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PubMed1979

[Characteristics of the seasonal distribution of typhoid fever cases in different areas of the USSR].

The results of the monthly registration of typhoid cases in all union republics and in the USSR as a whole for the period of 1970--1976 were analyzed. The mathematical parameters of the monthyly distribution of morbidity rate under the influence of long-term factors for each union republic were determined. In analyzing actual morbidity rates for definite years these data may help determine to what extent such rates are influenced by incidental factors. Mathematical analysis allowed to divide the territory of the USSR into 5 groups of areas with different patterns of the seasonal distribution of typhoid cases: the RSFSR, the Ukrainian SSR and the Moldavian SSR, the Byelorussian SSR and the Soviet Baltic republics, the Transcaucasian republics, the republics of Central Asia and the Kazakh SSR. April was found to be the optimum time for the immunoprophylaxis of typhoid fever throughout the whole territory of the USSR in the presence of epidemiological indications.

Disease Outbreaks↗
PubMed1969

A controlled field trial to evaluate the protective capacity of a single dose of acetone-killed agar-grown and heat-killed broth-grown typhoid vaccines.

In a strictly controlled field trial among schoolchildren a study was made of the protective capacity of single doses of 2 typhoid vaccines: a heat-killed broth-grown sorbed dried vaccine made in the USSR (vaccine G-66) and an acetone-killed agar-grown dried vaccine (vaccine K-66) made in Yugoslavia. The latter vaccine was supplied by the World Health Organization.A single dose of these preparations exerted a statistically significant protective effect during the first 10 months of observation. The protection afforded by the acetone-killed and heat-killed sorbed vaccines was similar in duration and intensity to that resulting from single doses of other types of typhoid vaccines that had been evaluated earlier in the USSR. The data obtained confirm once again that successful immunization against typhoid is possible with a single dose of vaccine.The absence of any substantial difference in morbidity between the groups concerned indicates that the heat-killed broth-grown and acetone-killed agar-grown vaccines exert a roughly similar protective effect.

Adolescent↗
PubMed1979

The role of cell-mediated immunity in typhoid.

The cell-mediated immunity in typhoid was assessed by the leukocyte migration inhibition test and delayed hypersensitivity skin test in 60 clinical typhoid patients. The property of leukocyte migration inhibition appeared first and was positive in 28 of 60 (46.7%) patients on admission and 45 of 60 (75%) at the time of discharge. This difference was definitely more in blood culture positive patients. The delayed hypersensitivity appeared later and was positive in 18 of 60 (30%) on admission and 31 of 60 (51.7%) at the time of discharge. Patients with positive cellular-immune response against typhoid antigen did not develop relapse. On the whole cell-mediated immunity seems to play an important role in typoid. The control groups--the medical and surgical patients, doctors, clinical students and preclinical students--showed positive cellular immune response of 43.3 81.3, 40.7 and 25% respectively. The significance of these results is discussed.

Adolescent↗
PubMed1977

Jaundice in typhoid hepatitis: a light and electron microscopy study based on liver biopsies.

Light and electron microscopy study of fourteen liver biopsies in typhoid fever disclosed a mild hepatitis in which there is marked reticulo-endothelial hyperplasia, with many lymphoid cells in the hepatic sinusoids. The hepatic cell lesion was non specific, manifested by reticulum endoplasmic dilatation, mitochondrial alteration and biliary canaliculus injury. Such findings were particularly evident in the jaundiced patients. Jaundice was, in our series, a more frequent complication of acute typhoid fever than commonly reported. Usually it is of short duration and the serum bilirubin was not markedly elevated. However, there were instances when the jaundice was so accentuated as to lead the clinician to a first diagnosis of virus hepatitis or leptospirosis. The pathogenesis of the intrahepatic cholestasis in typhoid fever is still obscure, but apparently it is, as has been described in other infectious diseases, due to an injury of the bile secretory apparatus brought out by the bacillary endotoxin.

Adolescent↗
PubMed1977

A study of the efficacy of typhoid vaccine in inducing humoral and cell-mediated immune responses in human volunteers.

The nature of protective immunity against typhoid fever in man is not at present well understood. Work on animal models and earlier studies from this laboratory indicate an important protective role for cellular immunity. The present work attempts to study the efficacy of the conventional typhoid vaccine in inducing specific cellular and humoral immune responses. The study on fifty-eight new army recruits and thirty-one civilian volunteers showed adequate humoral responses after vaccination. However, vaccination failed to induce a significant cellular immune response. In addition, a transient suppression of cellular immunity was observed in the immediate post-vaccination period in ten subjects who possessed natural cellular immunity before vaccination. These findings indicate the need for improving the typhoid vaccine so that it will induce cellular immunity as well as a humoral response. It also points to the necessity for obtaining detailed knowledge of the post-vaccination anergy as it could be important in timing public health programmes.

Antibody Formation↗
PubMed1984

Selectively increased adenosine deaminase levels in T cells during typhoid fever.

ADA and PNP levels were measured in T-enriched and T-depleted subpopulations of peripheral mononuclear cells from patients with typhoid fever. ADA activity was significantly increased in T-enriched, but normal in T-depleted preparations of typhoid patients. Elevated levels of ADA in T cells were observed from the initial phase up to 30 days from the onset of the disease. Unlike ADA changes, PNP modifications were transitory, and affected both T-enriched and T-depleted subpopulations. The usefulness of ADA determination in T cells to detect and follow up T-cell activation during typhoid fever is suggested.

Adenosine Deaminase↗
PubMed1983

Diagnosis of typhoid fever by indirect hemagglutination with lyophilized cells.

An IHA test using stable sensitized red cells was developed for diagnosis of typhoid fever. The antibodies to LPS and CB coated cells were measured in 39 patients with typhoid fever and 79 healthy controls. The diagnostic titer greater than or equal to 1:80 of HA-LPS and Widal reaction; and greater than or equal to 1 : 320 of HA-CB were considered significant. It was found that either IHA or Widal test gave the same degree of sensitivity capable of diagnosing 87.2% of patients with typhoid fever. Antigenicities of lyophilized sensitized cells were retained for at least 6 months of preservation.

Antibodies, Bacterial↗
PubMed1983

ELISA determination of IgM anti-LPS in the early phase of typhoid fever.

Sera from typhoid fever patients in the early stage of the disease were tested for the presence of IgM antibodies to LPS of S. typhi by an ELISA method. IgM anti-LPS were present in all 10 typhoid patients, while they were undetectable in sera from both normal and febrile controls. Determination of IgM anti-LPS can be a diagnostic aid in the early phase of typhoid fever.

Adolescent↗
PubMed1980

Utilization of the enzyme linked immunosorbent assay technique (ELISA) for the diagnosis of typhoid fever.

50 sera from patients with a bacteriological diagnosis of typhoid fever and 325 sera from healthy individuals were studied to quantify antibodies against S. typhi somatic antigen by means of Widal's technique and the enzyme linked inmmunosorbent assay ELISA and by means of the latter, determine the minimum diagnostic titer. Only 2.3 per cent of the healthy population had titers up to 1:300 while sera from patients varied from 1:150 (2 per cent) to 1:2500. A titer was established by ELISA--1:3000 as suggestive of typhoid fever. Widal's agglutination reaction was positive in 1:160 titers in 50 per cent of patients while ELISA technique was positive in 98 per cent of cases (p < 0.001). ELISA technique was more efficient, rapid and sensitive than Widal's test and its utilization is proposed for the clincial laboratory as the method of choice in the serological diagnosis of typhoid fever.

Antibodies, Bacterial↗
PubMedDate not supplied

Typhoid perforation: factors affecting mortality and morbidity.

Thirty-six patients were operated upon for terminal ileal perforations in a two-year period; four cases were due to trauma, four to ascariasis and 28 to typhoid. Ileal perforations due to ascaris worms are differentiated from typhoid ileal perforations because worms are usually found lying freely in the peritoneal cavity or in close association with the perforations. Also, tests for Salmonellae and Shigella are usually negative. Factors affecting mortality and morbidity in typhoid ileal perforation include the age of the patient, duration of perforation before surgery, presence of additional complications, such as massive rectal bleeding, the extent of the surgery, and the number of perforations present. Chloramphenicol in massive doses is indicated for all these patients. Our experience suggests that the hematoxicity of this drug has been over-rated. Postoperative complications are: wound infection (about 95% of cases), malarial fever, septicemia, fecal fistula, intraabdominal abscess, pulmonary infection, jaundice and transient psychosis.

Adolescent↗
PubMed1980

Immunological study of typhoid fever in man: humoral immune response.

Widal and indirect haemagglutination test were used to study the humoral immune response of 45 patients with typhoid fever. The Widal and IHA tests were positive in 41 (91.1%) and 42 (93.3%) of patients with typhoid fever after the second week of illness. Comparison between the Widal and IHA test showed that the latter was more sensitive as assessed by Wilcoxon matched-pairs signed-ranks test (p less than 0.01). The anti-LPS antibody belongs to all three classes of immunoglobulins namely IgG, IgM and IgA with the confinement mostly to IgG and IgM. It was found that the level of haemagglutinating enhancement activity was strongest in IgG class. The low level of anti LPS-antibody was found in healthy persons with the pattern of immunoglobulin class of antibody similar to that in patients with typhoid fever.

Adolescent↗
PubMed1978

Co-trimoxazole in the treatment of typhoid fever in children with glucose-6-phosphate dehydrogenase deficiency.

The efficacy and possible adverse reactions of co-trimoxazole in the treatment of typhoid fever with G-6-PD deficiency were investigated in 68 typhoid children aged 2 to 14 years old. Salmonella typhi was isolated from 45 patients but all had a significant rise of Widal agglutinin titres during the course of the disease. Decrease in G-6-PD activity of the red blood cells was found in 37 out of 51 patients tested. A daily dose of 6--10 mg of trimethoprim plus 30--50 mg of sulfamethoxazole per kg body weight was given for 14 days. Patients with G-6-PD deficiency were closely observed for evidence of intravascular hemolysis. All patients responded well and the mean period of defervescence after starting therapy was approximately 8 days. One patient with G-6-PD deficiency developed acute hemolysis on the second day of medication. The hemolytic symptoms subsided within 14 days with the continuation of co-trimoxazole therapy. No other major side-effect of the drug was observed. It is concluded that co-trimoxazole can be used successfully in the treatment of typhoid fever in G-6-PD deficient children with little risk of serious adverse reaction.

Adolescent↗
PubMed1995

Short course of ofloxacin for treatment of multidrug-resistant typhoid.

In recent years, multiresistant strains of Salmonella typhi have emerged in many tropical countries. These strains remain highly sensitive to the fluoroquinolone antibiotics, although use of these drugs by children is considered contraindicated because of their reported toxicity in the cartilage of experimental animals. In a paired, open, randomized study during an epidemic of multidrug-resistant typhoid in southern Vietnam, two short-course ofloxacin regimens (15 mg/kg daily for 3 days and 10 mg/kg daily for 5 days) were compared for the treatment of uncomplicated typhoid fever. Of 438 patients enrolled (of whom 286 were < or = 14 years old), 228 had blood cultures positive for Salmonella species (S. typhi, 207; S. paratyphi A, 19; and S. choleraesuis, 2). There was one treatment failure in a patient who took only one dose of ofloxacin. Otherwise, both regimens were completely effective; there were no proven carriers, and there was no evidence of toxicity, particularly in children. A 3-day course of ofloxacin proved to be safe and highly effective in the treatment of uncomplicated, multidrug-resistant typhoid fever.

Adolescent↗
PubMed1993

[Typhoid fever in South Vietnam, 1990-1993].

In South Viet-nam, typhoid fever remains a considerable intestinal infection. Between 1990 and 1993, among 15 districts in the South of the country, a total per year of 3,853 to 9,179 cases was registered: from 8 to 31 led to death. Recently a large epidemic of typhoid fever broke out in the An Minh district (territory of KiênGiang, South Viet-nam), affecting 3,049 people and bringing on two cases of death. Among the 574 blood samples, 266 strains of S. Typhi, 22 S. Paratyphi A and 2 S. Choleraesuis have been isolated. Our investigations on the spot led to some epidemiologic and clinical reflexions and enabled us to estimate the effectiveness of quinolones (?) in the treatment for typhoid fever. The epidemic may be ascribed to different causes: lack of pure water supply in rural area; fecal pollution caused by inhabitants of this endemic area defecating directly in the waterways; ingestion of contaminated food, especially vegetables sprayed with polluted water; quite low level of public sanitation and individual hygiene. Clinically, the disease consists in prolonged fever, with digestive disorders (anorexia, diarrhoeae, diffuse abdominal aches). Splenomegalia and hepatomegalia are inconstant. The dissociation of the pulse from the temperature is not frequent and the rosy spots are rare. The antibiogramm applied on the isolated strains of S. Typhi revealed their resistance (R) to usual antibiotics (chloramphenicol, ampicillin, Bactrim), but S. Typhi is very sensitive to quinolones (ofloxacin, fléroxacin, R = 0).(ABSTRACT TRUNCATED AT 250 WORDS)

Drug Resistance, Microbial↗
PubMed1994

Adenosine deaminase activity in typhoid fever.

Serum adenosine deaminase (ADA) activity was determined in 41 patients of typhoid fever and 15 normal controls. The mean ADA activity was significantly raised in typhoid fever patients as compared to controls (p < 0.001). The peak enzymatic activity was observed in the first week of illness. Complicated patients had lower mean ADA activity at diagnosis as compared to uncomplicated group and they showed a rise in enzyme level during defervescence, repeated in a few cases. A significant correlation between serum ADA activity and lymphocyte percentage was found (r = 0.4245, p < 0.001). It is concluded that ADA activity in typhoid fever patients not only indicates immunity but also has a prognostic value.

Adenosine Deaminase↗
PubMed1994

Typhoid fever: a review of its impact and diagnostic problems.

A retrospective analysis was done on the diagnosis of typhoid fever based on clinical symptoms and available laboratory data over the last 16 years from rural areas of four African countries. This analysis concentrated on the reliability of diagnosis without cultures which cannot be performed in most rural hospitals due to lack of the necessary expertise and equipment. The analysis showed the problem to be increasing perhaps because of interaction of salmonella infection with human immunodeficiency virus (HIV), malnutrition and other infections together with neglected sanitary facilities and lack of clean water. The use of certain cardinal clinical symptoms combined with available laboratory tests were shown to enhance the diagnosis of typhoid fever, especially in vulnerable persons. In conclusion the paper suggests that using the approach followed to obtain this data in rural tropical areas one can confidently make a diagnosis of typhoid fever.

Adult↗
PubMed1994

[Microbiologic diagnosis of typhoid fever: report on an outbreak].

BACKGROUND: The incidence of typhoid fever has greatly fallen in Spain although sporadic cases and limited outbreaks may be observed. The usefulness of the serum agglutinin studies for the diagnosis of this disease has been questioned by many authors. However, this diagnosis criteria continues to be used in Spain. The usefulness of blood cultures, stool cultures, urinecultures and serological test is herewith compared. METHODS: Three groups were prospectively studied: 18 patients with typhoid fever from one single outbreak, 50 blood donors, and 24 patients with other infections. Blood, stool culture, urinecultures and serology (agglutination) were carried out in the first group and in the other two groups serological test were used to determine the cut-off points and study cross reactions. RESULTS: Blood culture was found to be the most sensitive technique (94%) followed by stool culture (53%). No positive urineculture of seroconvesrion were observed. The cut off points accepted following the study of the donors were 1/160 or greater for the O antigen and 1/320 or greater for the H antigen. Two false positive for the O antigen and 3 for the H antigen were observed in the 24 patients with other infections. CONCLUSIONS: When suspecting typhoid fever, the combined use of blood culture and stool culture is recommended. The usefulness of serological test in our area lays in the observation of seroconversion associated to a compatible clinical picture. Its performance should not being considered as adequate in unspecific febrile syndromes.

Adolescent↗
PubMed1993

Haemophagocytosis in typhoid fever.

This report deals with a young man who developed features of haemophogocytosis during the course of typhoid fever. The pertinent clinical and laboratory features of typhoid-associated haemophagocytosis are discussed. The need for blood component replacement therapy in addition to specific anti-microbials to treat haemophagocytosis complicating typhoid fever is stressed.

Adult↗