Typhoid Fever: Pathogenesis and Immunologic Control

Hornick, Richard B.; Greisman, Sheldon E.; Woodward, Theodore E.; DuPont, Herbert L.; Dawkins, A. T.; Snyder, Marshall L.

doi:10.1056/nejm197009242831306

Cited by 507 publications

(248 citation statements)

References 13 publications

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“…In 1970, higher attack rates and shorter incubation periods were reported for volunteers fed increasingly larger doses of Salmonella typhi [1]. The clinical course, once illness occurred, did not vary with the dose of infectious inoculum.…”

Section: Introductionmentioning

confidence: 97%

Dose–response effects in an outbreak of Salmonella enteritidis

et al. 1994

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SUMMARYThe effects of ingested Salmonella enteritidis (SE) dose on incubation period and on the severity and duration of illness were estimated in a cohort of 169 persons who developed gastroenteritis after eating hollandaise sauce made from grade-A shell eggs. The cohort was divided into three groups based on self-reported dose of sauce ingested. As dose increased, median incubation period decreased (37 h in the low exposure group v. 21 h in the medium exposure group v. 17T5 h in the high exposure group, P = 0 006) and greater proportions reported body aches (71 v. 85 v. 94 %, P = 00009) and vomiting (21 v. 56 v. 57%, P = 0002). Among 118 casepersons who completed a follow-up questionnaire, increased dose was associated with increases in median weight loss in kilograms (3 2 v. 4-5 v. 5 0, P = 0 0001), maximum daily number of stools (12 5 v. 15 0 v. 20-0, P = 0 02), subjective rating of illness severity (P = 0 0007), and the number of days of confinement to bed (30 v. 6-5 v. 65, P = 004). In this outbreak, ingested dose was an important determinant of the incubation period, symptoms and severity of acute salmonellosis.

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Section: Introductionmentioning

confidence: 97%

Dose–response effects in an outbreak of Salmonella enteritidis

et al. 1994

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“…The virulence of S. typhi correlates with the expression of this molecule, because Ͼ98% S. typhi isolates derived from the blood of typhoid patients are encapsulated (6,7). Studies carried out in human volunteers have shown that Vi ϩ strains of S. typhi are more virulent than Vi Ϫ S. typhi (8). The expression of Vi is associated with resistance of S. typhi to the action of anti-O antibody and to phagocytosis and complement-mediated killing.…”

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confidence: 99%

Vi polysaccharide ofSalmonella typhitargets the prohibitin family of molecules in intestinal epithelial cells and suppresses early inflammatory responses

Sharma

Qadri

2004

Proc. Natl. Acad. Sci. U.S.A.

199

169

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Vi capsular polysaccharide (Vi) was first identified as a virulence antigen of Salmonella typhi, the causative agent of typhoid fever in humans; it renders S. typhi resistant to phagocytosis and the action of serum complement. However, the role of Vi during the infection of intestinal epithelium with S. typhi is not completely understood. We show here that Vi can interact with a model human intestinal epithelial cell line, Caco-2, through a cell-surfaceassociated molecular complex containing two major proteins of 30 and 35 kDa and a minor protein of Ϸ68 kDa. The two major proteins were identified as the putative tumor suppressor molecule, prohibitin, and its closely related homolog, B cell receptor-associated protein 37. These two proteins were enriched in lipid rafts, and Vi readily associated with these membrane microdomains. Engagement of Caco-2 cells with Vi inhibited their ability to produce an inflammatory response upon infection with Vi ؊ S. typhi. Consistent with this effect, infection of Caco-2 cells with Vi ؉ S. typhi produced less IL-8 compared with Vi ؊ S. typhi. Cells treated with Vi showed reduced extracellular signal-regulated kinase phosphorylation in response to infection with Vi ؊ S. typhi or stimulation with phorbol 12-myristate 13-acetate, suggesting that the mitogen-activated protein kinase pathway might be a target for Vi-mediated inhibition of inflammatory responses. These findings reveal a crucial role for Vi in the modulation of early inflammatory responses during infection with S. typhi. This kind of a modulation could play a significant role in the establishment of infection by S. typhi.Vi capsular polysaccharide ͉ putative tumor suppressor molecule ͉ IL-8

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“…Aging, gastrectomy, proton-pump inhibitors or antacids leads to achlorhydria and facilitates typhoid infection. 52,55 In the small intestine, the bacteria first adhere to mucosal cells and then invade the mucosa following which they rapidly penetrate the mucosal epithelium via either microfold cells or enterocytes and arrive in the lamina propria, where they rapidly elicit an influx of macrophage that ingest the bacilli but do not generally kill them. Some bacilli remain within the macrophage of the small intestinal lymphoid tissue and some microorganisms translocate to the intestinal lymphoid follicles and the draining mesenteric lymph nodes and by which they enter the thoracic duct and the general circulation.…”

Section: Pathogenesismentioning

confidence: 99%

Typhoid fever: a review

Paul¹,

Bandyopadhyay²

2017

Int J Adv Med

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Typhoid fever is still a deadly disease in developing countries, particularly in India. Although, the paediatric population is mostly affected by this disease, yet the disease is an important cause of morbidity and mortality in adult populations also. In India, most of the cases of typhoid fever are diagnosed clinically, or at the most by the Widal test which is not fool proof. The disease typhoid fever is an orally transmitted communicable infectious disease caused by the bacteria Salmonella typhi. It is usually caused by consuming impure water and contaminated food. Salmonella typhi is serologically positive for lipopolysaccharide antigens O9 and O12, protein ﬂagellar antigen Hd, and polysaccharide capsular antigen Vi. S. typhi Vi-positive strains are more infectious and virulent than Vi-negative strains. Following the incubation period of 7 to 14 days, there is onset of fever and malaise. The fever is then accompanied by chills, headache, malaise, anorexia, nausea, vague abdominal discomfort, dry cough and myalgia. These are followed by coated tongue, tender abdomen, hepatomegaly, and splenomegaly. Azithromycin (10mg/kg) given once daily for seven days has proven eﬀective in the treatment of typhoid fever in some adults and children. A dose of 1g per day for ﬁve days was also found to be more effective in most adults. Of the third generation cephalosporins, oral Ceﬁxime (15-20mg per kg per day, for adults, 100-200mg twice daily) has been widely used. Intravenous third generation cephalosporins (ceftriaxone, cefotaxime) are eﬀective. Aztreonam and imipenem are potential third line drugs.

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Typhoid Fever: Pathogenesis and Immunologic Control

Cited by 507 publications

References 13 publications

Dose–response effects in an outbreak of Salmonella enteritidis

Dose–response effects in an outbreak of Salmonella enteritidis

Vi polysaccharide ofSalmonella typhitargets the prohibitin family of molecules in intestinal epithelial cells and suppresses early inflammatory responses

Typhoid fever: a review

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