Intrafamilial Circulation of<i>Tropheryma whipplei</i>, France

Fénollar, Florence; Keïta, Abdoulaye; Buffet, Sylvain; Raoult, Didier

doi:10.3201/eid1806.111038

Cited by 61 publications

(60 citation statements)

References 31 publications

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“…This suggests that the bacterial load in stools is higher than in saliva samples and that the gut is the preferred niche of this bacterium. The amount of bacteria in fecal samples is also significantly higher in symptomatic patients than it is in carriers (16)(17)(18)43), indicating that a high load is associated with symptoms of T. whipplei infections.…”

Section: Human Carriage and Human-to-human Transmissionmentioning

confidence: 88%

“…Salival carriage was found to be 0.2% to 2.2% in sewage workers and 3.7% in the homeless. Interestingly, when saliva samples are positive, stool samples are generally positive as well (16)(17)(18)43). This suggests that the bacterial load in stools is higher than in saliva samples and that the gut is the preferred niche of this bacterium.…”

Section: Human Carriage and Human-to-human Transmissionmentioning

confidence: 89%

“…Relatives of chronic Whipple's disease patients have a higher chance of carrying the bacterium (16). It is unclear whether these family members have a higher rate of carriage because of human-to-human transmission or because they are infected by the same environmental source (16).…”

Section: Human Carriage and Human-to-human Transmissionmentioning

confidence: 99%

“…While the incidence of classic Whipple's disease is low, T. whipplei is now recognized as a widespread bacterium, as in the general populations of Europe and Senegal, respectively, 48% and 72% carried antibodies against the bacterium (16,17). Recent data suggest that the presence of T. whipplei in fecal samples from asymptomatic individuals varies between 1.5 to 4% (14,18,(41)(42)(43) in the general population of Europe but that it can be up to 12 to 25% in specific populations like sewage workers, HIV-infected, and the homeless (43,52,53).…”

Section: Human Carriage and Human-to-human Transmissionmentioning

confidence: 99%

“…Once in the intestinal mucosa, the bacterium is taken up by macrophages in which it then replicates (14). Although the disease is rare, T. whipplei is considered to be a bacterium that is common in the human gut, implying that only a small percentage of carriers actually become symptomatic (15)(16)(17). However, the assumption that carriers of T. whipplei are truly asymptomatic is based on little evidence and may result from a missed diagnosis of, e.g., gastroenteritis or other aspecific symptoms that are common in the general population.…”

Section: Introduction Wmentioning

confidence: 99%

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Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

et al. 2017

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SUMMARY Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with Tropheryma whipplei, a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity. The development of molecular techniques has resulted in more convenient methods for detecting T. whipplei infections, and this has greatly improved the diagnosis of this often missed infection. In addition, the molecular detection of T. whipplei has resulted in an increase in knowledge about its pathogenicity, and this review gives an overview of the new insights in epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of Tropheryma whipplei infections.

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Section: Human Carriage and Human-to-human Transmissionmentioning

confidence: 88%