Invasive non-typhoidal salmonella disease: An emerging and neglected tropical disease in Africa

Nicholas A. Feasey, Gordon Dougan, Robert A Kingsley, Robert S. Heyderman, Melita A Gordon

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Invasive strains of non-typhoidal salmonellae have emerged as a prominent cause of bloodstream infection in African adults and children, with an associated case fatality of 20-25%. The clinical presentation of invasive non-typhoidal salmonella disease in Africa is diverse: fever, hepatosplenomegaly, and respiratory symptoms are common, and features of enterocolitis are often absent. The most important risk factors are HIV infection in adults, and malaria, HIV, and malnutrition in children. A distinct genotype of Salmonella enterica var Typhimurium, ST313, has emerged as a new pathogenic clade in sub-Saharan Africa, and might have adapted to cause invasive disease in human beings. Multidrug-resistant ST313 has caused epidemics in several African countries, and has driven the use of expensive antimicrobial drugs in the poorest health services in the world. Studies of systemic cellular and humoral immune responses in adults infected with HIV have revealed key host immune defects contributing to invasive non-typhoidal salmonella disease. This emerging pathogen might therefore have adapted to occupy an ecological and immunological niche provided by HIV, malaria, and malnutrition in Africa. A good understanding of the epidemiology of this neglected disease will open new avenues for development and implementation of vaccine and public health strategies to prevent infections and interrupt transmission.

Original languageEnglish
Pages (from-to)2489-2499
Number of pages11
JournalThe Lancet
Volume379
Issue number9835
DOIs
Publication statusPublished - Jun 2012
Externally publishedYes

Cite this

Feasey, Nicholas A. ; Dougan, Gordon ; Kingsley, Robert A ; Heyderman, Robert S. ; Gordon, Melita A. / Invasive non-typhoidal salmonella disease : An emerging and neglected tropical disease in Africa. In: The Lancet. 2012 ; Vol. 379, No. 9835. pp. 2489-2499.
@article{f2a76b42883749dfb3f48589b8b96c8a,
title = "Invasive non-typhoidal salmonella disease: An emerging and neglected tropical disease in Africa",
abstract = "Invasive strains of non-typhoidal salmonellae have emerged as a prominent cause of bloodstream infection in African adults and children, with an associated case fatality of 20-25{\%}. The clinical presentation of invasive non-typhoidal salmonella disease in Africa is diverse: fever, hepatosplenomegaly, and respiratory symptoms are common, and features of enterocolitis are often absent. The most important risk factors are HIV infection in adults, and malaria, HIV, and malnutrition in children. A distinct genotype of Salmonella enterica var Typhimurium, ST313, has emerged as a new pathogenic clade in sub-Saharan Africa, and might have adapted to cause invasive disease in human beings. Multidrug-resistant ST313 has caused epidemics in several African countries, and has driven the use of expensive antimicrobial drugs in the poorest health services in the world. Studies of systemic cellular and humoral immune responses in adults infected with HIV have revealed key host immune defects contributing to invasive non-typhoidal salmonella disease. This emerging pathogen might therefore have adapted to occupy an ecological and immunological niche provided by HIV, malaria, and malnutrition in Africa. A good understanding of the epidemiology of this neglected disease will open new avenues for development and implementation of vaccine and public health strategies to prevent infections and interrupt transmission.",
author = "Feasey, {Nicholas A.} and Gordon Dougan and Kingsley, {Robert A} and Heyderman, {Robert S.} and Gordon, {Melita A}",
year = "2012",
month = "6",
doi = "10.1016/S0140-6736(11)61752-2",
language = "English",
volume = "379",
pages = "2489--2499",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier",
number = "9835",

}

Invasive non-typhoidal salmonella disease : An emerging and neglected tropical disease in Africa. / Feasey, Nicholas A.; Dougan, Gordon; Kingsley, Robert A; Heyderman, Robert S.; Gordon, Melita A.

In: The Lancet, Vol. 379, No. 9835, 06.2012, p. 2489-2499.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Invasive non-typhoidal salmonella disease

T2 - An emerging and neglected tropical disease in Africa

AU - Feasey, Nicholas A.

AU - Dougan, Gordon

AU - Kingsley, Robert A

AU - Heyderman, Robert S.

AU - Gordon, Melita A

PY - 2012/6

Y1 - 2012/6

N2 - Invasive strains of non-typhoidal salmonellae have emerged as a prominent cause of bloodstream infection in African adults and children, with an associated case fatality of 20-25%. The clinical presentation of invasive non-typhoidal salmonella disease in Africa is diverse: fever, hepatosplenomegaly, and respiratory symptoms are common, and features of enterocolitis are often absent. The most important risk factors are HIV infection in adults, and malaria, HIV, and malnutrition in children. A distinct genotype of Salmonella enterica var Typhimurium, ST313, has emerged as a new pathogenic clade in sub-Saharan Africa, and might have adapted to cause invasive disease in human beings. Multidrug-resistant ST313 has caused epidemics in several African countries, and has driven the use of expensive antimicrobial drugs in the poorest health services in the world. Studies of systemic cellular and humoral immune responses in adults infected with HIV have revealed key host immune defects contributing to invasive non-typhoidal salmonella disease. This emerging pathogen might therefore have adapted to occupy an ecological and immunological niche provided by HIV, malaria, and malnutrition in Africa. A good understanding of the epidemiology of this neglected disease will open new avenues for development and implementation of vaccine and public health strategies to prevent infections and interrupt transmission.

AB - Invasive strains of non-typhoidal salmonellae have emerged as a prominent cause of bloodstream infection in African adults and children, with an associated case fatality of 20-25%. The clinical presentation of invasive non-typhoidal salmonella disease in Africa is diverse: fever, hepatosplenomegaly, and respiratory symptoms are common, and features of enterocolitis are often absent. The most important risk factors are HIV infection in adults, and malaria, HIV, and malnutrition in children. A distinct genotype of Salmonella enterica var Typhimurium, ST313, has emerged as a new pathogenic clade in sub-Saharan Africa, and might have adapted to cause invasive disease in human beings. Multidrug-resistant ST313 has caused epidemics in several African countries, and has driven the use of expensive antimicrobial drugs in the poorest health services in the world. Studies of systemic cellular and humoral immune responses in adults infected with HIV have revealed key host immune defects contributing to invasive non-typhoidal salmonella disease. This emerging pathogen might therefore have adapted to occupy an ecological and immunological niche provided by HIV, malaria, and malnutrition in Africa. A good understanding of the epidemiology of this neglected disease will open new avenues for development and implementation of vaccine and public health strategies to prevent infections and interrupt transmission.

UR - http://www.scopus.com/inward/record.url?scp=84862886432&partnerID=8YFLogxK

U2 - 10.1016/S0140-6736(11)61752-2

DO - 10.1016/S0140-6736(11)61752-2

M3 - Review Article

VL - 379

SP - 2489

EP - 2499

JO - The Lancet

JF - The Lancet

SN - 0140-6736

IS - 9835

ER -