Detecting residual chronic Salmonella Typhi carriers on the road to typhoid elimination in Santiago, Chile, 2017-2019
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
OBJECTIVES: In Santiago, Chile, where typhoid had been hyperendemic (1977-1991), we investigated whether residual chronic carriers could be detected among household contacts of non-travel-related typhoid cases occurring 2017-2019.
METHODS: Culture-confirmed cases were classified as "autochthonous" (domestically-acquired) versus "travel/immigration-related". Household contacts of cases had stool cultures and serum Vi antibody measurements to detect chronic Salmonella Typhi carriers. Whole genome sequences of acute cases and their epidemiologically-linked chronic carrier isolates were compared.
RESULTS: Five of 16 autochthonous typhoid cases (31.3%) were linked to four chronic carriers in case households; two cases (onsets 23 months apart) were linked to the same carrier. Carriers were women aged 69-79 years with gallbladder dysfunction and Typhi fecal excretion; three had highly elevated serum anti-Vi titers. Genomic analyses revealed close identity (≤11 core genome SNP [Single Nucleotide Polymorphism] differences) between case and epidemiologically-linked carrier isolates; all were genotypes prevalent in 1980s Santiago. A cluster of four additional autochthonous cases un-linked to a carrier was identified based on genomic identity (0-1 SNPs). Travel/immigration isolate genotypes were typical for the countries of travel/immigration.
CONCLUSIONS: Although autochthonous typhoid cases in Santiago are currently rare, 5/16 such cases (31.3%) were linked to elderly chronic carriers identified among household contacts of cases.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
The Journal of infectious diseases - (2023) vom: 20. Dez. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lagos, Rosanna M [VerfasserIn] |
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| Links: |
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| Themen: |
Chronic typhoid carriers |
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| Anmerkungen: |
Date Revised 28.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/infdis/jiad585 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM366141201 |
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| 100 | 1 | |a Lagos, Rosanna M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Detecting residual chronic Salmonella Typhi carriers on the road to typhoid elimination in Santiago, Chile, 2017-2019 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a OBJECTIVES: In Santiago, Chile, where typhoid had been hyperendemic (1977-1991), we investigated whether residual chronic carriers could be detected among household contacts of non-travel-related typhoid cases occurring 2017-2019 | ||
| 520 | |a METHODS: Culture-confirmed cases were classified as "autochthonous" (domestically-acquired) versus "travel/immigration-related". Household contacts of cases had stool cultures and serum Vi antibody measurements to detect chronic Salmonella Typhi carriers. Whole genome sequences of acute cases and their epidemiologically-linked chronic carrier isolates were compared | ||
| 520 | |a RESULTS: Five of 16 autochthonous typhoid cases (31.3%) were linked to four chronic carriers in case households; two cases (onsets 23 months apart) were linked to the same carrier. Carriers were women aged 69-79 years with gallbladder dysfunction and Typhi fecal excretion; three had highly elevated serum anti-Vi titers. Genomic analyses revealed close identity (≤11 core genome SNP [Single Nucleotide Polymorphism] differences) between case and epidemiologically-linked carrier isolates; all were genotypes prevalent in 1980s Santiago. A cluster of four additional autochthonous cases un-linked to a carrier was identified based on genomic identity (0-1 SNPs). Travel/immigration isolate genotypes were typical for the countries of travel/immigration | ||
| 520 | |a CONCLUSIONS: Although autochthonous typhoid cases in Santiago are currently rare, 5/16 such cases (31.3%) were linked to elderly chronic carriers identified among household contacts of cases | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a chronic typhoid carriers | |
| 650 | 4 | |a short-cycle typhoid transmission | |
| 650 | 4 | |a transmission of typhoid | |
| 650 | 4 | |a typhoid elimination | |
| 650 | 4 | |a typhoid fever | |
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| 700 | 1 | |a Hormazábal, Juan Carlos |e verfasserin |4 aut | |
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| 700 | 1 | |a Rasko, David A |e verfasserin |4 aut | |
| 700 | 1 | |a Higginson, Ellen |e verfasserin |4 aut | |
| 700 | 1 | |a Nkeze, Joseph |e verfasserin |4 aut | |
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