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Enteric fever and its impact on returning travellers
Jayshree Dave1, Armine Sefton2
1Public Health Laboratory London, Public Health England, Barts Health NHS Trust, Royal London Hospital Department of Microbiology, 3rd Floor Pathology & Pharmacy Building, 80 Newark Street, London, E1 2ES, UK jayshree.dave@phe.gov.uk.
International Health
|March 27, 2015
Summary
Enteric fever, caused by Salmonella, affects millions globally, particularly travelers. Current vaccines protect against S. Typhi, but not S. Paratyphi, and antimicrobial resistance is rising.
Area of Science:
- Infectious Diseases
- Microbiology
- Vaccinology
Background:
- Enteric fever is a systemic illness caused by Salmonella enterica serovars Typhi (S. Typhi) and Paratyphi (S. Paratyphi).
- Transmission occurs via the fecal-oral route, with endemicity in areas lacking sanitation and clean water, affecting approximately 27 million individuals annually worldwide.
- Travelers to endemic regions, especially those visiting friends and relatives, are at increased risk.
Purpose of the Study:
- To review the current landscape of enteric fever, including causative agents, epidemiology, and challenges in prevention and treatment.
- To highlight the limitations of existing vaccines and the growing issue of antimicrobial resistance.
Main Methods:
- Literature review of enteric fever epidemiology, vaccine efficacy, and antimicrobial resistance patterns.
- Analysis of current treatment guidelines and emerging resistance trends.
Main Results:
- Vi polysaccharide and oral Ty21a vaccines are available and effective against S. Typhi, but no commercial vaccine exists for S. Paratyphi.
- Antimicrobial resistance to ciprofloxacin is widespread, and emerging resistance to ceftriaxone and azithromycin is a concern for empirical treatment.
- Vaccine uptake and adherence to precautions remain suboptimal among certain traveler groups.
Conclusions:
- There is a critical need for improved strategies to combat enteric fever, including the development of a S. Paratyphi vaccine.
- Addressing poor vaccine uptake and adherence to preventive measures in travelers is essential.
- Monitoring and managing antimicrobial resistance are crucial for effective treatment of enteric fever.
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