Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011.
Salmonella enterica serovar Typhi is transmitted by fecally contaminated food and water and causes approximately 22 million typhoid fever infections worldwide each year. Most cases occur in developing countries, where approximately 4% of patients develop intestinal perforation (IP). In Kasese Distri...
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ftdoajarticles:oai:doaj.org/article:d78cada1d77045c2966ff5af319ef9b4 2023-05-15T15:15:18+02:00 Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. Maroya Spalding Walters Janell Routh Matthew Mikoleit Samuel Kadivane Caroline Ouma Denis Mubiru Ben Mbusa Amos Murangi Emmanuel Ejoku Absalom Rwantangle Uziah Kule John Lule Nancy Garrett Jessica Halpin Nikki Maxwell Atek Kagirita Fred Mulabya Issa Makumbi Molly Freeman Kevin Joyce Vince Hill Robert Downing Eric Mintz 2014-03-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0002726 https://doaj.org/article/d78cada1d77045c2966ff5af319ef9b4 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3945727?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002726 https://doaj.org/article/d78cada1d77045c2966ff5af319ef9b4 PLoS Neglected Tropical Diseases, Vol 8, Iss 3, p e2726 (2014) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2014 ftdoajarticles https://doi.org/10.1371/journal.pntd.0002726 2022-12-31T09:49:45Z Salmonella enterica serovar Typhi is transmitted by fecally contaminated food and water and causes approximately 22 million typhoid fever infections worldwide each year. Most cases occur in developing countries, where approximately 4% of patients develop intestinal perforation (IP). In Kasese District, Uganda, a typhoid fever outbreak notable for a high IP rate began in 2008. We report that this outbreak continued through 2011, when it spread to the neighboring district of Bundibugyo.A suspected typhoid fever case was defined as IP or symptoms of fever, abdominal pain, and ≥1 of the following: gastrointestinal disruptions, body weakness, joint pain, headache, clinically suspected IP, or non-responsiveness to antimalarial medications. Cases were identified retrospectively via medical record reviews and prospectively through laboratory-enhanced case finding. Among Kasese residents, 709 cases were identified from August 1, 2009-December 31, 2011; of these, 149 were identified during the prospective period beginning November 1, 2011. Among Bundibugyo residents, 333 cases were identified from January 1-December 31, 2011, including 128 cases identified during the prospective period beginning October 28, 2011. IP was reported for 507 (82%) and 59 (20%) of Kasese and Bundibugyo cases, respectively. Blood and stool cultures performed for 154 patients during the prospective period yielded isolates from 24 (16%) patients. Three pulsed-field gel electrophoresis pattern combinations, including one observed in a Kasese isolate in 2009, were shared among Kasese and Bundibugyo isolates. Antimicrobial susceptibility was assessed for 18 isolates; among these 15 (83%) were multidrug-resistant (MDR), compared to 5% of 2009 isolates.Molecular and epidemiological evidence suggest that during a prolonged outbreak, typhoid spread from Kasese to Bundibugyo. MDR strains became prevalent. Lasting interventions, such as typhoid vaccination and improvements in drinking water infrastructure, should be considered to minimize the risk of ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 8 3 e2726 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Maroya Spalding Walters Janell Routh Matthew Mikoleit Samuel Kadivane Caroline Ouma Denis Mubiru Ben Mbusa Amos Murangi Emmanuel Ejoku Absalom Rwantangle Uziah Kule John Lule Nancy Garrett Jessica Halpin Nikki Maxwell Atek Kagirita Fred Mulabya Issa Makumbi Molly Freeman Kevin Joyce Vince Hill Robert Downing Eric Mintz Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Salmonella enterica serovar Typhi is transmitted by fecally contaminated food and water and causes approximately 22 million typhoid fever infections worldwide each year. Most cases occur in developing countries, where approximately 4% of patients develop intestinal perforation (IP). In Kasese District, Uganda, a typhoid fever outbreak notable for a high IP rate began in 2008. We report that this outbreak continued through 2011, when it spread to the neighboring district of Bundibugyo.A suspected typhoid fever case was defined as IP or symptoms of fever, abdominal pain, and ≥1 of the following: gastrointestinal disruptions, body weakness, joint pain, headache, clinically suspected IP, or non-responsiveness to antimalarial medications. Cases were identified retrospectively via medical record reviews and prospectively through laboratory-enhanced case finding. Among Kasese residents, 709 cases were identified from August 1, 2009-December 31, 2011; of these, 149 were identified during the prospective period beginning November 1, 2011. Among Bundibugyo residents, 333 cases were identified from January 1-December 31, 2011, including 128 cases identified during the prospective period beginning October 28, 2011. IP was reported for 507 (82%) and 59 (20%) of Kasese and Bundibugyo cases, respectively. Blood and stool cultures performed for 154 patients during the prospective period yielded isolates from 24 (16%) patients. Three pulsed-field gel electrophoresis pattern combinations, including one observed in a Kasese isolate in 2009, were shared among Kasese and Bundibugyo isolates. Antimicrobial susceptibility was assessed for 18 isolates; among these 15 (83%) were multidrug-resistant (MDR), compared to 5% of 2009 isolates.Molecular and epidemiological evidence suggest that during a prolonged outbreak, typhoid spread from Kasese to Bundibugyo. MDR strains became prevalent. Lasting interventions, such as typhoid vaccination and improvements in drinking water infrastructure, should be considered to minimize the risk of ... |
format |
Article in Journal/Newspaper |
author |
Maroya Spalding Walters Janell Routh Matthew Mikoleit Samuel Kadivane Caroline Ouma Denis Mubiru Ben Mbusa Amos Murangi Emmanuel Ejoku Absalom Rwantangle Uziah Kule John Lule Nancy Garrett Jessica Halpin Nikki Maxwell Atek Kagirita Fred Mulabya Issa Makumbi Molly Freeman Kevin Joyce Vince Hill Robert Downing Eric Mintz |
author_facet |
Maroya Spalding Walters Janell Routh Matthew Mikoleit Samuel Kadivane Caroline Ouma Denis Mubiru Ben Mbusa Amos Murangi Emmanuel Ejoku Absalom Rwantangle Uziah Kule John Lule Nancy Garrett Jessica Halpin Nikki Maxwell Atek Kagirita Fred Mulabya Issa Makumbi Molly Freeman Kevin Joyce Vince Hill Robert Downing Eric Mintz |
author_sort |
Maroya Spalding Walters |
title |
Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. |
title_short |
Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. |
title_full |
Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. |
title_fullStr |
Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. |
title_full_unstemmed |
Shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--Bundibugyo and Kasese Districts, Uganda, 2009-2011. |
title_sort |
shifts in geographic distribution and antimicrobial resistance during a prolonged typhoid fever outbreak--bundibugyo and kasese districts, uganda, 2009-2011. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2014 |
url |
https://doi.org/10.1371/journal.pntd.0002726 https://doaj.org/article/d78cada1d77045c2966ff5af319ef9b4 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 8, Iss 3, p e2726 (2014) |
op_relation |
http://europepmc.org/articles/PMC3945727?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0002726 https://doaj.org/article/d78cada1d77045c2966ff5af319ef9b4 |
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https://doi.org/10.1371/journal.pntd.0002726 |
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PLoS Neglected Tropical Diseases |
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e2726 |
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