Journal article : Review
Environmental surveillance as a tool for identifying high-risk settings for typhoid transmission
- Abstract:
- Enteric fever remains a major cause of morbidity in developing countries with poor sanitation conditions that enable fecal contamination of water distribution systems. Historical evidence has shown that contamination of water systems used for household consumption or agriculture are key transmission routes for Salmonella Typhi and Salmonella Paratyphi A. The World Health Organization now recommends that typhoid conjugate vaccines (TCV) be used in settings with high typhoid incidence; consequently, governments face a challenge regarding how to prioritize typhoid against other emerging diseases. A key issue is the lack of typhoid burden data in many low- and middle-income countries where TCV could be deployed. Here we present an argument for utilizing environmental sampling for the surveillance of enteric fever organisms to provide data on community-level typhoid risk. Such an approach could complement traditional blood culture-based surveillance or even replace it in settings where population-based clinical surveillance is not feasible. We review historical studies characterizing the transmission of enteric fever organisms through sewage and water, discuss recent advances in the molecular detection of typhoidal Salmonella in the environment, and outline challenges and knowledge gaps that need to be addressed to establish environmental sampling as a tool for generating actionable data that can inform public health responses to enteric fever.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 215.8KB, Terms of use)
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- Publisher copy:
- 10.1093/cid/ciaa513
Authors
- Publisher:
- Oxford University Press
- Journal:
- Clinical Infectious Diseases More from this journal
- Volume:
- 71
- Issue:
- S2
- Pages:
- S71-S78
- Publication date:
- 2020-07-29
- DOI:
- EISSN:
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1537-6591
- ISSN:
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1058-4838
- Pmid:
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32725227
- Language:
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English
- Keywords:
- Subtype:
-
Review
- Pubs id:
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1125983
- Local pid:
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pubs:1125983
- Deposit date:
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2021-08-06
Terms of use
- Copyright holder:
- Andrews et al.
- Copyright date:
- 2020
- Rights statement:
- © The Authors 2020. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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