title: Outbreak of typhoid fever in vaccinated members of the French Armed Forces in the Ivory Coast.
abstract: In 2001, an outbreak of typhoid fever occurred among the members of the French Armed Forces. All had received a typhoid vaccination as per the immunization schedule practiced in the Armed Forces (every 5 years). A retrospective cohort study was conducted in 94 personnel. The objectives were to confirm the diagnosis, determine the source of contamination and identify the factors associated with defective vaccinal efficacy. Twenty-four cases were clinically identified. A cucumber salad was identified as the contaminating dish (Risk Ratio = 3.6; 95%CI 1.5-8.9). Only one factor was related to defective vaccinal efficacy; the risk of typhoid fever was two-fold higher in people vaccinated more than 3 years previously (Risk Ratio = 2.2; 95%CI, 1.1-4.2). Compliance with food hygiene rules could have prevented 24 cases of typhoid fever. Nevertheless, repeat vaccination against typhoid fever is now conducted every 3 years in the French Forces, in compliance with the manufacturers' recommendations.
authors.affiliation: Départment d'épidémiologie et de santé publique, Institut de Médecine Tropicale du Service de Santé des Armées, Marseille, France. imtssa.ure@wanadoo.fr
authors.forename: Rémy
authors.initials: R
authors.lastname: Michel
authors.forename: Eric
authors.initials: E
authors.lastname: Garnotel
authors.forename: André
authors.initials: A
authors.lastname: Spiegel
authors.forename: Marc
authors.initials: M
authors.lastname: Morillon
authors.forename: Pierre
authors.initials: P
authors.lastname: Saliou
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Boutin
mesh_terms: D000328:Adult; D015331:Cohort Studies; D007560:Cote d'Ivoire / Q000453:epidemiology; D018553:Cucumis sativus / Q000382:microbiology; D004196:Disease Outbreaks; D005243:Feces / Q000382:microbiology; D005506:Food Contamination / Q000032:analysis; D005516:Food Microbiology; D005602:France / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D012307:Risk Factors; D012478:Salmonella Food Poisoning / Q000382:microbiology; D012485:Salmonella typhi / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D014435:Typhoid Fever / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D014436:Typhoid-Paratyphoid Vaccines / Q000008:administration & dosage / Q000276:immunology*
chemical_list: D014436:Typhoid-Paratyphoid Vaccines