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Delaware Health Alert Network #77

June 22, 2004 4:20 pm

Health Advisory

The Delaware Division of Public Health (DPH) wishes to alert the Delaware medical community about a Salmonella typhi investigation now in progress.


On June 21, 2004, the Maryland Department of Health and Mental Hygiene informed DPH about a single case of Typhoid Fever in a child with a travel history to Delaware on May 27-31, 2004. While the source of the infection is presently unknown, the child had eaten at three Delaware restaurants. Gastrointestinal symptoms began on June 1, 2004 and the child was hospitalized in Maryland on June 10, 2004. Salmonella typhi was isolated by the Maryland Department of Health and Mental Hygiene.

Clinical Description:

An illness caused by Salmonella typhi is often characterized by insidious onset of sustained fever, headache, malaise, anorexia, relative bradycardia, constipation or diarrhea, and nonproductive cough. However, many mild and atypical infections occur.

Incubation Period:

The incubation period depends on the size of the infecting dose; from 3 days to 3 months with a usual range of 1-3 weeks.

Period of Communicability:

Variable. About 10% of untreated typhoid fever patients will discharge bacilli for 3 months after onset of symptoms and 2%-5% become permanent carriers.

Laboratory Criteria for Diagnosis:

Isolation of S. typhi from blood, stool or other clinical specimen.

Reporting of Suspect Cases:

To aid in the investigation, the Delaware Division of Public Health (DPH) requests that health care providers be suspicious of patients presenting with clinically compatible illness and report suspicious cases and laboratory confirmed Salmonella typhi infections to DPH, Bureau of Epidemiology at 1-888-295-5156 immediately. This number is available during normal business hours and during non-business hours for emergencies.

For Further Information:

Categories of Health Alert messages:

  • Health Alert: Conveys the highest level of importance; warrants immediate action or attention.
  • Health Advisory: Provides important information for a specific incident or situation; may not require immediate action.
  • Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.
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