Abstract
Typhoid fever is endemic in the Neapolitan area, where its yearly incidence rate largely exceeds the corresponding national figure. During the period from January to June, 1990, a matched case-control study was carried out in order to identify risk factors of the disease in this area; 51 subjects (mean age 27.2 years) with typhoid fever were compared with 102 controls matched with respect to age, sex and educational level. Consumption of raw shellfish was reported by 76.5% of the cases, as opposed to 19.6% of the controls (P < 0.01). Subjects who had eaten this food item had a 13.3-fold risk (C.I. 95% = 5.5 - 32.8) of contracting typhoid fever. In contrast, no risk was found to be associated with consumption of cooked shellfish, raw vegetables, ice-cream, non-potable water, or unpasteurized milk.
The risk factor identified in this study shows that hazardous dietary habits and inadequate sewage treatment facilities, combined with lack of sanitation in the harvesting and marketing of shellfish, play a major role in the endemicity of typhoid fever in the Neapolitan area.
Similar content being viewed by others
References
Baine W.B., Zampieri A., Mazzotti M. et al. (1974): Epidemiology of cholera in Italy in 1973 - Lancet ii: 1370–1374.
Giusti G., Cesaro G., D'Alfonso G. et al. (1983): Fattori di rischio per l'infezione tifoide nell'area geografica del golfo di Napoli. Studio caso-controllo - L'Igiene Moderna 80: 97–101.
Hornick R.B. (1982): Typhoid Fever. in “Bacterial Infections of Humans. A.S. Evans and H.A. Feldman eds. Planum Medical Book, New York 659–676.
Hornick R.B. (1985): Selective primary health care: Strategies for control of disease in the developing world. Typhoid fever - Rev. Infect. Dis. 7: 536–546.
Levine M.M., Grados O., Gilman R.H. et al. (1978): Diagnostic value of Widal test in areas endemic for typhoid fever - Am. J. Trop. Med. Hyg. 27:795–800.
Ryan C.A., Hargrett-Bean N.T., Blake P.A. (1989): Salmonella typhi infection in the Unites States, 1975–1984: increasing role of foreign travel - Rev. Infect. Dis. 11: 1–8.
Rothman K.J. and Boice J.D. (1982): Epidemiologic analysis with a programmable calculator 2nd Edition. Epidemiology Resource Inc. Boston.
Sears S.D., Ferreccio C., Levine M.M. et al. (1984): The use of Moore swabs for isolation of Salmonella typhi from irrigation water in Santiago, Chile - J. Infect. Dis. 149: 640–642.
Stroffolini T., Silleni M., Curianò C.M. (1988): Epidemiologia della febbre tifoide in Italia- Ann. Inst. Super. Sanità 24: 319–322.
Author information
Authors and Affiliations
Additional information
Corresponding author.
Rights and permissions
About this article
Cite this article
Stroffolini, T., Manzillo, G., De Sena, R. et al. Typhoid fever in the neapolitan area: A case-control study. Eur J Epidemiol 8, 539–542 (1992). https://doi.org/10.1007/BF00146373
Issue Date:
DOI: https://doi.org/10.1007/BF00146373