The structure of the population morbidity with specific intestinal infections in areas with different intensities in the development of the epidemic process and an evaluation of its manifestations]

The authors analyze the morbidity structure in five enteric infections (typhoid fever, dysentery caused by Shigella flexneri and Shigella sonnei, hepatitis A, and hepatitis E (non A, non B) with the fecal/oral mechanism of the agent transmission) in three towns of Turkmenia and in the town of Novomoskovsk, Tula Province. The incidence of S. sonnei dysentery was found higher in Novomoskovsk and that of the rest enteric infections under study in Turkmenia. The incidence of typhoid fever and hepatitis E was the highest among schoolchildren and adults, whereas preschool children suffered mostly from hepatitis A and S. sonnei dysentery. The authors discuss the specific features of the epidemic process manifestation in enteric infections.     

Immunomodulatory Properties of 2-C-Methyl-D-Erythritol-2,4-Cyclopyrophosphate and the Search for Its New Derivatives

A strong immunomodulatory effect of 2-C-Methyl-D-erythritol-2,4-cyclopyrophosphate (MEC) responsible for the survival of bacteria was shown on isolated macrophages and in experimental infections in mice (typhoid and tularemia). Derivatives of MEC were found by ¹H-NMR spectroscopy under stress conditions in colorless mutants of the bacteria and isolated to be subsequently purified and used for modulation of the immune system of animals.     

Reactivity of typhoid patients sera with stress induced 55 kDa phenotype in Salmonella enterica serovar Typhi

Salmonella faces a variety of stresses including acid and heat, in the natural environment whether in the gastrointestinal tract of mammalian host or in the external environment during transmission where survival and multiplication is a priority for the pathogen. In the present study, Salmonella enterica serovar Typhi was grown under acid (inorganic and organic) as well as heat stress and the outermembrane protein (OMP) profiles were compared. A 55 kDa OMP was found to be expressed with high intensity under the selected stress conditions in comparison to normal conditions. The protein expressed under acidic stress reacted with antibodies raised against heat shock protein indicating the similarity of atleast some of the epitopes. In vivo immunogenicity (reactivity with typhoid patient sera) revealed that the 55kDa protein under each stress condition was reactive with 83% of the typhoid sera. In the light of role of the stress induced proteins in pathogenesis of microbial infections and their immunogenic potential, these findings may be relevant for a better understanding of the host-microbe interactions and for future development of diagnostic and preventive strategies.     

Mathematical modeling and prognosis of incidence of enteric anthroponoses with aqueous route of transmission

Using data on long-term dynamics of epidemic process of acute enteric infections enteric with aqueous route of transmission (typhoid fever, shigellosis caused by Shigella flexneri, hepatitis A, rotavirus gastroenteritis, etc.)the equation of regression was developed with the help of Chebyshev's polynoms. Predicted incidences of these infections for 2005 were on 61.2-99.5% in agree with the real ones on two territories of north region of West Siberia. Predicted incidence for 2006 is reflecting tendencies of epidemic process of mentioned infections.     

Immunomodulatory properties of 2-C-methyl-D-erythritol-2,4-cyclopyrophosphate and search for its new derivatives]

A strong immunomodulatory effect of 2-C-methyl-D-erythritol-2,4-cyclopyrophosphate (MEC) responsible for the survival of bacteria was shown on isolated macrophages and in experimental infections in mice (typhoid and tularemia). Derivatives of MEC were found by 1H-NMR spectroscopy under stress conditions in colorless mutants of the bacteria and isolated to be subsequently purified and used for modulation of the immune system of animals.     

Animal models of Salmonella infections: enteritis versus typhoid fever.

The most common disease syndromes caused by Salmonella serotypes in humans, typhoid fever and enteritis, can be modeled using Salmonella enterica serotype Typhimurium infections in mice and calves, respectively. This article reviews murine typhoid and bovine enteritis and discusses strengths, limitations and distinctive features of these animal models.     

CHANGING EPIDEMIOLOGIC ASPECTS OF TYPHOID FEVER IN CALIFORNIA

Typhoid fever in California is no longer a major public health problem. The previously high incidence of water- and milk-borne infections has been greatly reduced. Human carriers now are the source of most infections.Chloramphenicol has proven to be a valuable aid in the therapy of the acutely ill patient, but it has not as yet solved the therapeutic or public health problems of typhoid fever. It continues to be vital for the protection of the public that every suspected case of typhoid fever be definitely established by appropriate public health laboratory procedures, that thorough investigation be carried out to determine the source of infection, and that careful follow-up examinations be done so that if a carrier state develops, proper measures can be taken.     

On the behaviour ofE. Typhi in surface water

Summary 1. Several typhoid infections were traced to direct or indirect contact with contaminated water from which typhoid bacteria could be isolated. 2. Especially during the winter months typhoid bacteria could be isolated from surface water. 3. In experiments the disappearance of typhoid bacteria from contaminated water is accelerated much more by the influence of the light than by the action of protozoa. 4. The definite phototaxis of typhoid bacteria may cause the rapid decrease of the microbes from the depth of surface water as well.     

Specific antibodies bound to secretory IgA in the sera of patients with intestinal infections]

Specific IgA and sIgA antibodies were studied in the sera of patients suffering from various intestinal diseases (dysentery, salmonellosis, typhoid fever, chronic typhoid carrier state) and in the sera of healthy persons immunized by parenteral route with typhoid alcohol vaccine. The nature of antibodies was identified in Coombs' test, using monospecific antisera to alpha-chain and to the secretory component. IgA and sIgA antibodies were revealed most frequently in the sera of dysentery patients and of chronic typhoid carriers. No sIgA antibodies were found in the sera of subcutaneously immunized persons. The presence of specific sIgA antibodies in the serum reflects the participation of local immune mechanisms in the formation of systemic immunity in the intestinal infections.     

The experimental and clinical use of polymyxin,chloromycetin, and aureomycin

Polymyxin is an effective antibiotic for the treatment of severe infections produced by Ps. aeruginosa, H. pertussis, H. influenzae, E. coli, and A. aerogenes. Its toxicity to date precludes its general use in infections susceptible to its therapeutic effects. Chloromycetin has been demonstrated to be an effective antibiotic agent for the treatment of rickettsial diseases and typhoid fever. It will undoubtedly prove effective in the treatment of other infections produced by certain Gram-negative micro-organisms and viral agents. Aureomycin has been shown to be an active antibiotic agent against rickettsial diseases, primary atypical pneumonia, acute brucellosis, pneumococcal, streptococcal, and staphylococcal infections, urinary tract infections produced by E. coli, A. aerogenes and Strept. fecalis, certain types of infections of the eye, and in subacute bacterial endocarditis when the infecting agent is Strept. fecalis. Its clinical use in forms of extrapulmonary tuberculosis is in a completely experimental stage. It is not recommended in typhoid fever or in infections due to Ps. aeruginosa or P. vulgaris, and it seems to be ineffective in whooping cough. To date, neither chloromycetin nor aureomycin has shown significant signs of systemic toxicity.     

Toll-like receptor 4 Asp299Gly and Thr399Ile polymorphisms and typhoid susceptibility in Asian Malay population in Malaysia

Typhoid fever is a major health problem with frequent outbreaks in Kelantan, Malaysia. Prevalence of TLR4 gene polymorphisms varies with ethnic groups (0-20%) and predisposean individual to gram-negative infections. The prevalence rate of TLR4 Asp299Gly and Thr399lle polymorphisms in the Malay population or the influence of these on typhoid fever susceptibility is not yet reported. 250 normal and 304 susceptible Malay individuals were investigated for these polymorphisms using allele-specific PCR and analysed for its association with typhoid fever susceptibility. The total prevalence of polymorphisms in the normal population was 4.8% in comparison to 12.5% in the susceptible population (p?=?0.002). An increased frequency of both polymorphisms was observed in the susceptible population (p?相似文献   

Genetically engineered Bifidobacterium animalis expressing the Salmonella flagellin gene for the mucosal immunization in a mouse model

BACKGROUND: A critical component of the host defense against enteric infections is the immunological response of the mucosal membrane, a major starting point of infectious disease, such as typhoid fever. The mucosal immune system consists of an integrated network of lymphoid tissues, mucous membrane-associated cells, and effector molecules. In the present study, we developed a recombinant Bifidobacterium animalis (B. animalis) genetically modified with the Salmonella flagellin gene for mucosal immunization as an oral typhoid vaccine. METHODS: We constructed an oral vaccine against Salmonella typhimurium, consisting of recombinant B. animalis containing the flagellin gene of Salmonella. The recombinant B. animalis was administered orally to mice every other day for 6 weeks. Anti-flagellin antibodies in the serum and stools were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: We detected significantly higher levels of flagellin-specific IgA in the serum and stools of the mice treated with the recombinant B. animalis containing the flagellin gene than was seen in those treated with parental B. animalis. CONCLUSIONS: Our findings suggest that an oral vaccination using recombinant B. animalis genetically modified with the flagellin gene of Salmonella may be effective against Salmonella infections.     

THE EXPERIMENTAL AND CLINICAL USE OF POLYMYXIN,CHLOROMYCETIN, AND AUREOMYCIN

Polymyxin is an effective antibiotic for the treatment of severe infections produced by Ps. aeruginosa, H. pertussis, H. influenzae, E. coli, and A. aerogenes. Its toxicity to date precludes its general use in infections susceptible to its therapeutic effects.Chloromycetin has been demonstrated to be an effective antibiotic agent for the treatment of rickettsial diseases and typhoid fever. It will undoubtedly prove effective in the treatment of other infections produced by certain Gram-negative micro-organisms and viral agents.Aureomycin has been shown to be an active antibiotic agent against rickettsial diseases, primary atypical pneumonia, acute brucellosis, pneumococcal, streptococcal, and staphylococcal infections, urinary tract infections produced by E. coli, A. aerogenes and Strept. fecalis, certain types of infections of the eye, and in subacute bacterial endocarditis when the infecting agent is Strept. fecalis. Its clinical use in forms of extrapulmonary tuberculosis is in a completely experimental stage. It is not recommended in typhoid fever or in infections due to Ps. aeruginosa or P. vulgaris, and it seems to be ineffective in whooping cough.To date, neither chloromycetin nor aureomycin has shown significant signs of systemic toxicity.     

On the epidemiological situation in quarantine, natural focal and other infections on the territory of the Southern Federal District

The data on the sanitary and epidemiological situation in the Southern Federal District are presented. The analysis of morbidity in tuberculosis, measles, HIV infection, viral hepatitis A, typhoid fever, cholera and quarantine infections, Crimean hemorrhagic fever, West Nile fever, rabies, malaria has been carried out. Special attention has been given to "new and newly returning infections", and among them to the spread of SARS ("atypical pneumonia"). The role of regional epidemiological safety programs, in particular such program as "The prophylaxis of quarantine and natural focal infections and the sanitary protection of the territory of the Southern Federal District of the Russian Federation from the import and spread infectious diseases in 2003-2005", has been substantiated.     

Did Osler suffer from "paranoia antitherapeuticum baltimorensis"?: A comparative content analysis of The Principles and Practice of Medicine and Harrison's Principles of Internal Medicine, 11th edition

One of the most important legacies of Sir William Osler was his textbook The Principles and Practice of Medicine. A common criticism of the book when it was first published was its deficiency in the area of therapeutics. In this article, the 1st edition of The Principles and Practice of Medicine is compared with the 11th edition of Harrison''s Principles of Internal Medicine. The analysis focuses on the treatment recommendations for 4 conditions that were covered in both books (diabetes mellitus, ischemic heart disease, pneumonia and typhoid fever). Osler''s textbook dealt with typhoid fever and pneumonia at greater length, whereas Harrison''s placed more emphasis on diabetes mellitus and ischemic heart disease. Notwithstanding Osler''s reputation as a therapeutic nihilist, the 2 books devoted equivalent space to treatment (in terms of proportion of total sentences for the conditions). For all conditions except ischemic heart disease, Osler concentrated on general measures and symptomatic care. Throughout Osler''s textbook numerous negative comments are made about the medicinal treatment of various conditions. A more accurate statement about Osler''s therapeutic approach was that he was a "medicinal nihilist." His demand for proof of efficacy before use of a medication remains relevant.     

Method of culturing typhoid microorganisms with automatic regulation of glucose feed]

A system of oxygen-glucose inverse relationship is not acceptable for cultivation of typhoid bacilli with a high reproductive rate and glucose utilization. The elaborated method of automatic glucose supply during typhoid bacilli cultivation permits to lead the process under the optimal conditions by pH and the residual glucose concentration.     

The etiological structure of shigellosis in the former USSR--an indicator of the activity of the main routes of infection transmission]

The data on the etiological structure of Shigella infections in the USSR in 1988-1989 are presented. The study showed the dominating role of S. flexneri with S. sonnei also retaining great importance in Shigella infections. The process of the liquidation of S. dysenteriae and S. boydii infections began in some large cities. The domination of dysentery caused by S. flexneri and a high typhoid rate, particularly in Central Asia, were due to poor water supply of the population. The spread of dysentery caused by S. sonnei was completely independent of the water factor. The decisive role in the transmission of S. sonnei in infective doses was explained by decentralized milk supply.     

Is travel prophylaxis worth while? Economic appraisal of prophylactic measures against malaria,hepatitis A,and typhoid in travellers.

OBJECTIVES--To estimate the costs and benefits of prophylaxis against travel acquired malaria, typhoid fever, and hepatitis A in United Kingdom residents during 1991. DESIGN--Retrospective analysis of national epidemiological and economic data. MAIN OUTCOME MEASURES--Incidence of travel associated infections in susceptible United Kingdom residents per visit; costs of prophylaxis provision from historical data; benefits to the health sector, community, and individuals in terms of avoided morbidity and mortality based on hospital and community costs of disease. RESULTS--The high incidence of imported malaria (0.70%) and the low costs of providing chemoprophylaxis resulted in a cost-benefit ratio of 0.19 for chloroquine and proguanil and 0.57 for a regimen containing mefloquine. Hepatitis A infection occurred in 0.05% of visits and the cost of prophylaxis invariably exceeded the benefits for immunoglobulin (cost-benefit ratio 5.8) and inactivated hepatitis A vaccine (cost-benefit ratio 15.8). Similarly, low incidence of typhoid (0.02%) and its high cost gave whole cell killed, polysaccharide Vi, and oral Ty 21a typhoid vaccines cost-benefit ratios of 18.1, 18.0, and 22.0 respectively. CONCLUSIONS--Fewer than one third of travellers receive vaccines but the total cost of providing typhoid and hepatitis A prophylaxis of 25.8m pounds is significantly higher than the treatment costs to the NHS (1.03m pounds) of cases avoided by prophylaxis. Neither hepatitis A prophylaxis nor typhoid prophylaxis is cost effective, but costs of treating malaria greatly exceed costs of chemoprophylaxis, which is therefore highly cost effective.     

Experience in dividing Tyumen Province into districts according to typhoid morbidity based on sanitary demographic factors

For the first time the territory of Tyumen Province has been zoned according to situation in typhoid fever morbidity by means of a complex of methods for computerized statistical data processing in combination with extensive epidemiological analysis. As a result, 43 administrative districts have been grouped in 5 zones having similar epidemiological, sanitary, hygienic, and demographic characteristics. For these zones territorially differentiated measures for decreasing typhoid fever morbidity have been worked out.     

Evaluation of Trimethoprim-sulphamethoxazole Compound in Treatment of Salmonella Infections

Fifty patients suffering from infections caused by various salmonella species were treated with trimethoprim-sulphamethoxazole compound. Twenty-three had enteric fever and two were biliary carriers of Salmonella typhi. The other 25 suffered from infections caused by salmonella species other than S. typhi or S. paratyphi B. Twenty-one of the patients with enteric fever responded clinically to the drug, one failed treatment, and one died. Two patients suffering from typhoid fever relapsed and three temporarily excreted S. typhi in stools following treatment. One of the typhoid carriers was successfully treated. All patients with infections caused by salmonella species other than S. typhi or S. paratyphi B responded to treatment but 17 continued to excrete the organism in their stools after the course of trimethoprim-sulphamethoxazole compound. Four patients developed rashes during therapy and two became anaemic.