Typhoid epidemic in Hakkari - March 2007: evaluation of affected pediatric patients.

Objective: Salmonella typhi is a food and water-borne agent of a serious human disease, and it is transmitted by faecal-oral route. In the presence of inadequate infrastructure facilities; poor sanitation and health care; outbreaks of typhoid fever via contamination of drinking water were reported. In this study; pediatric cases of typhoid fever outbreak were reviewed in Hakkari and we also emphasized that typhoid fever is still a serious health problem in East and Southeast Anatolia region. Methods: In this article children who were diagnosed and treated for typhoid fever were reviewed. Totally 118 children who were admitted to Hakkari State Hospital and a private medical center, diagnosed as typhoid fever were included during the period between 5. and 30. of March 2007. The diagnosis of typhoid fever was based on the results of Gruber Widal agglutination tests. Results: Sixty eight patients were male (57.6%) and 50 were female (42.4%). Mean age was 8.4 years (10 months-17 years). Presenting symptoms in order of decreasing frequency were fever (100%), malaise (100%), headache (74%), abdominal pain (39.8%), vomiting (29.6%), diarrhea (21.1%), cough (16.9%), and epistaxis (5%). Hepatomegaly was remarkable compared to splenomegaly in physical examination of the cases. The most common laboratory features were elevated acute phase reactants, anemia (81%), leukopenia (56%), thrombocytopenia (3.5%), and elevated transaminase levels (28%). Conclusion: Forty four patients (37.2%) were hospitalized and treated for deydration due to vomiting and poor oral intake. One patient had developed a clinical picture of subileus as a complication.