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Paratyphoid fever is endemic in Yunnan Province, China. We investigated a countywide outbreak of paratyphoid fever in Yuanjiang County of the province in 2010. From January through October of the year, 469 cases were identified. Salmonella Paratyphi A was isolated from 370 (79%) cases. Three hundred eighty (80%) patients were adults aged between 20 to 49 years, 277 (60%) were farmers, and more than half of the cases occurred in the capital township of the county. A case-control study of culture-confirmed cases and controls matched with healthy family members was conducted to detect behavior risk factors. Consuming cold and raw food (matched odds ratio 5.5, 95% confidence interval 2.4-12.3) was associated with the infection. Poor sanitary system in both hospital and the city were observed during the environmental study, and 10 (8%) recovering patients and 2 (8%) healthy relatives of patients were identified as carriers. Improvement on sanitation, cooked food and access to safe water, and appropriate treatment for patients and carriers were suggested in outbreak control and prevention.
Keywords: Paratyphi A, outbreak, case-control study, continual exposure, China