title: Typhoid fever.
abstract: Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures.
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich, UK. Electronic address: j.wain@uea.ac.uk.
authors.forename: John
authors.initials: J
authors.lastname: Wain
authors.affiliation: National Food Institute, Technical University of Denmark, WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, Kongens Lyngby, Denmark.
authors.forename: Rene S
authors.initials: RS
authors.lastname: Hendriksen
authors.affiliation: National Enteric Reference Laboratory Team, Enteric Diseases Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Mikoleit
authors.affiliation: Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Keddy
authors.affiliation: Independent Consultant (Vaccines), Tokyo, Japan.
authors.forename: R Leon
authors.initials: RL
authors.lastname: Ochiai
mesh_terms: D000349:Africa; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001208:Asia; D024881:Drug Resistance, Bacterial / Q000502:physiology; D018432:Drug Resistance, Multiple; D006801:Humans; D010284:Paratyphoid Fever / Q000188:drug therapy / Q000517:prevention & control*; D019779:Salmonella enterica / Q000276:immunology / Q000502:physiology; D012482:Salmonella paratyphi A / Q000276:immunology / Q000502:physiology*; D014435:Typhoid Fever / Q000188:drug therapy / Q000517:prevention & control*; D014436:Typhoid-Paratyphoid Vaccines / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D014436:Typhoid-Paratyphoid Vaccines