The Current Status of Enteric Fever Diagnostics and Implications for Disease Control

Abstract

Enteric (typhoid) fever remains a problem in low- and middle-income countries that lack the infrastructure to maintain sanitation and where inadequate diagnostic methods have restricted our ability to identify and control the disease more effectively. As we move into a period of potential disease elimination through the introduction of typhoid conjugate vaccine (TCV), we again need to reconsider the role of typhoid diagnostics in how they can aid in facilitating disease control. Recent technological advances, including serology, transcriptomics, and metabolomics, have provided new insights into how we can detect signatures of invasive Salmonella organisms interacting with the host during infection. Many of these new techniques exhibit potential that could be further explored with the aim of creating a new enteric fever diagnostic to work in conjunction with TCV. We need a sustained effort within the enteric fever field to accelerate, validate, and ultimately introduce 1 (or more) of these methods to facilitate the disease control initiative. The window of opportunity is still open, but we need to recognize the need for communication with other research areas and commercial organizations to assist in the progression of these diagnostic approaches. The elimination of enteric fever is now becoming a real possibility, but new diagnostics need to be part of the equation and factored into future calculations for disease control.

Enteric Fever Presenting With Complete Heart Block (CHB): A Rare Case of Reversible Arrhythmia

“…The bacterium Salmonella enterica serotype Typhi, also referred to as Salmonella Typhi, is the cause of typhoid fever, or simply "typhoid" [1]. Typhoid fever and paratyphoid fever are both enteric fevers.…”

Proinflammatory Cytokines Associated with InvA and PagC Genes of Salmonella typhi Isolated from Patients Undergoing Cholecystectomy

“…When some people are exposed to S. typhi, they become carriers, as they keep bacteria in the gallbladder that are responsible for storing and excreting bile from the liver to the small intestine. 7 Abdominal ultrasound screening showed an ulcerative inflammatory reaction with fluid accumulation and an obvious thickening of the gallbladder in more than 59% of patients with typhoid fever, which may be these features in response to a local infection. 8 With the advent of molecular biology, including DNA fingerprinting and plasmid profiling, many vivo studies investigate gene variations of S. typhi that help bacterial organisms to adhere and survive in different environmental niches, as strains that lack the invasion machinery have drastically reduced capacity to colonize, spread 9 and/or drive inflammation 10 in mouse models.…”