Enteric Fever in Israeli Travelers: A Nationwide Study

Meltzer, Eyal; Sadik, Chantal; Schwartz, Eli

doi:10.2310/7060.2005.12507

Cited by 54 publications

(40 citation statements)

References 17 publications

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“…Observations from a large randomized placebo-controlled field trial in Plaju, Indonesia, strongly suggested that Ty21a is unable to confer cross-protection against S. Paratyphi A infection (57). In contrast, a retrospective study by Meltzer et al among travelers from Israel to the Indian subcontinent suggested that Ty21a might confer some protection against S. Paratyphi A (42). However, in a subsequent report the authors stated that current typhoid vaccines offer no protection against S. Paratyphi A (43).…”

mentioning

confidence: 99%

Live Oral Typhoid Vaccine Ty21a Induces Cross-Reactive Humoral Immune Responses against Salmonella enterica Serovar Paratyphi A andS. Paratyphi B in Humans

Wahid

Simon

Zafar

et al. 2012

Clin Vaccine Immunol

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ABSTRACTEnteric fever caused bySalmonella entericaserovar Paratyphi A infection has emerged as an important public health problem. Recognizing that in randomized controlled field trials oral immunization with attenuatedS. entericaserovar Typhi live vaccine Ty21a conferred significant cross-protection againstS. Paratyphi B but notS. Paratyphi A disease, we undertook a clinical study to ascertain whether humoral immune responses could explain the field trial results. Ty21a immunization of adult residents of Maryland elicited predominantly IgA antibody-secreting cells (ASC) that recognizeS. Typhi lipopolysaccharide (LPS). Cross-reactivity toS. Paratyphi A LPS was significantly lower than that toS. Paratyphi B LPS. ASC producing IgG and IgA that bind LPS from each of theseSalmonellaserovars expressed CD27 and integrin α4β7 (gut homing), with a significant proportion coexpressing CD62L (secondary lymphoid tissue homing). No significant differences were observed in serum antibody against LPS of the different serovars. Levels of IgA B memory (BM) cells toS. Typhi LPS were significantly higher than those againstS. Paratyphi A or B LPS, with no differences observed betweenS. Paratyphi A and B. The response of IgA BMto outer membrane proteins (OMP) fromS. Typhi was significantly stronger than that to OMP ofS. Paratyphi A but similar to that to OMP ofS. Paratyphi B. The percentages of IgG or IgA BMresponders to LPS or OMP from theseSalmonellastrains were similar. Whereas cross-reactive humoral immune responses toS. Paratyphi A or B antigens are demonstrable following Ty21a immunization, they cannot explain the efficacy data gleaned from controlled field trials.

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confidence: 99%

Live Oral Typhoid Vaccine Ty21a Induces Cross-Reactive Humoral Immune Responses against Salmonella enterica Serovar Paratyphi A andS. Paratyphi B in Humans

Wahid

Simon

Zafar

et al. 2012

Clin Vaccine Immunol

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“…During the period 1989-2004, S. Typhi strains carrying an R factor encoding resistance to several clinically relevant antibiotics (chloramphenicol, amoxicillin, and trimethoprim/sulfamethoxazole) emerged and disseminated throughout South and Southeast Asia [3]. As the Asian pandemic of multidrug-resistant typhoid diminished in the early twentyfirst century, paratyphoid fever caused by S. Paratyphi A became increasingly common [4] and also emerged as a problem among travelers to Asia [5]. This changing epidemiologic profile has rekindled interest in vaccines to prevent paratyphoid fever.…”

mentioning

confidence: 99%

Ty21a Live Oral Typhoid Vaccine and Prevention of Paratyphoid Fever Caused by Salmonella enterica Serovar Paratyphi B

Levine

Ferreccio

Black

et al. 2007

Clinical Infectious Diseases

107

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In randomized, controlled field trials in Area Norte and Area Occidente of Santiago, Chile, 2 (Norte) or 3 (Occidente) doses of live oral typhoid vaccine Ty21a in enteric-coated capsules conferred protection against confirmed Salmonella enterica serovar Typhi disease (53% efficacy in Norte; 67% efficacy in Occidente) during 3 years of follow-up. There was also a trend in each trial showing protection against S. enterica serovar Paratyphi B disease (56% efficacy in Norte; 42% efficacy in Occidente). To enhance statistical power, an analysis was performed using pooled data from the 2 trials; this pooling of data was justified by the following facts: epidemiologic surveillance and microbiological methods were identical, the trials overlapped during 22 of the 36 months of follow-up in each trial, the estimates of efficacy against paratyphoid B fever in the 2 trials were roughly similar, and the ratio of follow-up of vaccine recipients to control subjects in both trials was ~1 : 1. In the pooled analysis, Ty21a conferred significant protection against paratyphoid B fever (efficacy, 49%; 95% confidence interval, 8%-73%; P=.019).

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“…In the study by Mermin et al (1998) describing the epidemiological patterns of imported cases of enteric fever into USA, it was shown that between 1985 and 1994, the incidence among travellers to the Indian subcontinent increased from 23.4 to 81.2 per 100,000. In a study from Israel, 74 % of imported typhoid fever cases were acquired in India and the calculated attack rate was 24 per 100,000 travellers, which is 100 times a higher figure when compared to Thailand or to the Middle East (Meltzer et al 2005;Connor and Schwartz 2005). Our findings underline the fact that Indian subcontinent is a high-risk destination in this respect.…”

Section: Discussionmentioning

confidence: 53%

“…Our study was significantly limited by relatively low number of cases, and there have been no identified statistically significant differences between typhoid and paratyphoid cases, except from the elevation of liver function parameters in S. Typhi cases. Similarly, other studies neither found the clinical difference between typhoid and paratyphoid fever, nor confirmed that paratyphoid fever had milder clinical course (Clark et al 2010;Patel et al 2010;Meltzer et al 2005;Shlim et al 1995).…”

Section: Discussionmentioning

confidence: 86%

Enteric fever imported to the Czech Republic: epidemiology, clinical characteristics and antimicrobial susceptibility

et al. 2014

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The aim of this study was to describe epidemiological and clinical characteristics of imported enteric fever in Czech travellers and to determine the antimicrobial susceptibility of isolated strains. Retrospective descriptive study included adult patients treated with enteric fever at Hospital Na Bulovce during January 2004-December 2012. A case of typhoid or paratyphoid fever was defined as isolation of Salmonella Typhi or Paratyphi from blood or stool. During the study period, there have been diagnosed 19 cases of enteric fever (12 males and 7 females) with age median of 30 years; 14 cases were caused by Salmonella Typhi and 5 cases by S. Paratyphi A. The infection has been acquired in South Asia (16 patients; 84.2 %), in Africa (Egypt, Angola) in two cases (10.5 %), and in Mexico (1; 5.3 %). Symptoms included fever (all patients), diarrhoea (16 cases; 84.2 %), headache (9; 47.4 %), and abdominal pain (7; 36.8 %). Seventeen patients (89.5 %) were treated with fluoroquinolones; however, the treatment failure was observed in seven of them (41.2 %). Decreased ciprofloxacin susceptibility was detected in eight strains (66.7 %), and one strain (8.3 %) was multidrug resistant. Sequence analysis of quinolone resistance-determining regions (QRDR) of the gyrA gene revealed the presence of amino acid substitutions in all tested isolates with decreased ciprofloxacin susceptibility. Typhoid and paratyphoid fevers represent epidemiologically important diseases that may lead to potentially life-threatening complications. Major issue in the management of enteric fever represents the non-susceptibility of Salmonella strains to fluoroquinolones and other antimicrobials.

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Enteric Fever in Israeli Travelers: A Nationwide Study

Cited by 54 publications

References 17 publications

Live Oral Typhoid Vaccine Ty21a Induces Cross-Reactive Humoral Immune Responses against Salmonella enterica Serovar Paratyphi A andS. Paratyphi B in Humans

Live Oral Typhoid Vaccine Ty21a Induces Cross-Reactive Humoral Immune Responses against Salmonella enterica Serovar Paratyphi A andS. Paratyphi B in Humans

Ty21a Live Oral Typhoid Vaccine and Prevention of Paratyphoid Fever Caused by Salmonella enterica Serovar Paratyphi B

Enteric fever imported to the Czech Republic: epidemiology, clinical characteristics and antimicrobial susceptibility

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