Unlocking the Potential of Genomic Data to Inform Typhoid Fever Control Policy: Supportive Resources for Genomic Data Generation, Analysis, and Visualization.

The global response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic demonstrated the value of timely and open sharing of genomic data with standardized metadata to facilitate monitoring of the emergence and spread of new variants. Here, we make the case for the value of Salmonella Typhi (S. Typhi) genomic data and demonstrate the utility of freely available platforms and services that support the generation, analysis, and visualization of S. Typhi genomic data on the African continent and more broadly by introducing the Africa Centres for Disease Control and Prevention's Pathogen Genomics Initiative, SEQAFRICA, Typhi Pathogenwatch, TyphiNET, and the Global Typhoid Genomics Consortium.

Thyroid outbreak during the pandemic of COVID-19: a report

Background : In the 19th Week of 2020, Integrated Disease Surveillance Programme (IDSP) noted an unusual increase in the number of fever cases in Routine Syndromic Surveillance. Objectives : The unusual increase of fever cases were investigated to identify the agent, the source of infection and to propose recommendations for control measures. Methods : Active surveillance of fever cases done, blood samples, stool samples and water samples were collected from the affected area. The secondary data of indoor and outdoor patient were collected from the nearest health facilities. Result : It was a single peak outbreak of typhoid, started from 1st May, 2020, had peaked during the 19th Week of May. 2020 and ended on 31st May, 2020. The epicentre of the outbreak was the residential colony of Industrial labour. The outbreak of Typhoid occurred due to conditions generated due to the pandemic of COVID -19. Two sources of active infection were found. First, contaminated supply of drinking water and second a food-handler, who was the carrier of Typhoid. Interpretation and Conclusion : It is a lesson to learn that the local communicable diseases should be monitor during the pandemic. Otherwise, that can cause the situation of co-epidemic.

False sero-positivity of Salmonella typhi Specific Antibody in Dengue and Corona Virus Infected Patients: An Observational Study

Typhoid fever is a major concern in developing nations. People living in endemic area may frequently get exposed to the typhoid bacilli and can carry some amount of antibody in their circulations which can easily lead to misdiagnosis during other febrile illness. To assess the frequency of false sero-positivity of Salmonella specific antibody in Dengue and COVID-19 patients. An observational case control study was conducted in a multispecialty teaching hospital in north India. A total of 110 serum samples which included dengue IgM positive patients (N= 40), COVID-19 RT-PCR positive patients (N=40) and control subjects (N=30) without any febrile illness were studied. All the samples were tested for Salmonella specific antibody by Widal test and by immune chromatography strip test (ICT). Patient's detail were documented in a structured Performa. Out of 110 samples 63(57%) were male and 47(43%) were female with age mean age +/-45 years. Among the dengue IgM positive patients 8(20%) patients sample showed significant O and H titre of Salmonella typhi (O:80;H:160) in Widal test. Similarly in SARS-CoV-2 RT-PCR positive patients sample 8(20%) patients serum sample showed significant titre of O and H antigen. In control group population significant O antigen along with H antigen of Salmonella typhi were observed in 2(6.6%) sample. False positivity in the serological test should be reported with caution and repeated test should be performed until the etiological agents were not confirmed, in this way we can minimize the misdiagnosis and can prevent the morbidity and mortality as well. Copyright © 2023 The Author(s).

Trends in bacteriological spectrum and antibiotic susceptibility on blood culture in pediatric cardiac patients at a tertiary childcare health facility

Objectives: To report trends in bacteriological spectrum and antibiotic susceptibility on blood culture in admitted pediatric cardiac patients at a Tertiary Childcare Health Facility. Methods: This cross-sectional observational study was conducted at the Department of Pediatric Cardiology, The Children's Hospital and Institute of Child Health, Multan from January 2018 to December 2020. We included admitted children of both genders aged one day to 12 years and whose blood sample was sent for blood culture analysis. Gram staining was used to identify isolated organisms. Distribution of types of strains, bacterial isolates and antimicrobial sensitivity/resistance were recorded. Results: During the study period, a total of 772 blood samples were sent for blood culture analysis, out of which, 154 (19.9%) turned out to be positive. Mean age was noted to be 1.12±2.3 years. Gram negative rods were the most frequently noted strains found among 69 (44.8%) cases. A total of 131 strains were found to have bacterial isolates. Salmonella typhi was the commonest bacterial agent noted in 30 (19.4%) cases while Coagulase Negative Staphylococcus in 18 (11.7%) and acinetobacter baumannii in 16 (10.4%). Conclusion: Blood culture positivity rate was found to be 19.9%. Gram negative rods were the most frequently noted strains. Salmonella typhi, Coagulase Negative Staphylococcus and Acinetobacter baumannii were found to be the commonest bacterial isolates responsible. Routinely used antibiotics like Ciprofloxacin, Cefotaxime, Ceftizadime and Ampicillin were found to have high rates of resistance against most commonly found bacterial isolates.

Diagnostic bias during the COVID-19. A rare case report of salmonella typhi.

INTRODUCTION: In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of COVID-19 case. CASE PRESENTATION: A 17-year-old male patient was presented to the Hospital with a fever up to 39 °C associated with rigor, sweating, generalized body pain, myalgia, fatigue, loss of appetite, headache, and multiple joint pain with no swelling and redness. The vital signs were steady on physical examination, except temperature which was 39 °C. The chest was clear, and the pulse rate was 90 beats per minute. The heart rate relative bradycardia and lungs were normal. Both a PCR test for COVID-19, and a viral assay ELISA were negative. After further investigations, the culture findings revealed the strong development of Gram-negative coccobacilli (Salmonella serotype Typhi) bacteria under the microscope, which was confirmed by using VITEK 2 to identify it. and treated with ciprofloxacin tab, two times per day for five days and amikacin ampule 500 mg IV every 24 hours for 10 days. DISCUSSION: Fever is a well-known sign of COVID-19 infection which has been observed in 83%-98% of patients with COVID19. As a result, it may be difficult to tell the difference between COVID-19 and other febrile infections, causing delays in diagnosis and treatment and may blind the physician from considering other febrile illnesses. CONCLUSION: Physicians should construct more comprehensive differential diagnoses for people who experience fever, headache, or myalgia symptoms that are linked to a pandemic. COVID-19.

Sterilization of paper during crisis.

Paper sheets represent one of the infection risk sources inside educational and administrative institutions under biological pandemics. So, the present study aimed to validate the efficiency of gamma radiation or dry heat techniques to sterilize contaminated paper sheets with different indicator pathogens while retaining their structure. The results showed that gamma radiation at 6, 12, or 24 kGy can successfully kill Gram-positive bacteria such as Bacillus cereus and Staphylococcus aureus, Gram-negative bacteria such as Escherichia coli and Salmonella typhi, and fungi such as Candida albicans. Moreover, dry heating at 100 °C for 60 min, 150 °C for 30 min, or 200 °C for 15 min can be successful in paper decontamination of all tested species. Surprisingly, scanning electron microscopy (SEM) micrographs proved that gamma radiation at 6 kGy, dry heat at 100 °C for 60 min or 150 °C for 30 min or 200 °C for 15 min, is suitable for paper sheet sterilization while maintaining their structure. Ultimately, dry heat is a simple, effective, fast, safe, and inexpensive technique for paper sterilization. It may be used as a precautionary step inside educational institutions, especially during written examination periods, to ensure a safe life for academic members during biological pandemics such as COVID-19.

Co-infection With Dengue Virus and Extensively Drug-Resistant Salmonella typhi.

In South Asia, infectious diseases are associated with significant morbidity and mortality. Malaria, typhoid, and dengue are the most common infectious diseases, and patients may be co-infected with these diseases, resulting in diagnostic and treatment dilemmas. Dengue is caused by the Arboviridae family of viruses and is transmitted by Aedes aegypti. Dengue virus has four serotypes and the symptoms of dengue fever mimic those of other infectious diseases such as malaria, chikungunya, Zika virus disease, influenza A, enteric fever, and coronavirus disease 2019, which are also prevalent in areas of frequent dengue fever outbreak. Dengue fever is characterized by fever, severe myalgia, retro-orbital pain, skin rashes, and bone pain, which is why dengue fever is also referred to as breakbone fever. Patients with secondary dengue virus infection more commonly present with abdominal pain when compared with those with primary dengue virus infection. Salmonella typhi causes enteric fever, which is a human infection with no animal reservoir, but the symptoms of enteric fever closely resemble those of dengue fever. Concurrent infections with multiple organisms are especially difficult to diagnose. In this report, we present the case of a 15-year-old boy from Peshawar, Pakistan, who was co-infected with the dengue virus and extensively drug-resistant Salmonella typhi. To the best of our knowledge, this is the first reported case of co-infection with dengue virus and extensively drug-resistant Salmonella typhi.

Typhoid fever in travellers: estimating the risk of acquisition by country.

BACKGROUND: Typhoid fever is a notifiable disease within Australia. Although studies in endemic regions give an indication of acquisition risk, many countries lack reliable data, and little is known of the absolute or relative risk in Australian travellers. By combining notified case data with travel statistics provided by the Australian Bureau of Statistics, the aim of this study was to give an indication of risk for typhoid acquisition among Australian travellers. METHODS: Australian typhoid notifications between 1st January 2010 and 30th June 2017 were grouped by country of acquisition and age category (<15 or ≥15 years). Australian travel data were used to inform time at risk and incidence rate of Australian typhoid notifications pertaining to country and region of acquisition. Salmonella Paratyphi infections, though notifiable, were excluded as the focus was vaccine preventable illness. Data from New South Wales and Victoria were used to examine the incidence in those acquiring infection in their country of birth (COB) against travellers who did not. RESULTS: Nine hundred twenty-three cases of typhoid were notified over the period of review, 96% of which were acquired overseas. The greatest determinant of risk was travel destination, with countries in south Asia associated with highest crude incidence rate (252 per 100 000 person-years), particularly Bangladesh. Younger age and immigrants returning to their COB were generally associated with higher risk of acquisition. CONCLUSIONS: The risk of typhoid fever in Australian travellers to endemic regions is considerable. Immigrants returning to their COB appear to be at higher risk and it is likely that this risk extends to their traveling dependents. These findings help clinicians and public health officials to plan and advise pre-travel vaccination strategies with at-risk individuals and groups. Additional sociodemographic data collection with Australian typhoid notifications would enhance the surveillance of differing international travel risk groups leaving Australia.

Clinical Perspectives of Multiple and Extensively Drug-Resistant Typhoid; result from a tertiary care hospital from Pakistan.

INTRODUCTION: Typhoid fever remains a problem in developing countries, including Pakistan. The emergence of multidrug-resistant and, since 2016, of extensively drug-resistant cases is a continuous challenge for health care workers. The COVID-19 pandemic is making management more difficult. METHODOLOGY: In the present study, a total of 52 confirmed cases of typhoid have been studied during 2019. Detailed clinical features, complications and, lab findings were studied. Typhoid culture and sensitivity were recorded and patients were treated accordingly. Patients were asked about risk factors to aim at informing prevention. RESULTS: Out of the 52 having blood culture positive for Salmonella Typhi 47 (90.4%) and Salmonella Paratyphi 5 (9.6%), 4 (7.7%) were sensitive to first-line (Non-resistant), 11 (21.2%) MDR and 37 (71.2%) patient were XDR. One case was resistant to azithromycin. Nausea, vomiting or, abdominal pain was present in 12 (23%), abdominal distension present in 9 (17.3%), abdominal tenderness in 8 (15.4%), hepatomegaly in 10 (19.2%) and, splenomegaly in 22 (42.3%).There were ultrasound abnormalities in 58% of patients and GI complications in 19% of patients. No significant difference was found in clinical findings and complications between resistant and non-resistant cases. Only 23-27% of patients were aware of typhoid prevention and vaccination measures. CONCLUSIONS: The increasing prevalence of resistance and higher degree of complications seen in typhoid fever raises the concern further about prevention and effective infection management in the community as well as clinical settings. Moreover, judicial use of antibiotics is much needed in developing countries like Pakistan.