Although the incidence of typhoid fever in the United States is steadily decreasing, urban outbreaks may still occur and present formidable problems in public health and clinical management. The clinical manifestations of typhoid, particularly in children, are protean and misdiagnosis is common. A recent outbreak of typhoid fever occurred in Atlanta. The cases were limited to three households in a single neighborhood. Fourteen children were stricken, with one death and one classical typhoid relapse. The diagnosis was readily confirmed by culture of blood and feces in each case. The presence of a missed case in an adult preparing food in one of the households was thought to have been the principal cause of the outbreak.
Collins RN, Marine WM, Nahmias AJ. The 1964 Epidemic of Typhoid Fever in AtlantaClinical and Epidemiologic Observations. JAMA. 1966;197(3):179–184. doi:10.1001/jama.1966.03110030073028
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