Typhoid fever and childhood vaccine strategies.

ABSTRACT

PIP This article reports findings on the true incidence of typhoid fever in a poor area of Delhi, India. Anju Sinha and colleagues did a prospective study among 8172 patients over a 1-year period. The study detected 63 cases of typhoid fever, 44% of which were in children under 5 years old. The analysis revealed that children under age 5 had a three-fold increase in culture-positive typhoid fever compared with 5-19 year olds. These findings--prospectively acquired clinical and microbiological data correlated with carefully controlled epidemiological data--confound the common view that typhoid fever occurs principally in schoolchildren and young adults. The researchers noted that their findings have relevance to the urban area they studied and may not be generally applicable. On the other hand, the idea that typhoid vaccine might be introduced into the pediatric vaccination schedule raises concerns on the route and efficacy of available vaccines and the difficulty of introducing a vaccine into pediatric schedules.^ieng