An outbreak investigation of typhoid fever in Pondicherry, South India, 2013

Cherian, Johnson; Somanna, Sampath; Sunderamurthy, Bhuvaneswary; K, Chavada V; Vasudevan, Kavita; Govindasamy, Anbusenthil

doi:10.5455/ijmsph.2015.0000201448

Cited by 6 publications

(8 citation statements)

References 6 publications

(5 reference statements)

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“…Several outbreak investigations studies have been done in India where few studies are multifactorial, while most of them are concluding contaminated water to be the source of outbreak and clean water and hygienic measures had been proven to be effective. [ 3 4 8 9 10 11 12 17 ]…”

Section: Discussionmentioning

confidence: 99%

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Clinico-epidemiological study of an outbreak of typhoid in North India

Pardal

Nimonkar²,

Goyal³

et al. 2022

Journal of Family Medicine and Primary Care

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Introduction: Typhoid fever is endemic in India. There have been various outbreaks of typhoid fever reported from different parts of India. Considering the outbreak potential of typhoid, the present study was undertaken wherein an outbreak of typhoid occurred in a city in northern India. Methodology: The study design used was a cross-sectional descriptive study. Detailed information was obtained from each reported case. Active case finding surveys were conducted. Case definitions for suspect, probable, and confirmed case taken for our study, have already been validated by the World health organisation (WHO). All patients were subjected to requisite investigations. A sanitary survey was carried out to locate defects in water supply and sewage disposal. Record of bacteriological survey of water samples from the area was scrutinized. Descriptive epidemiology of cases was carried out. Results: Attack rate was 16.1% and 17.4% among men and women, respectively. Fever was present in 52 (69.3%) cases. The epidemic curve displayed a sudden peak and an abrupt fall of cases. This is suggestive of a common point source outbreak. There were no fatalities. Sanitary survey teams found a sewage leak in the locality where maximum cases were reported. Lab reports tested positive for salmonella species in water. The outbreak was promptly controlled after repair of the leaking sewage pipeline; and provision of alternative source of water supply. Conclusion: This study reemphasises the requirement of a basic public health measure and infrastructure, that is, water quality monitoring by concerned authorities to break the chain of transmission of typhoid fever.

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Section: Discussionmentioning

confidence: 99%

“…[ 6 ] Typhoid fever is endemic in India. [ 7 ] There have been various outbreaks of typhoid fever reported from different parts of India including Pondicherry,[ 8 ] Maharashtra,[ 9 ] Bangalore,[ 10 ] Rajasthan,[ 11 ] and West Bengal. [ 12 ]…”

Section: Introductionmentioning

confidence: 99%

Clinico-epidemiological study of an outbreak of typhoid in North India

Pardal

Nimonkar²,

Goyal³

et al. 2022

Journal of Family Medicine and Primary Care

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“…Second, testing of water sources used by actual cases would have provided a stronger linkage between infection and water sources. Third, while this study has a larger sample size and more comprehensive set of water source types than previous environmental studies associated with outbreaks (10)(11)(12)(13)(14)(15), data from additional samples, especially from unprotected springs, wells, and taps, would have allowed a more robust analysis of water quality. Fourth, S. Typhi is difficult to culture from environmental samples; improved culture methods are needed.…”

Section: <1mentioning

confidence: 99%

“…Despite the high incidence of typhoid fever globally, relatively few outbreak investigations incorporate drinking water testing (10)(11)(12)(13)(14)(15) and routine water testing for S. Typhi is rarely done in regions where S. Typhi is endemic (16). While these studies have provided useful information, more comprehensive sampling and testing strategies are needed to identify drinking water sources that represent higher disease transmission risks and areas of focus for public health interventions.…”

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confidence: 99%

Environmental Survey of Drinking Water Sources in Kampala, Uganda, during a Typhoid Fever Outbreak

Murphy

Kahler

Nansubuga

et al. 2017

Appl Environ Microbiol

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In 2015, a typhoid fever outbreak began in downtown Kampala, Uganda, and spread into adjacent districts. In response, an environmental survey of drinking water source types was conducted in areas of the city with high case numbers. A total of 122 samples was collected from 12 source types and tested for , free chlorine, and conductivity. An additional 37 grab samples from seven source types and 16 paired large volume (20 liter) samples from wells and springs were also collected and tested for the presence of serovar Typhi. was detected in 60% of kaveras (drinking water sold in plastic bags) and 80% of refilled water bottles; free chlorine was not detected in either source type. Most jerry cans (68%) contained and had free chlorine residuals below the WHO-recommended level of 0.5 mg/liter during outbreaks. Elevated conductivity readings for kaveras, refilled water bottles, and jerry cans (compared to treated surface water supplied by the water utility) suggested that they likely contained untreated groundwater. All unprotected springs and wells and more than 60% of protected springs contained Water samples collected from the water utility were found to have acceptable free chlorine levels and no detectable While Typhi was not detected in water samples, spp. were detected in samples from two unprotected springs, one protected spring, and one refilled water bottle. These data provided clear evidence that unregulated vended water and groundwater represented a risk for typhoid transmission. Despite the high incidence of typhoid fever globally, relatively few outbreak investigations incorporate drinking water testing. During waterborne disease outbreaks, measurement of physical-chemical parameters, such as free chlorine residual and electrical conductivity, and of microbiological parameters, such as the presence of or the implicated etiologic agent, in drinking water samples can identify contaminated sources. This investigation indicated that unregulated vended water and groundwater sources were contaminated and were therefore a risk to consumers during the 2015 typhoid fever outbreak in Kampala. Identification of contaminated drinking water sources and sources that do not contain adequate disinfectant levels can lead to rapid targeted interventions.

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“…A World Health Organization study estimated the incidence and mortality rate to be 21.7 million and 217 000 cases annually . Typhoid fever outbreaks in Uganda, North India, South India, Songkhla, and Malawi‐Mozambique border in recent years suggested that the disease has yet to be eradicated. S .…”

Section: Introductionmentioning

confidence: 99%

Integration of molecular dynamics simulation and hotspot residues grafting for de novo scFv design against Salmonella Typhi TolC protein

Leong

Lim

Ismail

et al. 2017

J of Molecular Recognition

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With the development of de novo binders for protein targets from non-related scaffolds, many possibilities for therapeutics and diagnostics have been created. In this study, we described the use of de novo design approach to create single-chain fragment variable (scFv) for Salmonella enterica subspecies enterica serovar Typhi TolC protein. Typhoid fever is a global health concern in developing and underdeveloped countries. Rapid typhoid diagnostics will improve disease management and therapy. In this work, molecular dynamics simulation was first performed on a homology model of TolC protein in POPE membrane bilayer to obtain the central structure that was subsequently used as the target for scFv design. Potential hotspot residues capable of anchoring the binders to the target were identified by docking "disembodied" amino acid residues against TolC surface. Next, scFv scaffolds were selected from Protein Data Bank to harbor the computed hotspot residues. The hotspot residues were then incorporated into the scFv scaffold complementarity determining regions. The designs recapitulated binding energy, shape complementarity, and interface surface area of natural protein-antibody interfaces. This approach has yielded 5 designs with high binding affinity against TolC that may be beneficial for the future development of antigen-based detection agents for typhoid diagnostics.

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An outbreak investigation of typhoid fever in Pondicherry, South India, 2013

Cited by 6 publications

References 6 publications

Clinico-epidemiological study of an outbreak of typhoid in North India

Clinico-epidemiological study of an outbreak of typhoid in North India

Environmental Survey of Drinking Water Sources in Kampala, Uganda, during a Typhoid Fever Outbreak

Integration of molecular dynamics simulation and hotspot residues grafting for de novo scFv design against Salmonella Typhi TolC protein

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