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  1. Fulltext Seafood poisoning symptom, treatment and prevention
    Yoshida, Teruaki, Zarinah Waheed, Mohd Yusof Ibrahim, Mohammad Illzam Elahee, Shahjee Hussain, Sharifa Mariam Uma Abdullah, et al.
    Borneo Journal of Marine Science and Aquaculture, 2018;2(1):64-69.
    MyJurnal
    Food related disease or food poisoning is prevalent worldwide and is associated with high mortality. It can be caused by bacteria, viruses, parasites, enterotoxins, mycotoxins, chemicals, histamine poisoning (scombroid) ciguatera and harmful algal bloom (HAB). Illness can also result by red tide while breathing in the aerosolized brevitoxins (i.e. PbTx or Ptychodiscus toxins). Bacterial toxin food poisoning can affect within 1-6 hours and 8-16 hours, and illness can be with or without bloody diarrhea. The common symptoms of food poisoning include abdominal cramps, vomiting and diarrhea. Diagnosis includes examination of leftover food, food preparation environment, food handlers, feces, vomitus, serum and blood. Treatment involves oral rehydration, antiemetic, and anti-peristaltic drugs. Antimicrobial agents may be needed in the treatment of shigellosis, cholera, lifesaving invasive salmonellosis and typhoid fever. Proper care in handling and cooking is important to prevent any food borne diseases.
    Matched MeSH terms: Typhoid Fever
  2. Fulltext Retrospective analysis of older travellers attending a specialist travel health clinic
    Darrat M, Flaherty GT
    Trop Dis Travel Med Vaccines, 2019;5:17.
    PMID: 31548898 DOI: 10.1186/s40794-019-0094-8
    Background: Older people represent a significant proportion of overseas travellers. The epidemiology of older international travellers is not well described in the literature. This study aims to identify demographics, travel characteristics and the medical profile of older travellers seeking pre-travel health advice in a specialist travel medicine clinic.

    Methods: Records of travellers aged 60 years and older attending the Tropical Medical Bureau clinic in Galway, Ireland between 2014 and 2018 were examined. Descriptive and inferential.analysis of data was performed.

    Results: A total of 337 older travellers sought pre-travel health advice during the study period. The mean age of the cohort was 65.42 (±10) years. Most of the travellers (n = 267, 80%) had at least one travelling companion. Nearly half of older travellers (n = 155, 46.8%) were travelling with a single companion. Tourism was the main reason for travel for the majority (n = 260, 77.6%), followed by visiting friends and relatives (VFR) (n = 23, 6.9%) travellers. The mean interval remaining before the planned trip was 4.36 (±2) weeks, and the mean duration of travel was 3.16 (±1) weeks. The most popular single country of destination was India with 33 (9.8%) visitors, and South East Asia was the most popular region with 132 (39.2%) older travellers. The majority of travellers (n = 267, 79.2%) had a documented pre-existing medical condition. The most commonly reported medical conditions were hypertension (n = 26, 7.7%), dyslipidaemia (n = 18, 5.3%), diabetes mellitus (n = 12, 3.5%), insect bite sensitivity (n = 11, 3.3%), and hypothyroidism (n = 9, 2.6%). Antihypertensive agents (n = 32, 9.4%) and statins (n = 24, 7.1%) were the most frequently used medications. Typhoid (n = 112, 33.2%) and hepatitis A (n = 84, 24.9%) were the most common vaccinations administered to older travellers at the clinic.

    Conclusions: This study provides an insight into the demographics, travel characteristics, and medical profile of elderly travellers seeking advice at a large travel clinic in Ireland. A wide range of travel destinations, diseases and medication use was reported among this group of travellers, which may enable travel medicine physicians to provide more tailored advice and to more appropriately counsel older travellers.

    Matched MeSH terms: Typhoid Fever
  3. Fulltext Analysis of Salmonella enterica Serovar Typhi by Outer Membrane Protein (OMP) Profiling, Random Amplification of Polymorphic DNA (RAPD) and Pulsed Field Gel Electrophoresis (PFGE)
    Kumar Y, Mani KR, Tahlan AK
    Trop Life Sci Res, 2019 Jan;30(1):57-71.
    PMID: 30847033 DOI: 10.21315/tlsr2019.30.1.4
    A number of countries, including developed countries, still have typhoid fever as a major problem resulting in frequent outbreaks. The importance of controlling spread of typhoid fever is well known and necessitates periodic studies to delineate epidemiological relationships. Although phage typing remains to be the preferred conventional method for characterisation of typhoid bacilli, it is of limited use due to prevalence of few predominant phage types in the country like India. Therefore, an effort has been made to assess three molecular methods [Outer Membrane Protein (OMP) Profiling, Random Amplification of Polymorphic DNA (RAPD) and Pulsed Field Gel Electrophoresis (PFGE)] for typing of Salmonella enterica serovar Typhi. 128 Salmonella enterica serovar Typhi isolates were identified using biotyping and serotyping followed by antimicrobial susceptibility testing. These isolates were further subjected to OMP analysis, RAPD and PFGE. PFGE (114 unique clusters) was found to be the most discriminatory method followed by RAPD (94 unique clusters) and OMP profiling (50 unique clusters). Multidrug resistant strains were well discriminated by all three methods used in the study. PFGE still remains the most preferred method for detailed epidemiological investigations. However, random amplification of polymorphic DNA and outer membrane protein profiling can also be considered for molecular discrimination of the isolates in the laboratories lacking high-end facilities.
    Matched MeSH terms: Typhoid Fever
  4. Spectrum of flood-related diseases encountered during flood disaster in Johore, Malaysia
    Badrul Hisham, A.S., Nor Azian Shaharom, C.M.D., Marzukhi, M.I., Norli, R., Fatimah, O., Kee, KF, et al.
    Malaysian Journal of Community Health, 2009;15(3):15-23.
    MyJurnal
    The state of Johore, Malaysia had been hit by the worst flood in the Malaysian modern history on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) affecting all the eight districts. A total number of 157,018 and 155,368 Johore population had been displaced by the first and the second wave event respectively. The Johore State Health Department activated the Flood Action Plan which include mobilising medical teams to conduct daily clinical examinations on the flood victims and health teams to inspect flood relief centres, food premises and homes at flood-hit areas with regard to prevent and control communicable diseases. The spreadsheet format was used to collect data on diseases, injury and death throughout the Johore flood disaster period starting from the 19th December 2006 until 19th February 2007. Analyses showed that 19,670 flood victims (36.3%) had communicable diseases and 34,530 (67.0%) had non-communicable diseases. As for the communicable diseases and symptoms/syndromes related to communicable disease, 41.3% were acute respiratory infections (ARI) followed by 25.9% skin infections, 19.1% fever, 10.1% acute gastroenteritis (AGE) and 3.0% acute conjunctivitis. Other infectious diseases include 61 notifiable diseases (46 food poisoning, 14 dengue fever and one tuberculosis), 20 leptospirosis (with two deaths), 20 chicken pox and two melioidosis cases. The Batu Pahat district had the highest incidence for the majority of the communicable diseases because of the prolonged flooding period. No cholera, typhoid, malaria, measles or hand-foot-mouth disease (HFMD) cases were detected among the Johore flood victims. Trends of disease incidence follow the number of evacuees placed in the relief centres corresponding to respective wave. A total of 507 flood victims had physical injuries related to flood mostly due to fall onto wet floor at the relief centres. Fifteen deaths due to drowning were mainly caused by accidental fall into the flood water. The incidence of communicable diseases encountered had been appropriately anticipated and managed attributed to enhanced public health control programmes augmented by syndromic and laboratory surveillance on potentialy fatal infectious diseases. Equal emphasis should be given to the surveillance and control of chronic diseases.
    Matched MeSH terms: Typhoid Fever
  5. Fulltext Pengawalan mutu air minuman dan sanitasi semasa banjir 2006-2007 di Johor Darul Ta’zim
    Md Rajuna, A.S., Norazema, S.
    Malaysian Journal of Community Health, 2009;15(3):41-54.
    MyJurnal
    Background : Safe potable water is critical during and post flood. In the pre-flood period, Johore has an excellent, systematic and comprehensive water supply system. More than 98.6% of Johore population received treated water supply from the water treatment plants.
    Methodology : Data collection was performed by conducting additional water sampling at routine sampling stations as well as the flood relief centres, water tankers (lorries) and static water tanks. Water treatment plant outlet and water tanker inlet shall have a minimum level of 2.0 mg/l of residual chlorine so that reticulation, water tanker outlets and static water tanks would have at least 0.5 mg/l as a measure to prevent the incidence of water borne diseases. Sampling was done everyday to monitor water quality at the flood relief centres as well as flood-hit areas. Inspections and surveillance on sanitation were also conducted on latrines, solid waste disposal systems and on the surrounding environment.
    Results : A total of 6,283 water samples had been collected during and post flood. Violations on E. coli, turbidity and residual chlorine were 0.8%, 0.6% and 4.0% respectively with the Kluang district recorded the highest percentages for all the three parameters. A number of 621 wells had been inspected with 378 of them (60.9%) had been chlorinated. In order to ensure environmental cleanliness, 26,815 houses in 708 villages had been visited. Out of them, 2,011 houses (7.5%) were not satisfactory. Sanitation inspections found that 1,778 latrines, 2,719 domestic water sewerage systems and 2,955 solid waste disposal systems were under substandard conditions thus remedial actions had been taken immediately.
    Conclusion : Although the flood disaster was massive with prolonged flooding period, however, an overall quality status on treated water supply was satisfactory whilst sanitary hygiene was under control. Hence, the incidence of communicable disease especially water borne diseases would not progress into serious outbreak, in fact, neither cholera nor typhoid was reported during the Johore flood disaster.
    Matched MeSH terms: Typhoid Fever
  6. Fulltext Food safety issues in recent Flood 2006-2007 in Johore
    Daud, A.R., Thayalan, R., Farhatun Najmi, M.G.
    Malaysian Journal of Community Health, 2009;15(3):55-59.
    MyJurnal
    Background and Objective : Johor was affected by the worst flood in 100 years in December 2006 and again in January 2007. The concern that improper sanitary facilities and contaminated water supply at relief centres would result in contaminated food made monitoring of food hygiene vital. The objective of this paper is to describe food hygiene surveillance activities carried out in flood relief centres and flood affected areas and the challenges faced in carrying out these activities.
    Methodology : The food hygiene surveillance activities were carried out by the Assistant Environmental Health Officers (AEHO) in the districts. Among the surveillance activities carried out are inspection of food preparation areas in relief centres, inspection of food premises in flood affected areas and food sampling. Premise inspections were carried out using a specific inspection format. Food samples taken were sent to Public Health Laboratory, Johor Bahru for microbiological analysis. Anti typhoid vaccination for food handlers were also carried out. Apart from that, observations made by the health teams were alsotaken into account.
    Results : A total of 3,159 food preparation areas in relief centres were inspected. During the same period, a total of 2,317 food premises in flood affected areas were inspected as soon these premises started operating after the floods. Inspections showed that 69 food preparation areas in relief centres and 181 food premises in flood affected areas had unsatisfactory hygiene. A total of 1,566 holding samples were taken and 425 samples were sent to the laboratory for analysis. Forty-six of the samples analysed were found to be positive for pathogenic bacteria such as e. coli, staphylococcus aureus and salmonella.
    Conclusion : The health personnel from the Johor Health Department in various districts carried out an excellent job in ensuring food safety during the floods. There were no outbreaks of food poisoning. However analysis of food samples taken during the floods did show the presence of pathogenic organisms but probably their numbers were not high enough to cause any food poisoning. The promotion and enforcement of food hygiene requirements should be carried out continuously to ensure that every individual understands the need for hygiene and food safety during disaster situation such as flood.
    Matched MeSH terms: Typhoid Fever
  7. Fulltext Food poisoning outbreak in UiTM, Dungun, Terengganu, 1999.
    Faizan, G., Balkis, A.K., Kasemani, E., Che Mohd Shabri, A., Amirullah, M.A.
    Malaysian Journal of Public Health Medicine, 2002;2(1):50-53.
    MyJurnal
    Food poisoning is still a major problem in the state of Terengganu. The study was conducted during an episode of food poisoning outbreak which occurred in October, 1999, at Universiti Tekonologi Mara (UiTJ1rO, Dungun to determine the etiology, mode of transmission, source and the risk factors of the outbreak and hence to take appropriate remedial actions and preventive measures. A retrospective cohort study was conducted amongst 925 students using a standard questionnaire as well as environmental investigation and bacterial subtyping. All the samples were Malay females, age ranging jrom /9 — 22 years. It was found that majority ofthe victims (72 %) presented with abdominal cramp, 68.5% headache, 60.0% diarrhea, 55.2% fever, 45.0% nausea, 39.0% muscle
    ache and 3]. 7% vomiting. The epidemic curve suggested of a common source of infection and the most probable food that has been contaminated was taken during lunch hour on October 20'I'1999, Statistical analysis showed that spices jiied chicken and "nasi minyak" were significantly associated with the illness (p < 0. 05). The most likely causative organism was Salmonella spp as supported by the clinical presentation and incubation period of the disease, identdication of contaminated food, bacterial subtyping result and environmental findings. Following the outbreaks, several remedial actions were taken including immediate close—up ofthe canteen for I4 days, treatment for the cases and health examination and typhoid immunization for all food handlers.
    Matched MeSH terms: Typhoid Fever
  8. Trends in the antibiotic resistance patterns of enteric Fever isolates - a three year report from a tertiary care centre
    Gupta V, Singla N, Bansal N, Kaistha N, Chander J
    Malays J Med Sci, 2013 Jul;20(4):71-5.
    PMID: 24043999
    BACKGROUND: The incidence of multidrug resistant enteric fever is increasing alarmingly. This study was planned to determine the rate of isolation of Salmonella spp. and to compare the isolates for their epidemiological parameters and antimicrobial susceptibility patterns at our center.

    METHODS: The study was conducted over a span of three years with a total of 8142, 8134, and 8114 blood culture samples processed for the years 2008, 2009, and 2010 respectively. The minimum inhibitory concentration (MIC) for ciprofloxacin and chloramphenicol was determined using an agar dilution method. The MIC for ciprofloxacin was also confirmed by Epsilon-test (E -test) strips.

    RESULTS: Of the total 302 Salmonella spp. isolated, 257 were Salmonella enterica serotype Typhi (85.1%) and 45 (14.9%) were S. enterica serotype Paratyphi A. The majority of the isolates recovered were from the pediatric age group (54.6%) and males (60.6%). Complete susceptibility was observed to chloramphenicol, cefotaxime, ceftriaxone, and azithromycin over the last two years (2009 and 2010), with an increase in resistance to nalidixic acid (100%) and ciprofloxacin (13.6%).

    CONCLUSION: In our study, we found augmentation of resistance to nalidixic acid and fluoroquinolones and complete sensitivity to ceftriaxone along with reemergence of chloramphenicol sensitivity for Salmonella isolates. This report emphasises the necessity of continuous surveillance of antibiograms of enteric fever isolates in an area.

    Matched MeSH terms: Typhoid Fever
  9. Fulltext Multi-isotype antibody responses against the multimeric Salmonella Typhi recombinant hemolysin E antigen
    Ong EB, Ignatius J, Anthony AA, Aziah I, Ismail A, Lim TS
    Microbiol. Immunol., 2015 Jan;59(1):43-7.
    PMID: 25399538 DOI: 10.1111/1348-0421.12211
    The detection and measurement of different antibody isotypes in the serum provide valuable indicators of the different stages of typhoid infection. Here, the ability of S. Typhi recombinant hemolysin E (HlyE) to detect multi-isotype antibody responses in sera of patients with typhoid and paratyphoid A was investigated using an indirect antibody immunoassay. Nanogram amounts of HlyE were found to be sufficient for detection of IgG and IgA isotypes and, in a study of individuals' sera (n = 100), the immunoassay was able to distinguish between typhoid and non-typhoid sera. The overall sensitivity, specificity and efficiency of the ELISA were 70% (39/56), 100% (44/44) and 83% respectively.
    Matched MeSH terms: Paratyphoid Fever/diagnosis; Typhoid Fever/diagnosis*
  10. Performance of the rural health improvement scheme in reducing the incidence of waterborne diseases in rural Sarawak, Malaysia
    Liew KB, Lepesteur M
    Trans R Soc Trop Med Hyg, 2006 Oct;100(10):949-55.
    PMID: 16730364 DOI: 10.1016/j.trstmh.2005.11.018
    This study evaluates and discusses the impact of the rural health improvement scheme in reducing the incidence of dysentery, enteric fever, cholera and viral hepatitis in Sarawak, Malaysia, using data compiled from state and federal health department reports. This study suggests that from 1963 to 2002, water supply intervention contributed to a more than 200-fold decrease in dysentery and a 60-fold decrease in enteric fever. Variations in reporting of viral hepatitis during that period make it difficult to detect a trend. Cholera was still endemic in 2002. Cholera and dysentery outbreaks, occurring when rural populations relied on contaminated rivers for their water supply, suggested that sanitation intervention was not as effective in reducing waterborne diseases. Recommendations are made for successive one-component interventions focusing on catchment management to ensure protection of current and alternative water supplies.
    Matched MeSH terms: Typhoid Fever/prevention & control
  11. Multidrug-resistant strains of Salmonella enterica serotype typhi are genetically homogenous and coexist with antibiotic-sensitive strains as distinct, independent clones
    Thong KL, Bhutta ZA, Pang T
    Int J Infect Dis, 2000;4(4):194-7.
    PMID: 11231181
    OBJECTIVE: The goal of this study was to report the molecular analysis of antibiotic-sensitive and multidrug-resistant (MDR) strains of Salmonella typhi, using pulsed-field gel electrophoresis (PFGE), with a particular emphasis on the coexistence of these strains in a typhoid-endemic region of Karachi, Pakistan.

    METHODS: One hundred isolates of S. typhi in humans (50 MDR and 50 antibiotic-sensitive isolates) from sporadic cases of typhoid fever were analyzed by Vi-phage typing, antibiograms and PFGE.

    RESULTS: The MDR S. typhi strains were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. Analysis by PFGE showed that 50 MDR isolates of S. typhi had a single, homogenous PFGE profile, which was distinctly different from that of 50 antibiotic-sensitive isolates obtained in the same time frame from the same area. This latter group of isolates showed much greater diversity of PFGE profiles, as has been observed in other endemic regions.

    CONCLUSIONS: Multidrug-resistant and antibiotic-susceptible strains of S. typhi can coexist in endemic areas as epidemiologically independent pathogens and are not in competition for continued persistence and transmission.

    Matched MeSH terms: Typhoid Fever/microbiology*
  12. Cloning, expression, and purification of the hemolysin/cytolysin (HlyE antigen) from Salmonella enterica serovar Typhi: potential application for immunoassay development
    Ong EB, Anthony AA, Ismail A, Ismail A, Lim TS
    Diagn Microbiol Infect Dis, 2013 Sep;77(1):87-9.
    PMID: 23790417 DOI: 10.1016/j.diagmicrobio.2013.05.010
    The hemolysin (HlyE) protein of Salmonella enterica serovar Typhi was reported to be antigenic. This work describes the cloning, expression, and purification of a hexahistidine-tagged HlyE protein under native conditions. Immunoblot analysis and a competitive enzyme-linked immunosorbent assay using sera from typhoid patients showed the presence of HlyE-specific antibodies in circulation.
    Matched MeSH terms: Typhoid Fever/diagnosis*
  13. Rapid and reliable serological diagnosis of enteric fever: comparative sensitivity and specificity of Typhidot and Typhidot-M tests in febrile Malaysian children
    Choo KE, Davis TM, Ismail A, Tuan Ibrahim TA, Ghazali WN
    Acta Trop, 1999 Mar 15;72(2):175-83.
    PMID: 10206117
    The Typhidot test, which detects IgM and IgG antibodies to a Salmonella typhi-specific outer membrane protein, is as sensitive as, and more specific than, the Widal test in the diagnosis of enteric fever in Malaysian children. It is easier and quicker to perform. In order to increase diagnostic accuracy in an area of high endemicity, the Typhidot-M test has been developed in which IgG is first removed. This theoretically allows improved detection of IgM, and thus would differentiate new from recent infections. We evaluated both tests in 134 unselected febrile children admitted to the General Hospital Kota Bharu, Malaysia. The children were divided into two groups: (i) those who were blood and/or stool culture positive for S. typhi and/or who had clinical features strongly suggestive of enteric fever (n = 62); and (ii) those who were both culture-negative and had clinical evidence of another diagnosis (n = 72). The sensitivity and specificity of the Typhidot and Typhidot-M tests were identical at 90.3 and 93.1%, respectively. Both tests had comparable sensitivity but greater specificity than those of the Widal test (91.9 and 80.6%, respectively). When used together, a positive result for Typhidot and/or Typhidot-M was more specific than either test alone (95.2%) but specificity was lower (87.5%). We conclude that the Typhidot and Typhidot-M tests have comparatively high diagnostic accuracy, suggesting that IgM can be detected in children who may have a predominant IgG response to S. typhi. Using these tests in combination increases the negative predictive value but at the cost of a lower positive predictive value.
    Matched MeSH terms: Typhoid Fever/diagnosis*
  14. Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test
    Bhutta ZA, Mansurali N
    Am J Trop Med Hyg, 1999 Oct;61(4):654-7.
    PMID: 10548305
    We evaluated the diagnostic sensitivity and specificity of two dot-enzyme-linked immunoassays (Typhidot and Typhidot-M; Malaysian Biodiagnostic Research SDN BHD, Kuala Lumpur, Malaysia), assessing IgG and IgM antibodies against the outer membrane protein (OMP) of Salmonella typhi, and the Widal test in comparison with blood culture in a consecutive group of children with suspected typhoid fever. Of 97 children with suspected typhoid fever, the disease was confirmed bacteriologically in 46 (47%), whereas 25 (26%) were considered to have typhoid fever on clinical grounds. An alternative diagnosis was made in 26 (27%). The Typhidot and Typhidot-M were superior to the Widal test in their diagnostic sensitivity and specificity, although values (sensitivity = 85-94% and specificity = 77-89%) were significantly lower than in other regional reports. The lower specificity of the Typhidot in our series may represent regional differences in the genomic structure and plasticity of the OMP of S. typhi and merits further evaluation of these tests in diverse geographic locations.
    Matched MeSH terms: Typhoid Fever/diagnosis*
  15. Non-radioisotopic glucose turnover in children with falciparum malaria and enteric fever
    Singh B, Choo KE, Ibrahim J, Johnston W, Davis TM
    Trans R Soc Trop Med Hyg, 1998 12 23;92(5):532-7.
    PMID: 9861371
    To determine whether glucose turnover is increased in acute falciparum malaria compared to enteric fever in children, steady-state 6,6-D2-glucose turnover was measured in 9 Malaysian children with uncomplicated malaria (6 males and 3 females; median age 10 years, body weight 22 kg) and in 12 with uncomplicated enteric fever (8 males and 4 females; median age 10 years, body weight 24 kg) in acute illness, after quinine (5 malaria patients) and in convalescence. Baseline plasma glucose concentrations in malaria and enteric fever were similar (all values are medians [ranges in brackets]) 5.6 [3.2-11.3] vs. 5.5 [4.2-8.0] mmol/L), as were serum insulin levels (5.6 [0.4-26.5] vs. 6.8 [1.1-22.5] milliunits/L; P > 0.4). Glucose turnover in the malaria patients was higher than in patients with enteric fever (6.27 [2.71-6.87] vs. 5.20 [4.50-6.08] mg/kg.min; P = 0.02) and in convalescence (4.74 [3.35-6.79] mg/kg.min; P = 0.05 vs. acute malaria study), and fell after quinine together with a rise in serum insulin (P = 0.03). Basal plasma lactate concentrations were higher in enteric fever than in malaria (3.4 [1.8-6.4] vs. 0.8 [0.3-3.8] mmol/L; P < 0.0001) and correlated inversely with glucose turnover in this group (rs = -0.60; n = 12; P = 0.02). These data suggest that glucose turnover is 20% greater in malaria than in enteric fever. This might reflect increased non-insulin-mediated glucose uptake in falciparum malaria and/or impaired gluconeogenesis in enteric fever, and may have implications for metabolic complications and their clinical management in both infections.
    Matched MeSH terms: Typhoid Fever/metabolism*
  16. Fulltext Febrile illness in Malaysia--an analysis of 1,629 hospitalized patients
    Brown GW, Shirai A, Jegathesan M, Burke DS, Twartz JC, Saunders JP, et al.
    Am J Trop Med Hyg, 1984 Mar;33(2):311-5.
    PMID: 6324601
    We studied 1,629 febrile patients from a rural area of Malaysia, and made a laboratory diagnosis in 1,025 (62.9%) cases. Scrub typhus was the most frequent diagnosis (19.3% of all illnesses) followed by typhoid and paratyphoid (7.4%); flavivirus infection (7.0%); leptospirosis (6.8%); and malaria (6.2%). The hospital mortality was very low (0.5% of all febrile patients). The high prevalence of scrub typhus in oil palm laborers (46.8% of all febrile illnesses in that group) was confirmed. In rural Malaysia, therapy with chloramphenicol or a tetracycline would be appropriate for undiagnosed patients in whom malaria has been excluded. Failure to respond to tetracycline within 48 hours would usually suggest a diagnosis of typhoid, and indicate the need for a change in therapy.
    Matched MeSH terms: Paratyphoid Fever/diagnosis; Typhoid Fever/diagnosis
  17. Fulltext Genome sequence and comparative pathogenomics analysis of a Salmonella enterica Serovar Typhi strain associated with a typhoid carrier in Malaysia
    Yap KP, Gan HM, Teh CS, Baddam R, Chai LC, Kumar N, et al.
    J Bacteriol, 2012 Nov;194(21):5970-1.
    PMID: 23045488 DOI: 10.1128/JB.01416-12
    Salmonella enterica serovar Typhi is a human pathogen that causes typhoid fever predominantly in developing countries. In this article, we describe the whole genome sequence of the S. Typhi strain CR0044 isolated from a typhoid fever carrier in Kelantan, Malaysia. These data will further enhance the understanding of its host persistence and adaptive mechanism.
    Matched MeSH terms: Typhoid Fever/microbiology
  18. Induction and characterization of heat shock proteins of Salmonella typhi and their reactivity with sera from patients with typhoid fever
    Tang SW, Abubakar S, Devi S, Puthucheary S, Pang T
    Infect Immun, 1997 Jul;65(7):2983-6.
    PMID: 9199477
    The heat shock protein (HSP) response of Salmonella typhi following exposure to elevated growth temperatures was studied. Three major proteins with molecular sizes of 58, 68, and 88 kDa were abundantly expressed when S. typhi cells were shifted from 37 to 45 degrees C and to 55 degrees C. These proteins were also constitutively expressed at 37 degrees C. Western blotting and immunoprecipitation studies with anti-HSP monoclonal antibodies revealed that the 58- and 68-kDa proteins were analogous to the GroEL and DnaK proteins, respectively, of Escherichia coli. These HSPs are also abundantly present in the outer membrane fraction of disrupted cells and, to a lesser extent, in the cytosol. Immunoblotting experiments with sera from patients with a culture-positive diagnosis of typhoid fever showed the presence of antibodies to these HSPs. Nine of twelve sera reacted with the 58-, 68-, and 88-kDa proteins, while three sera reacted only with the 68- and 88-kDa proteins. All 10 sera from healthy individuals showed no binding to these HSPs. In light of the well-documented roles of HSPs in the pathogenesis of microbial infections and as immunodominant antigens, these findings may be relevant for a better understanding of disease processes and for the future development of diagnostic and preventive strategies.
    Matched MeSH terms: Typhoid Fever/immunology*
  19. Molecular analysis of isolates of Salmonella typhi obtained from patients with fatal and nonfatal typhoid fever
    Thong KL, Passey M, Clegg A, Combs BG, Yassin RM, Pang T
    J Clin Microbiol, 1996 Apr;34(4):1029-33.
    PMID: 8815078
    Molecular characterization of a total of 52 human isolates of Salmonella typhi from Papua New Guinea was performed by using pulsed-field gel electrophoresis (PFGE) after digestion of chromosomal DNA with three restriction endonucleases, XbaI (5'-TCTAGA-3'), AvrII (5'-CCTAGG-3'), and SpeI (5'-ACTAGT-3'). Of the 52 isolates tested, 11 were obtained from patients with fatal typhoid fever and 41 were obtained from patients with nonfatal disease. The 52 isolates showed limited genetic diversity as evidenced by only three different PFGE patterns detected following digestion with XbaI (patterns X1 to X3; F [coefficient of similarity] = 0.86 to 1.0), four patterns detected following digestion with AvrII (patterns A1 to A4; F =0.78 to 1.0), and two patterns detected following digestion with SpeI (patterns S1 and S2; F = 0.97 to 1.0). Of the 52 isolates, 37 were phage typed, and all belonged to phage type D2. All 11 isolates obtained from patients with fatal typhoid fever were identical (F = 1.0) and possessed the PFGE pattern combination X1S1A1, whereas the 41 isolates from patients with nonfatal typhoid fever had various PFGE pattern combinations, the most common being X2S1A2 (39%), X1S1A1 (24%), and X1S1A2 (15%). Thus, all the isolates from patients with the fatal disease had the X1 and A1 patterns, whereas the majority of the isolates from patients with nonfatal typhoid fever possessed the X2 and A2 patterns. The data suggest that there is an association among strains of S. typhi between genotype, as assessed by PFGE patterns, and the capability to cause fatal illness. Analysis of blood and fecal isolates of S. typhi from the same patient also indicated that some genetic changes occur in vivo during the course of infection.
    Matched MeSH terms: Typhoid Fever/microbiology*
  20. Molecular analysis of environmental and human isolates of Salmonella typhi
    Thong KL, Cordano AM, Yassin RM, Pang T
    Appl Environ Microbiol, 1996 Jan;62(1):271-4.
    PMID: 8572705
    Molecular characterization of a total of 54 isolates of Salmonella typhi from Santiago, Chile, was performed by pulsed-field gel electrophoresis (PFGE) after digestion of chromosomal DNA with three restriction endonucleases: XbaI (5'-TCTAGA-3'), AvrII (5'-CCTAGG-3'), and SpeI (5'-ACTAGT-3'). Thirteen of the 54 isolates were obtained from environmental sources (sewage and river water), and the rest were isolates from clinical cases of typhoid fever. Considerable genetic diversity was detected among the human isolates obtained in 1994, as evidenced by the presence of 14 to 19 different PFGE patterns among 20 human isolates, with F (coefficient of similarity) values ranging from 0.69 to 1.0 (XbaI), 0.61 to 1.0 (AvrII), and 0.70 to 1.0 (SpeI). A total of eight phage types were detected among these 20 isolates, with 50% possessing the E1 or 46 phage type. There was no correlation between PFGE pattern and phage types. Similar diversity was seen among 21 isolates obtained in 1983, with 17 to 19 PFGE patterns detected and F values of 0.56 to 1.0 (XbaI), 0.55 to 1.0 (AvrII), and 0.67 to 1.0 (SpeI). Comparison of these two groups of human isolates obtained 11 years apart indicated that certain molecular types of S. typhi are shared and are able to persist for considerable periods. A similar degree of genetic diversity was also detected among the environmental isolates of S. typhi, for which 10 to 12 different PFGE patterns were detected among the 13 isolates analyzed, with F values ranging from 0.56 to 1.0 (XbaI), 0.52 to 1.0 (AvrII), and 0.69 to 1.0 (SpeI). Certain molecular types present among the environmental isolates of S. typhi were also found among the human isolates from the same time period, providing evidence for the epidemiological link between environmental reservoirs and human infection.
    Matched MeSH terms: Typhoid Fever/microbiology
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