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Abstract

On 6 April 2022, the Public Health Service of Kennemerland, the Netherlands, was notified about an outbreak of fever and abdominal complaints on a retired river cruise ship, used as shelter for asylum seekers. The diagnosis typhoid fever was confirmed on 7 April. An extensive outbreak investigation was performed. Within 47 days, 72 typhoid fever cases were identified among asylum seekers (n = 52) and staff (n = 20), of which 25 were hospitalised. All recovered after treatment. Consumption of food and tap water on the ship was associated with developing typhoid fever. The freshwater and wastewater tanks shared a common wall with severe corrosion and perforations, enabling wastewater to leak into the freshwater tank at high filling levels. Typhi was cultured from the wastewater tank, matching the patient isolates. In the freshwater tank, species DNA was detected by PCR, suggesting the presence of the bacterium and supporting the conclusion of contaminated freshwater as the probable source of the outbreak. Outbreaks of uncommon infections may occur if persons from endemic countries are accommodated in crowded conditions. Especially when accommodating migrants on ships, strict supervision on water quality and technical installations are indispensable to guarantee the health and safety of the residents.

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/content/10.2807/1560-7917.ES.2024.29.5.2300211
2024-02-01
2024-12-22
/content/10.2807/1560-7917.ES.2024.29.5.2300211
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Large outbreak of typhoid fever on a river cruise ship used as accommodation for asylum seekers, the Netherlands, 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Daisy+Ooms&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ooms Daisy</a>, <a href="/search?value1=Anne+de+Vries&option1=author&noRedirect=true" class="nonDisambigAuthorLink">de Vries Anne</a>, <a href="/search?value1=Femke+DH+Koedijk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Koedijk Femke DH</a>, <a href="/search?value1=Ellen+Generaal&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Generaal Ellen</a>, <a href="/search?value1=Ingrid+HM+Friesema&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Friesema Ingrid HM</a>, <a href="/search?value1=Maxine+Rouvroye&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rouvroye Maxine</a>, <a href="/search?value1=Steven+FL+van+Lelyveld&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Lelyveld Steven FL</a>, <a href="/search?value1=Maaike+JC+van+den+Beld&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van den Beld Maaike JC</a>, <a href="/search?value1=Daan+W+Notermans&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Notermans Daan W</a>, <a href="/search?value1=Patrick+van+Schelven&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van Schelven Patrick</a>, <a href="/search?value1=Janine+FH+van+den+Brink&option1=author&noRedirect=true" class="nonDisambigAuthorLink">van den Brink Janine FH</a>, <a href="/search?value1=Tanja+Hartog&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hartog Tanja</a>, <a href="/search?value1=Thijs+Veenstra&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Veenstra Thijs</a>, <a href="/search?value1=Serena+Slavenburg&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Slavenburg Serena</a>, <a href="/search?value1=Jan+C+Sinnige&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sinnige Jan C</a>, <a href="/search?value1=Wilhelmina+LM+Ruijs&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Ruijs Wilhelmina LM</a></span>. Large outbreak of typhoid fever on a river cruise ship used as accommodation for asylum seekers, the Netherlands, 2022. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(5):pii=2300211. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.5.2300211" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.5.2300211</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 09 Apr 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 28 Sept 2023 </span> </p>
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