title: The challenge of enteric fever.
abstract: Enteric fever, a non-specific, systemic infection caused by S. Typhi or Paratyphi A, B or C, is common in resource-limited regions of the world, where poor sanitation infrastructure facilitates faeco-oral transmission. Prompt treatment with appropriate antibiotics minimises illness severity, but presentation to health care facilities is often delayed because of the non-specific nature of the symptoms and the lack of reliable diagnostic tests. Disease prevention requires significant investment in provision of clean water and sanitation in the long term; vaccination offers a more realistic strategy for medium term control. However, implementation of existing vaccines and development of more efficacious vaccines has been hindered by the lack of an established correlate of protection and under appreciation of the true disease burden. Human microbial infection studies could provide a vehicle for the rapid evaluation of novel vaccines and investigation of the immunobiology of enteric infection.
authors.affiliation: Department of Paediatrics, University of Oxford, Children's Hospital, Oxford OX3 9DU, United Kingdom. Electronic address: claire.waddington@paediatrics.ox.ac.uk.
authors.forename: Claire S
authors.initials: CS
authors.lastname: Waddington
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Darton
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Pollard
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D022562:Salmonella Vaccines / Q000008:administration & dosage*; D012499:Sanitation / Q000379:methods*; D014435:Typhoid Fever / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents; D022562:Salmonella Vaccines
keywords: Challenge studies; Controlled human infection; Disease control; Enteric fever; Paratyphoid; S. Paratyphi; S. Typhi; Typhoid; Vaccine