, Volume 81, Issue 5, p 511
Date: 14 Sep 2013

Enteric Fever in Children Below 2 y — Need for an Effective Conjugate Vaccine?

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To the Editor: The occurrence of enteric fever in children less than 2 y is significant [1, 2] but not yet quantified. The vaccines currently available, target age group above 2 y and whether there is a need for effective vaccines in children below 2 y is a question that needs to be addressed.

We conducted a retrospective study of case records of children below 2 y, admitted between January 2009 and June 2012 with blood culture growth of S.typhi/S. paratyphi.

During this period, 48 children under 18 y of age were admitted with culture positive enteric fever of which 14 (29 %) were under 2 y, of which 7 (50 %) were under 1 y. Febrile gastroenteritis was the commonest presentation. Hepatomegaly was seen in 14.3 % but none had icterus, rash or splenomegaly. Two children under 3 mo of age had meningitis.

Though total counts were normal in 78.6 %, absolute eosinopenia was universal. Two of the 14 blood cultures grew S. paratyphiand the rest, S. typhi. Most of the isolates (92.9 %) were resista ...