Outbreak of typhoid fever in vaccinated members of the French Armed Forcesin the Ivory Coast

• DOI: 10.1007/s10654-005-7454-6
• Publication Date: 2005-07-12T18:58:09Z
• Authors: Rémy Michel; Eric Garnotel; André Spiegel; Marc Morillon; Pierre Saliou; Jean-Paul Boutin
• Keywords: Adult; Male; Typhoid-Paratyphoid Vaccines; Food Contamination; Middle Aged; Salmonella typhi; 16. Peace & justice; Disease Outbreaks; 3. Good health; Cohort Studies; Feces; 03 medical and health sciences; Cote d'Ivoire; Military Personnel; 0302 clinical medicine; Risk Factors; Surveys and Questionnaires; Food Microbiology; Humans; Salmonella Food Poisoning; France; Cucumis sativus; Typhoid Fever

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.