Managing presumptive Paratyphoid B to minimise harm from unnecessary exclusion from child care or work
PHE ePoster Library. Leung W. Sep 12, 2019; 274539; 94
Ms. Wendy Leung
Ms. Wendy Leung
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Abstract MethodWe reviewed a case of presumptive Paratyphoid B where exclusion of a child from child care was causing distress to two working parents with no alternative arrangements.We examined HPZone entries from April 2010 – 7 November 2018 to identify cases reported locally as presumptive paratyphoid B looking at case records of Paratyphoid, Salmonella java and Salmonella unnamed.
There were 93 cases of Paratyphoid Fever (Paratyphoid A 34; Paratyphoid B 0; Paratyphoid not classified 59). Of 59 non-classified Paratyphoid, eight were Paratyphoid B.Of the Paratyphoid B three were confirmed and five were discarded.From 113 cases of Salmonella java 19 were reported locally as presumptive Paratyphoid B. Three out of 133 unnamed Salmonella were locally reported as Paratyphoid B.3/30 (10%) presumptive Paratyphoid B cases were confirmed. All of these were isolated from blood culture. Only one of the 27 discarded cases had a blood specimen.Two discarded cases were lost to follow up and the remaining 25 were followed up by the Health Protection Team (normally with the enhanced questionnaire). In three cases, two under 5s and one food handler, exclusions from nursery or work was advised pending stool clearance.
Only 10% of presumptive Paratyphoid B cases are confirmed, in this case all were blood isolates. While precautionary enquiries are justified, exclusions from work or school should be minimised.We recommend following national guidance that Health Protection Teams ensure rapid processing of specimens through the reference laboratory to identify paratyphoid B cases. External funding details None
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