Top

Journal of Medical Case Reports

Published in:

Open Access 01-12-2013 | Case report

A young traveller presenting with typhoid fever after oral vaccination: a case report

Authors: Martin Grimm, Christoph Lübbert, Joachim Mössner, Sebastian Weis

Published in: Journal of Medical Case Reports | Issue 1/2013

Abstract

Introduction

Typhoid fever is one of the most common vaccine-preventable diseases in travellers returning from tropical destinations. However, immunity and the immune response to infection are barely understood.

Case presentation

We report a case of tyhoid fever in a 29-year-old Caucasian, previously healthy woman who did not develop protective immunity or seroconversion of H or O antibodies neither after vaccination with the oral Ty21 vaccine, nor after infection with Salmonella typhi.

Conclusions

This case highlights the insufficiencies of the current vaccination and the lack of a reliable, rapid serologic diagnostic tool for typhoid fever. With this case report, we aim to sensitize the reader that typhoid fever has to be taken into account as a differential diagnosis in patients even after vaccination and with negative serological test results.

Available only for authorised users

Paz A, Cohen E, Odeh M, Potasman I: Typhoid fever in travellers: time for reassessment. Eur J Intern Med. 2007, 18: 150-151. 10.1016/j.ejim.2006.09.016.CrossRefPubMed

Wilson ME, Weld LH, Boggild A, Keystone JS, Kain KC, von Sonnenburg F, Schwartz E, GeoSentinel Surveillance Network: Fever in returned travellers: results from the GeoSentinel surveillance network. Clin Infect Dis. 2007, 44: 1560-1568. 10.1086/518173.CrossRefPubMed

Robert Koch Institute: Current statistics of mandatory reportings of infectious diseases in Germany, 2012. Epid Bull. 2013, 3: 30-

Crump JA, Mintz ED: Global trends in typhoid and paratyphoid fever. Clin Infect Dis. 2010, 50: 241-246. 10.1086/649541.CrossRefPubMedPubMedCentral

Connor BA, Schwartz E: Typhoid and paratyphoid fever in travellers. Lancet Inf Dis. 2005, 5: 623-628. 10.1016/S1473-3099(05)70239-5.CrossRef

House D, Ho VA, Diep TS, Chinh NT, Bay PV, Vinh H, Duc M, Parry CM, Dougan G, White NJ, Farrar JJ, Hien TT, Wain J: Antibodies to the Vi capsule of Salmonella Typhi in the serum of typhoid patients and healthy control subjects from a typhoid endemic region. J Infect Dev Ctries. 2008, 2: 308-312.PubMed

Fraser A, Goldberg E, Acosta CJ, Paul M, Leibovici L: Vaccines for preventing typhoid fever. Cochrane Database Syst Rev. 2007, CD001261-

Podda A, Saul AJ, Arora R, Bhutta Z, Sinha A, Gaind R, Singhal T, Saha S, Brooks A, Martin LB, Amdekar Y, Chitkara AJ, Shieh M, Kapur AN, Chugh TD: Conjugate vaccines for enteric fever: proceedings of a meeting organized in New Delhi, India in 2009. J Infect Dev Ctries. 2010, 4: 404-411.PubMed

Sur D, Ochiai RL, Bhattacharya SK, Ganguly NK, Ali M, Manna B, Dutta S, Donner A, Kanungo S, Park JK, Puri MK, Kim DR, Dutta D, Bhaduri B, Acosta CJ, Clemens JD: A cluster-randomized effectiveness trial of Vi typhoid vaccine in India. N Eng J Med. 2009, 361: 335-344. 10.1056/NEJMoa0807521.CrossRef

10.

Schwartz E, Shlim DR, Eaton M, Jenks N, Houston R: The effect of oral and parenteral typhoid vaccination on the rate of infection with Salmonella typhi and Salmonella paratyphi A among foreigners in Nepal. Arch Intern Med. 1990, 150: 349-351. 10.1001/archinte.1990.00390140079017.CrossRefPubMed

11.

Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ: Typhoid fever. N Engl J Med. 2002, 347: 1770-1782. 10.1056/NEJMra020201.CrossRefPubMed

12.

Somily AM, Adam MH, Gad El Rab MO, Morshed MG, Shakoor Z: Detection of Salmonella typhi agglutinins in sera of patients with other febrile illnesses and healthy individuals. Ann Afr Med. 2011, 10: 41-44. 10.4103/1596-3519.76584.CrossRefPubMed

13.

Sarasombath S, Banchuin N, Sukosol T, Vanadurongwan S, Rungpitarangsi B, Dumavibhat B: Systemic and intestinal immunities after different typhoid vaccinations. Asian Pac J Allergy Immunol. 1987, 5: 53-61.PubMed

14.

Olopoenia LA, King AL: Widal agglutination test – 100 years later: still plagued by controversy. Postgrad Med J. 2000, 76: 80-84. 10.1136/pmj.76.892.80.CrossRefPubMedPubMedCentral

15.

Oral enteric bacterial vaccines. Report of a WHO scientific group. World Health Organ Tech Rep Ser. 1972, 500: 1-34.

16.

Lindow JC, Fimlaid KA, Bunn JY, Kirkpatrick BD: Antibodies in action: role of human opsonins in killing Salmonella enterica serovar Typhi. Infect Immun. 2011, 79: 3188-3194. 10.1128/IAI.05081-11.CrossRefPubMedPubMedCentral

17.

Sarasombath S, Banchuin N, Sukosol T, Rungpitarangsi B, Manasatit S: Systemic and intestinal immunities after natural typhoid infection. J Clin Microbol. 1987, 25: 1088-1093.

18.

Dham SK, Thompson RA: Studies of cellular and humoral immunity in typhoid and TAB vaccinated subjects. Clin Exp Immunol. 1982, 48: 389-395.PubMedPubMedCentral

19.

Song J, Willinger T, Rongvaux A, Eynon EE, Stevens S, Manz MG, Flavell RA, Galán JE: A mouse model for the human pathogen Salmonella typhi. Cell Host Microbe. 2010, 8: 369-376. 10.1016/j.chom.2010.09.003.CrossRefPubMedPubMedCentral

Title: A young traveller presenting with typhoid fever after oral vaccination: a case report
Authors: Martin Grimm
Christoph Lübbert
Joachim Mössner
Sebastian Weis
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2013
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/1752-1947-7-237

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A young traveller presenting with typhoid fever after oral vaccination: a case report

Abstract

Introduction

Case presentation

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Introduction

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2013

Neuromyelitis optica in a Ugandan woman: a case report

Mood disorder in a patient with a benign thalamic cystic lesion: a case report

Gastric non-secreting neuroendocrine tumor and hypochlorhydria-related hypergastrinemia: a case report

The role of high mobility group box chromosomal protein 1 expression in the differential diagnosis of hepatic actinomycosis: a case report

Polycythemia vera revealed via a bladder tumor in a patient with erectile dysfunction: a case report

A child with autoimmune polyendocrinopathy candidiasis and ectodermal dysplasia treated with immunosuppression: a case report