Abstract
The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations.
Highlights
Enteric fever is a systemic, human-restricted infection caused predominantly by Salmonella enterica serovars typhi (S. typhi) and Paratyphi A (S. paratyphi A), resulting in typhoid and paratyphoid fevers, respectively (Parry et al 2002; Basnyat 2005)
Available clinical and laboratory-confirmed surveillance data suggest that Fiji experiences a peak of typhoid cases between January and June annually, corresponding approximately with the peak of the rainy season that extends from November to April (WHO/FMOH/UNDP 2011; Scobie et al 2014)
Typhoid appears to be a considerable problem in Fiji, basic epidemiological data are limited
Summary
Enteric fever is a systemic, human-restricted infection caused predominantly by Salmonella enterica serovars typhi (S. typhi) and Paratyphi A (S. paratyphi A), resulting in typhoid and paratyphoid fevers, respectively (Parry et al 2002; Basnyat 2005). Prior to 2005, the incidence of reported culture-confirmed cases of typhoid was generally
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