Enteric fever: a travel medicine oriented view.

Abstract:

PURPOSE OF REVIEW:Enteric fever continues to be an important infection among populations in endemic countries and among travelers to these areas. This review aims to describe recent epidemiological trends and developments in diagnosis, treatment and prevention. RECENT FINDINGS:Data indicate that the burden of enteric fever is declining in many middle-income countries, whereas the bulk of cases occur in the Indian subcontinent and in south-east Asia. In these regions, Salmonella Paratyphi A is increasingly seen and sometimes surpasses Salmonella Typhi as the main pathogen. Enteric fever caused by S. Paratyphi A is indistinguishable from that caused by S. Typhi. In addition, drug resistance, including nalidixic acid/quinolone resistance now occurs in the majority of clinical isolates of S. Typhi and S. Paratyphi A in Asia. Currently, third generation cephalosporins and azythromycin are the only reasonable therapeutic options for most cases of travel-related enteric fever. SUMMARY:The ongoing emergence of S. Paratyphi A results in partial benefit from current typhoid vaccines in the prevention of enteric fever in travelers. Increasing antimicrobial resistance complicates therapy for travel-related enteric fever. New vaccines, offering protection against both agents of enteric fever, are urgently needed; however, none of the current vaccine candidates is likely to be available for several years.

journal_name

Curr Opin Infect Dis

authors

Meltzer E,Schwartz E

doi

10.1097/QCO.0b013e32833c7ca1

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

432-7

issue

5

eissn

0951-7375

issn

1473-6527

journal_volume

23

pub_type

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