q000627:therapeutic use; D016358:Contact Tracing; D004739:England / Q000453:epidemiology; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic; D015980:Public Health Practice / Q000592:standards*; D014435:Typhoid Fever / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
D000890:Anti-Infective Agents; D002939:Ciprofloxacin