War-associated cases of typhoid fever imported to Split-Dalmatia County (Croatia).
OBJECTIVE
The goal was to investigate the number and origin of typhoid fever cases in Split-Dalmatia County, Croatia, during the period of 1970-2005.


METHODS
Data from the medical records of typhoid fever cases treated at the University Hospital during the 35-year period were analyzed. Cases were defined as those in which Salmonella typhi was isolated from blood and/or stool. All isolates were tested for susceptibility to antimicrobial agents.


RESULTS
A total of 45 cases were identified. Forty-four patients originated from Bosnia and Herzegovina, and all of their isolates were susceptible to all antimicrobial agents tested. One patient from Pakistan was infected with multidrug-resistant S. typhi. No autochthonous case of typhoid fever was identified.


CONCLUSIONS
All cases of typhoid fever were acquired in countries where typhoid fever is endemic, and their importation to Croatia was the result of war-associated population movements. Increased awareness of health care workers regarding persons who originated from or have traveled to a typhoid-endemic area is needed. To avoid treatment failure, particular attention should be given to persons coming from regions with a known presence of multidrug-resistant S. typhi.
Punda-Polić
Volga
V
Department of Microbiology, Split University School of Medicine and Split University Hospital, 21000 Split, Croatia.
Kraljević
Katarina Sisko
KS
Bradarić
Nikola
N
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012485:Salmonella typhi / Q000302:isolation & purification*; D014435:Typhoid Fever / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014857:Warfare