Typhoid fever risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Aslam, M.B.B.S[2]

Overview

Common risk factors in the development of typhoid fever are travel to endemic areas, poor hygiene habits, poor sanitation conditions, proximity to flying insects feeding on feces, contact with someone who recently suffered from typhoid fever, recent use of antibiotics, achlorhydria, immunosuppressive illnesses such as AIDS, crowded housing, consumption of raw fruits and vegetables contaminated with sewage, and childhood.[1][2][3][4][5][6] The presence of the C282Y mutation and CFTR polymorphism may confer protection against typhoid fever. [7][8][9]

Risk factors

Common risk factors in the development of typhoid fever are:[1][2][3][10][11][6]

  • Travel to endemic areas
  • Poor hygiene habits
  • Poor sanitation conditions
  • Proximity to flying insects feeding on feces
  • Contact with someone who recently suffered from typhoid fever
  • Recent use of antibiotics
  • Achlorhydria
  • Immunosuppressive illnesses such as AIDS
  • Crowded housing
  • Consumption of raw fruits and vegetables contaminated with sewage
  • Prolonged illness
  • Being a health care worker
  • Being a clinical microbiologists who handles salmonella typhi
  • Childhood

Protective factors

Presence of certain biological characteristics may confer protection against typhoid fever.

C282Y mutation causing hemochromatosis

Hemochromatosis results in depletion of intracellular iron in macrophages, which is required for growth of salmonella typhi.[7][8]

CFTR polymorphism

CFTR protein enables the translocation of salmonella typhi in the intestine if mutated, thereby conferring relative protection against typhoid fever.[9]

References

  1. 1.0 1.1 Luby SP, Faizan MK, Fisher-Hoch SP, Syed A, Mintz ED, Bhutta ZA; et al. (1998). "Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan". Epidemiol Infect. 120 (2): 129–38. PMC 2809381. PMID 9593481.
  2. 2.0 2.1 Marshall E, Howells RE (1986). "Turnover of the surface proteins of adult and third and fourth stage larval Brugia pahangi". Mol Biochem Parasitol. 18 (1): 17–24. PMID 2870432.
  3. 3.0 3.1 Srikantiah P, Vafokulov S, Luby SP, Ishmail T, Earhart K, Khodjaev N; et al. (2007). "Epidemiology and risk factors for endemic typhoid fever in Uzbekistan". Trop Med Int Health. 12 (7): 838–47. doi:10.1111/j.1365-3156.2007.01853.x. PMID 17596250.
  4. Mermin, Jonathan H., et al. "A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water." Journal of Infectious Diseases 179.6 (1999): 1416-1422.
  5. Black, Robert E., et al. "Case—control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile." Bulletin of the World Health Organization 63.5 (1985): 899.
  6. 6.0 6.1 Parry CM, Thompson C, Vinh H, Chinh NT, Phuong le T, Ho VA; et al. (2014). "Risk factors for the development of severe typhoid fever in Vietnam". BMC Infect Dis. 14: 73. doi:10.1186/1471-2334-14-73. PMC 3923984. PMID 24512443.
  7. 7.0 7.1 Weinberg ED (2008). "Survival advantage of the hemochromatosis C282Y mutation". Perspect Biol Med. 51 (1): 98–102. doi:10.1353/pbm.2008.0001. PMID 18192769.
  8. 8.0 8.1 Moalem S, Weinberg ED, Percy ME (2004). "Hemochromatosis and the enigma of misplaced iron: implications for infectious disease and survival". Biometals. 17 (2): 135–9. PMID 15088940.
  9. 9.0 9.1 van de Vosse E, de Visser AW, Al-Attar S, Vossen R, Ali S, van Dissel JT (2010). "Distribution of CFTR variations in an Indonesian enteric fever cohort". Clin Infect Dis. 50 (9): 1231–7. doi:10.1086/651598. PMID 20233062.
  10. Mermin, Jonathan H., et al. "A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water." Journal of Infectious Diseases 179.6 (1999): 1416-1422.
  11. Black, Robert E., et al. "Case—control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile." Bulletin of the World Health Organization 63.5 (1985): 899.

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