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    Data on Palestinian population and incidence of typhoid. Available from http://www.pcbs.org & http://www.moh.gov.ps

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EPIDEMIOLOGY AND CLINICAL ASPECTS OF ENTERIC FEVER IN ISRAEL

EYAL MELTZERCenter for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel; Infectious Disease Unit, E. Wolfson Medical Center, Holon, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Epidemiology Department, Ministry of Health, Jerusalem, Israel

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ORIT YOSSEPOWITCHCenter for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel; Infectious Disease Unit, E. Wolfson Medical Center, Holon, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Epidemiology Department, Ministry of Health, Jerusalem, Israel

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CHANTAL SADIKCenter for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel; Infectious Disease Unit, E. Wolfson Medical Center, Holon, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Epidemiology Department, Ministry of Health, Jerusalem, Israel

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MICHAEL DANCenter for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel; Infectious Disease Unit, E. Wolfson Medical Center, Holon, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Epidemiology Department, Ministry of Health, Jerusalem, Israel

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ELI SCHWARTZCenter for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel; Infectious Disease Unit, E. Wolfson Medical Center, Holon, Israel; Faculty of Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Epidemiology Department, Ministry of Health, Jerusalem, Israel

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Enteric fever decreased in Israel in the last 50 years, but its current epidemiology is unknown. In a nationwide study, we evaluated all cases of enteric fever from 1995 to 2003. On hundred thirty-six cases met the case definition. During the period studied, the incidence of enteric fever decreased from 0.42 to 0.23/100,000. A total of 57.4% of the cases were acquired abroad. The incidence of endemic enteric fever was 2.7 times higher in Arabs than in Jews. In Arabs, Salmonella Typhi was the causative agent in all cases, and almost all cases were endemic. In Jews, most cases were imported, with a decrease in imported S. typhi, cases and an increase in imported S. Paratyphi A cases. Salmonella Paratyphi B was endemic, and restricted to the Jewish population. The reasons for the difference in causative agents along ethnic lines need further evaluation. A more efficient vaccine for travelers that includes S. Paratyphi A is needed.

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