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Embora Salmonella Enteritidis (SE) seja capaz de metabolizar 1,2-propanodiol (1,2-Pd), utilizado como fonte de carbono e de energia ao longo de uma rota dependente de vitamina B12, a importância deste composto na infeção de Gallus gallus domesticus por SE permanece desconhecida. No presente estudo, foram construídos um mutante de SE sem os genes pduCDE, que codifica a propanodiol desidratase (Pdu), e outro contendo as deleções no pduCDE e também nos genes cobS e cbiA, responsáveis pela síntese de vitamina B12. Em seguida, avaliou-se a importância do metabolismo do 1,2-Pd em SE para colonização intestinal de infecção sistêmica de poedeiras comerciais. As estirpes mutantes de SE foram capazes de colonizar o intestino, de serem excretadas nas fezes e de invadir o baço e o fígado na mesma intensidade que a estirpe selvagem, o que sugere que os produtos dos genes pduC, pduD, pduE, cobS e cbiA não são essenciais durante infecção por Salmonella Enteritidis nessa espécie.(AU)
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Animales , Salmonella enteritidis/patogenicidad , Salmonella enteritidis/ultraestructura , Pollos/microbiología , Microbioma Gastrointestinal , TranscobalaminasRESUMEN
Background & objectives: The temporal trends in the development of antimicrobial resistance (AMR) among Salmonella Typhi and Salmonella Paratyphi in India have not been systematically reported. We aimed to systematically review the temporal AMR trends (phenotypic and molecular mechanisms) in bacterial isolates from patients with enteric fever over two decades in India. Methods: To identify trends in AMR in India, resistance patterns among 4611 individual S. Typhi isolates and 800 S. Paratyphi A isolates, reported from 1992 to 2017 in 40 publications, were analysed. Molecular resistance determinants were extracted from 22 publications and also reviewed in accordance with the PRISMA guidelines. Articles were sourced using a predefined search strategy from different databases. Results: The analyses suggested that multidrug-resistant (MDR) enteric fever was declining in India and being replaced by fluoroquinolone (FQ) resistance. Mutations in gyrA and parC were key mechanisms responsible for FQ resistance, whereas MDR was largely driven by resistance determinants encoded on mobile genetic elements (plasmids, transposons). Interpretation & conclusions: The results reflect the effect of antimicrobial pressure which has been driving AMR in typhoidal Salmonella in India. Understanding these trends is important in planning future approaches to therapy, which serve as a baseline for assessment of the impact of new typhoid conjugate vaccines against these resistant organisms.
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Objective To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013,and provide evidence for the prevention and control of typhoid and paratyphoid,the development and improvement of surveillance strategies.Methods Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid,and related public health emergencies in China during 2009-2013.Pathogen isolation and culture,serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites.The isolates were subjected to antimicrobial susceptibility testing.Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates.Results The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000.The reported case number and incidence decreased with year.The provinces reporting high case numbers were Yunnan,Guizhou,Guangxi,Hunan,Zhejiang,Guangdong and Xinjiang.The incidence of age group 0-4 years was highest.The proportion of farmers and children outside child care settings showed an increasing tendency over time.The annual incidence peak was during July-August.Twenty five outbreaks occurred during 2009-2013.The results of pathogen isolation and culture showed that the positive rate was 3.00％ (940/31 322),among the positive isolates,the proportion of Salmonella paratyphi A accounted for higher proportion (68.19％,641/940) compared with Salmonella typhi (31.60％,297/940).The drug resistances of Salmonella typhi and Salmonella paratyphi varied,but their resistances to nalidixic acid were highest (50.22％ and 85.33％) respectively.A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins.PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A.Conclusion The epidemic level of typhoid and paratyphoid in China was relatively low,but the outbreak occurred occasionally.It is necessary to enhance the laboratory-based surveillance,particularly the capability of etiological diagnosis,outbreak investigation,response and antibiotic resistance monitoring,and conduct risk factor investigation in provinces with high incidences in recent years.
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Objective To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013,and provide evidence for the prevention and control of typhoid and paratyphoid,the development and improvement of surveillance strategies.Methods Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid,and related public health emergencies in China during 2009-2013.Pathogen isolation and culture,serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites.The isolates were subjected to antimicrobial susceptibility testing.Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates.Results The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000.The reported case number and incidence decreased with year.The provinces reporting high case numbers were Yunnan,Guizhou,Guangxi,Hunan,Zhejiang,Guangdong and Xinjiang.The incidence of age group 0-4 years was highest.The proportion of farmers and children outside child care settings showed an increasing tendency over time.The annual incidence peak was during July-August.Twenty five outbreaks occurred during 2009-2013.The results of pathogen isolation and culture showed that the positive rate was 3.00％ (940/31 322),among the positive isolates,the proportion of Salmonella paratyphi A accounted for higher proportion (68.19％,641/940) compared with Salmonella typhi (31.60％,297/940).The drug resistances of Salmonella typhi and Salmonella paratyphi varied,but their resistances to nalidixic acid were highest (50.22％ and 85.33％) respectively.A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins.PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A.Conclusion The epidemic level of typhoid and paratyphoid in China was relatively low,but the outbreak occurred occasionally.It is necessary to enhance the laboratory-based surveillance,particularly the capability of etiological diagnosis,outbreak investigation,response and antibiotic resistance monitoring,and conduct risk factor investigation in provinces with high incidences in recent years.
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A comparative survey between non-systemic (paratyphoid Salmonellae) and systemic (S. Pullorum and S. Gallinarum) Salmonella strains was performed to produce a virulence gene profile for differentiation among the groups. The following virulence genes were evaluated: invA, spvC, sefC, pefA, fimY, sopB, sopE1, stn and avrA. There are substantial differences among paratyphoid Salmonellae, S. Pullorum, and S. Gallinarum regarding the genes sefC, spvC, sopE1 and avrA. A higher frequency of sefC, spvC, sopE1 and avrA genes were detected in S. Gallinarum and S. Pullorum when compared with strains from the paratyphoid group of Salmonella. These results may be useful for differentiating among different groups and serotypes.(AU)
Uma investigação comparativa entre amostras de Salmonella não-sistêmicas (grupo paratifoide) e sistêmicas (S. Pullorum and S. Gallinarum) foi desenvolvida para produzir um perfil de genes de virulência para diferenciação entre os grupos. Os seguintes genes de virulência foram avaliados invA, spvC, sefC, pefA, fimY, sopB, sopE1, stn e avrA. Detectou-se uma diferença substancial entre Salmonella do grupo paratifoide, S. Pullorum e S. Gallinarum considerando os genes sefC, spvC, sopE1 e avrA. Os genes sefC, spvC, sopE1 e avrA foram detectados, em maior número, em S. Gallinarum e S. Pullorum quando comparados com as amostras de Salmonella do grupo paratifoide. Estes resultados podem ser úteis para a diferenciação entre os diferentes grupos e sorotipos de Salmonella.(AU)
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Animales , Enfermedades de las Aves de Corral/microbiología , Salmonella/genética , Salmonella/patogenicidad , PollosRESUMEN
Objective To analyze the spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in Yunnan, Guizhou and Guangxi provinces in southwestern China in recent years. Methods The incidence data of typhoid and paratyphoid fever cases at county level in 3 provinces during 2001-2012 were collected from China Information System for Diseases Control and Prevention and analyzed by the methods of descriptive epidemiology and geographic informatics. And the map showing the spatial and temporal clustering characters of typhoid and paratyphoid fever cases in three provinces was drawn. SaTScan statistics was used to identify the typhoid and paratyphoid fever clustering areas of three provinces in each year from 2001 to 2012. Results During the study period, the reported cases of typhoid and paratyphoid fever declined with year. The reported incidence decreased from 30.15 per 100000 in 2001 to 10.83 per 100000 in 2006 (annual incidence 21.12 per 100000);while during 2007-2012, the incidence became stable, ranging from 4.75 per 100000 to 6.83 per 100000 (annual incidence 5.73 per 100000). The seasonal variation of the incidence was consistent in three provinces, with majority of cases occurred in summer and autumn. The spatial and temporal clustering of typhoid and paratyphoid fever was demonstrated by the incidence map. Most high-incidence counties were located in a zonal area extending from Yuxi ofYunnan to Guiyang of Guizhou, but were concentrated in Guilin in Guangxi. Temporal and spatial scan statistics identified the positional shifting of class Ⅰ clustering area from Guizhou to Yunnan. Class Ⅰ clustering area was located around the central and western areas (Zunyi and Anshun) of Guizhou during 2001-2003, and moved to the central area of Yunnan during 2004-2012. Conclusion Spatial and temporal clustering of typhoid and paratyphoid fever existed in the endemic areas of southwestern China, and the clustering area covered a zone connecting the central areas of Guizhou and Yunnan. From 2004 to 2012, the most important clustering area shifted from Guizhou to Yunnan. Findings from this study provided evidence for the identifying key areas for typhoid and paratyphoid fever control and prevention and allocate health resources.
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Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68％),children (15.89％) and students (12.01％).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.
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Objective To analyze the spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in Yunnan, Guizhou and Guangxi provinces in southwestern China in recent years. Methods The incidence data of typhoid and paratyphoid fever cases at county level in 3 provinces during 2001-2012 were collected from China Information System for Diseases Control and Prevention and analyzed by the methods of descriptive epidemiology and geographic informatics. And the map showing the spatial and temporal clustering characters of typhoid and paratyphoid fever cases in three provinces was drawn. SaTScan statistics was used to identify the typhoid and paratyphoid fever clustering areas of three provinces in each year from 2001 to 2012. Results During the study period, the reported cases of typhoid and paratyphoid fever declined with year. The reported incidence decreased from 30.15 per 100000 in 2001 to 10.83 per 100000 in 2006 (annual incidence 21.12 per 100000);while during 2007-2012, the incidence became stable, ranging from 4.75 per 100000 to 6.83 per 100000 (annual incidence 5.73 per 100000). The seasonal variation of the incidence was consistent in three provinces, with majority of cases occurred in summer and autumn. The spatial and temporal clustering of typhoid and paratyphoid fever was demonstrated by the incidence map. Most high-incidence counties were located in a zonal area extending from Yuxi ofYunnan to Guiyang of Guizhou, but were concentrated in Guilin in Guangxi. Temporal and spatial scan statistics identified the positional shifting of class Ⅰ clustering area from Guizhou to Yunnan. Class Ⅰ clustering area was located around the central and western areas (Zunyi and Anshun) of Guizhou during 2001-2003, and moved to the central area of Yunnan during 2004-2012. Conclusion Spatial and temporal clustering of typhoid and paratyphoid fever existed in the endemic areas of southwestern China, and the clustering area covered a zone connecting the central areas of Guizhou and Yunnan. From 2004 to 2012, the most important clustering area shifted from Guizhou to Yunnan. Findings from this study provided evidence for the identifying key areas for typhoid and paratyphoid fever control and prevention and allocate health resources.
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Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68％),children (15.89％) and students (12.01％).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.
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Objective To investigate some pathogenic characters of Salmonella enterica strains isolated from poultry. Methods Twenty-three genetically distinct Salmonella enterica strains, of different serovars and pulsotype, were examined for virulence traits. Resistance to gastric acid environment was estimated by measuring the percentage of survived bacterial cells after exposure for 2 h to a synthetic gastric juice. Strains were analyzed with PCR for the presence of the following virulence genes: mgtC and rhuM located on SPI-3, sopB and pipB located on SPI-5, Salmonella virulence plasmid (spv) R (spvR), spvB and spvC located on Salmonella plasmid virulence and sodCI, sopE, and gipA located on prophage. Finally, resistance to 21 antibiotics was tested with Kirby–Bauer method. Results A percentage of 82.60% of strains were resistant to gastric environment after induction and 60.87% of the strains exhibited constitutive resistance too. Nineteen different virulence profiles were detected. The phage related genes sodCI and sopE and the plasmid mediated operon spvR, spvB and spvC (spvRBC) were detected in 82.60%, 47.82% and 52.17% of strains, respectively. Typhimurium and Enteritidis strains showed the highest number of virulence genes. Twenty-one different antibiotic resistance profiles were obtained and two isolates (Typhimurium and Enteritidis) resulted sensible to all the tested molecules. The ampicillin, streptomycin, sulfonamide and tetracycline resistance profile was detected in seven isolates (30.43%). Conclusion Our results show that paratyphoid Salmonella strains with several characters of pathogenicity, that may be cause of severe pathology in animals and humans, are circulating among poultry.
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OBJECTIVE@#To investigate some pathogenic characters of Salmonella enterica strains isolated from poultry.@*METHODS@#Twenty-three genetically distinct Salmonella enterica strains, of different serovars and pulsotype, were examined for virulence traits. Resistance to gastric acid environment was estimated by measuring the percentage of survived bacterial cells after exposure for 2 h to a synthetic gastric juice. Strains were analyzed with PCR for the presence of the following virulence genes: mgtC and rhuM located on SPI-3, sopB and pipB located on SPI-5, Salmonella virulence plasmid (spv) R (spvR), spvB and spvC located on Salmonella plasmid virulence and sodCI, sopE, and gipA located on prophage. Finally, resistance to 21 antibiotics was tested with Kirby-Bauer method.@*RESULTS@#A percentage of 82.60% of strains were resistant to gastric environment after induction and 60.87% of the strains exhibited constitutive resistance too. Nineteen different virulence profiles were detected. The phage related genes sodCI and sopE and the plasmid mediated operon spvR, spvB and spvC (spvRBC) were detected in 82.60%, 47.82% and 52.17% of strains, respectively. Typhimurium and Enteritidis strains showed the highest number of virulence genes. Twenty-one different antibiotic resistance profiles were obtained and two isolates (Typhimurium and Enteritidis) resulted sensible to all the tested molecules. The ampicillin, streptomycin, sulfonamide and tetracycline resistance profile was detected in seven isolates (30.43%).@*CONCLUSION@#Our results show that paratyphoid Salmonella strains with several characters of pathogenicity, that may be cause of severe pathology in animals and humans, are circulating among poultry.
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Salmonella (S.) Typhimurium is highly contagious, and its infection may rapidly spread within pig populations of herd. According to the survey (1,191 pigs) from 2003 to 2012, 155 pigs (13.0%) were diagnosed as salmonellosis in Jeju. Major porcine salmonellosis cases (88.4%) were concentrated in 4- to 12-week-old weaned pigs, but 6 pigs (3.9%) under 4 weeks old were also diagnosed. Based on the histopathologic examinations, ulcerative enteritis (63.9%) in the large intestine and/or paratyphoid nodules formation (57.4%) in the liver were most prevalent lesions in porcine salmonellosis. Single infection of S. Typhimurium and mixed infection with more than 2 pathogens were detected in 38 (24.5%) and 117 (75.5%) in pigs, respectively. Co-infections of Porcine reproductive and respiratory syndrome virus and Porcine circovirus type 2 were very common in porcine salmonellosis in Jeju and detected in 84 (54.2%) and 59 (38.1%) pigs, respectively. Based on the serotyping tests using 41 bacterial isolates, S. Typhimurium and S. Rissen were confirmed in 39 (95.1%) and 2 (4.9%) cases, respectively.
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Circovirus , Coinfección , Enteritis , Intestino Grueso , Hígado , Virus del Síndrome Respiratorio y Reproductivo Porcino , Prevalencia , Salmonella , Infecciones por Salmonella , Salmonella typhimurium , Serotipificación , Porcinos , ÚlceraRESUMEN
To develop a live vaccine strain against fowl typhoid and paratyphoid caused by Salmonella serovar Gallinarum biovar Gallinarum (Salmonella Gallinarum) and Salmonella serovar Enteritidis (Salmonella Enteritidis), respectively, several nalidixic acid resistant mutants were selected from lipopolysaccharide (LPS) rough strains of Salmonella Gallinarum that escaped from fatal infection of a LPS-binding lytic bacteriophage. A non-virulent and immunogenic vaccine strain of Salmonella Gallinarum, SR2-N6, was established through in vivo pathogenicity and protection efficacy tests. SR2-N6 was highly protective against Salmonella Gallinarum and Salmonella Enteritidis and safer than Salmonella Gallinarum vaccine strain SG 9R in the condition of protein-energy malnutrition. Thus, SR2-N6 may be a safe and efficacious vaccine strain to prevent both fowl typhoid and paratyphoid.
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Bacteriófagos , Ácido Nalidíxico , Desnutrición Proteico-Calórica , Salmonella , Salmonella enteritidis , Fiebre Tifoidea , Naciones Unidas , VirulenciaRESUMEN
Background: The protean manifestations of enteric fever make this disease a true diagnostic challenge. Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within 1 month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications. This is a prospective study of fifty confirmed enteric fever adult patients done in Kasturba Hospital Mumbai. Methods: Fifty enteric fever patients with clinical and laboratory diagnosis were included in the study. They were admitted in wards with the aim of documenting the epidemiological pattern, clinical picture, therapeutic response and complications of Salmonella. Their history and detailed physical examination were recorded and tests including antibiotic sensitivity and resistance were done. Results: In the study incidence of fever 100%, chills 26%, vomiting 44%, diarrhea 28%, abdominal pain 64%, headache 26%, and signs as splenomegaly 36%, hepatomegaly 42%, rose spots 6%, relative bradycardia 34% were reported. Anemia, leukocytosis and leukopenia and elevated liver enzymes were found in 42.9%, 10%, 21% and 45% respectively. Incidence of Salmonella Typhi, Salmonella Paratyphi was 80% and 20% respectively. There was no mortality in the study. Conclusion: Clinical presentation, signs and symptoms of Typhoid fever patients are varying. For the confirmatory diagnosis in addition to a high index of suspicion, Widal test and blood culture are required. For the proper treatment of Typhoid fever in view of emergence of resistant strains of S. Typhi antibiotic sensitivity and resistance test should be done whenever facilities available.
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Objective This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever,in Guizhou province,from 2007 to 2012, to provide evidence for the improvement of related programs. Methods Data on typhoid fever and paratyphoid including information on epidemics,individual,cases,measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province,from 2007 to 2012. Information related to the average annual incidence,nature of outbreaks, time span before confirmed diagnosis was made,unit which carried the case report,proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excelland EpiInfo software were used for data analysis. Results In the period of 2007-2009,a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012,2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former,data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ 2=0.08,P=0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47%. The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in,inputted and audited showed increase of 8.44%,6.76%and 2.40%respectively. Conclusion Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province,but the potential risk of outbreaks still existed in some areas,suggesting that health education and surveillance programs including laboratory diagnosis,should be strengthened.
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Objective This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever,in Guizhou province,from 2007 to 2012, to provide evidence for the improvement of related programs. Methods Data on typhoid fever and paratyphoid including information on epidemics,individual,cases,measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province,from 2007 to 2012. Information related to the average annual incidence,nature of outbreaks, time span before confirmed diagnosis was made,unit which carried the case report,proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excelland EpiInfo software were used for data analysis. Results In the period of 2007-2009,a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012,2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former,data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ 2=0.08,P=0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47%. The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in,inputted and audited showed increase of 8.44%,6.76%and 2.40%respectively. Conclusion Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province,but the potential risk of outbreaks still existed in some areas,suggesting that health education and surveillance programs including laboratory diagnosis,should be strengthened.
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Objective Through analyzing the national statutory reporting data on typhoid,paratyphoid fever in 2012,we were trying to understand the whole picture of typhoid,paratyphoid fever at the national level as well as to understand the trends and characteristics of typhoid and paratyphoid fever in provinces with high incidence rate,so as to the development of prevention and control strategies of the diseases in those high-incidence rate provinces.Methods We descriptively analyzed the national typhoid and paratyphoid fever statutory reporting data which was reported through disease surveillance information reporting system in 2012.Results 11 998 cases with typhoid and paratyphoid fever were reported with 3 fatal ones,in 2012 in the whole country.The incidence rate was 0.89 per 100 000.Compared to the data gathered in 2011,the incidence rates of typhoid/paratyphoid fever increased by 1.20％.The total number of the confirmed cases on typhoid and paratyphoid fever was 6522 and was accounted for 54.36％ of the total cases,in which paratyphoid fever accounted for 36.86％.Cases were mainly involved farmers and followed by students and children.Incidence rates of typhoid and paratyphoid fever in children aged 0-4 years old appeared the highest (respectively 1.31/100 000 and 0.46/100 000).Yunnan,Guizhou,Guangdong,Guangxi,Zhejiang,Hunan and Xinjiang provinces (autonomous regions) were identified as provinces with high-incidence rates of typhoid and paratyphoid fever.During 2005-2012,the incidence rates in most of the above high-incidence provinces showed a downward trend,except for in Guangdong which had only showed a slight change.There were variations on peak period and highly-hit population in seven high-incidence provinces.Conclusion The incidence rate of typhoid/paratyphoid fever was in a relatively low level in China.Prevention and control strategies on the diseases in children under 5 years old remained a challenge,warranted more work to be done.The epidemiological situation is still severe in some high-incidence rate provinces.
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Objective To explore the distribution of prevalence rates of typhoid and paratyphoid,with drug resistance and molecular types ofSalmonella(S.) typhi and S.paratyphi in Jiangsu province.Methods Data,collected by the national infectious disease reporting system in Jiangsu province from 2007 to 2011,was analyzed.K-B method was used to test the sensibility to 9 kinds of antibiotics among 210 stains of S.typhi and S.paratyphi.81 strains of S.typhi were classified by pulse-field gel electrophoresis (PFGE).Results The annual average incidence of typhoid and paratyphoid was 0.47 per 100 000 in the last five years,showing a decreasing trend.Highest incidence (1.70 per 100 000)was seen in the ＜ 1 year age group,with S.typhi and S.paratyphi A accounted for 66.19％ and 23.81％ among the 210 stains.The rate of drug resistance to nalidixic acid appeared to be the highest as 66.19％.The drug resistant rates to 6 kinds of antibiotics were on average,lower than 10.00％.The multi-drug resistant rate of S.typhi and S.paratyphi was 30.00％.In the last 3 years,37 types from 81 S.typhi strains had been classified into 4 clusters by PFGE.The predominant type was JPPX01.JS0027,accounted for 11.11％.JPPX01.JS0001 type had a specific regional distribution,but JPPX01.JS0014,JPPX01.JS0018 and JPPX01.JS0024 strains were widely spread.Results from the clustering analysis showed that cases in the 3 events tended to have a clustering nature.Conclusion The morbidity of typhoid and paratyphoid was in a relatively low level in Jiangsu province.Although S.typhi and S.paratyphi were sensitive to most of the commonly used antibiotics,the resistance rates to some kinds of antibiotics were increasing.The distribution of typhoid was sporadic in Jiangsu and without the dominant strain,it was unlikely that typhoid could become epidemic in the future,in Jiangsu.
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Objective To evaluate the burden of paratyphoid fever A in Hongta district, Yuxi city, Yunnan province from May 1, 2008 to April 30, 2009 so as to provide information for the development of comprehensive intervention measures. Methods Based on the Fever Syndromic Surveillance System, information as attendance rate of patients with fever, rate of patients being sampled, laboratory testing rate, sensitivity on the detection of blood culture and the rate of case reporting etc. were calculated. According to the pyramid model of food-borne disease on disease burden, the local actual incidence of paratyphoid fever A was estimated and analyzed. Results Under the Fever Syndromic Surveillance System, there were 6642 fever cases being detected, among whom 6570 cases were sampled and undergone testing, with the sampling rate as 98.92% and all the samples received laboratory testing. There were 354 positive cases of paratyphoid fever A reported,all from the Hongta district. Data showed that the attendance rate of the feverish patients was 73.53%,with the highest rate seen in whose under 10 years old (100%). Assumed that the sensitivity of paratyphoid fever blood culture was 70%, and the case reporting rate was 90%, we estimated that the annual incidence of paratyphoid fever A in Hongta was 220.33 (95% CI: 170.1-521.4) per 100 thousand, with 965 (95%CI: 745-2284) as new cases. Among all the age groups, the incidence in the age group from 15 to 44 years old was estimated to be at the highest (318.27 per 100 thousand).Conclusion Hongta seemed to be an endemic region for paratyphoid fever A, with the highest incidence occurred in the age group of between 15 and 44 years old. These findings highlighted the urgent need to carry out further investigation on the risk factors and to implement targeted effective prevention and control measures.
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Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.