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A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.

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Enteric fever: a travel medicine oriented view.

Eyal Meltzer¹, Eli Schwartz

¹Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer, Israel.

Current Opinion in Infectious Diseases

|July 9, 2010

Summary

Enteric fever is declining in some areas but rising in South Asia, with increasing drug resistance. New vaccines are needed to combat both Salmonella Typhi and Salmonella Paratyphi A.

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Area of Science:

Infectious Diseases
Epidemiology
Microbiology

Background:

Enteric fever remains a significant global health concern, particularly in endemic regions and for international travelers.
Recent trends show a decline in middle-income countries, with a concentrated burden in South and Southeast Asia.

Purpose of the Study:

To review current epidemiological trends of enteric fever.
To discuss advancements in diagnosis, treatment, and prevention strategies.
To highlight challenges posed by emerging pathogens and antimicrobial resistance.

Main Methods:

Literature review of recent studies on enteric fever.
Analysis of epidemiological data and clinical isolate trends.
Evaluation of current and emerging diagnostic and therapeutic options.

Main Results:

The incidence of enteric fever is decreasing in many middle-income nations.
South and Southeast Asia bear the highest burden, with Salmonella Paratyphi A increasingly prevalent, sometimes exceeding Salmonella Typhi.
Widespread antimicrobial resistance, including quinolone resistance, is observed in both S. Typhi and S. Paratyphi A isolates in Asia.
Third-generation cephalosporins and azithromycin are primary treatment options for travel-related cases.

Conclusions:

Emergence of S. Paratyphi A limits the efficacy of existing typhoid vaccines for travelers.
Growing antimicrobial resistance complicates the management of travel-associated enteric fever.
Urgent development of novel vaccines effective against both S. Typhi and S. Paratyphi A is critical, though availability is several years away.