Typhoid fever: a continuing problem

S. Newsom
{"title":"Typhoid fever: a continuing problem","authors":"S. Newsom","doi":"10.1177/14690446070080020501","DOIUrl":null,"url":null,"abstract":"Introduction Typhoid or enteric fever has been known for centuries – although the final stages of the illness (the typhoid state) are almost indistinguishable from those of typhus fever, another scourge of the ancient world. The Emperor Augustus who as we saw was cured by his Greek doctor (Antonius Musa) was said to have had typhoid. Queen Victoria’s husband Albert was among many notables who died of the disease. The clinical picture of epidemic typhoid was documented by Thomas Willis (better known for describing the ‘circle of Willis’ formed by cerebral blood vessels) in 1659. The worldwide incidence is estimated at six million cases, with 600,000 deaths a year – mainly in Africa and Asia. Like polio and cholera, it is a strictly human infection, and spread via the faecal-oral route. The Communicable Disease Surveillance Centre (CDSC) recorded only 248 cases in England and Wales in 2006, 122 of which were imported, reflecting the value of good sanitation (recently awarded the most important advance in health since 1840 by readers of the British Medical Journal – out of 15 ‘medical milestones’). Such improvements are within living memory as my grandmother died of typhoid in 1940. My interest in the epidemiology was sparked off in 1946, when by chance we drove through Aberystwyth on the very day an outbreak started – spread by ice cream. Luckily for me, we didn’t stop. The reservoir of infection is the human carrier (a word first used by Robert Koch – typhusbazillentrgerin). Carriers may have recovered from the disease, or be entirely ‘silent’. Carriage can persist for ages. Four senior officers planning the D-Day invasion of France in 1944 who went to stay at the pub in a remote Devon village caught typhoid. The organism was of an unusual type, last seen in the Boer War 40 years earlier. Investigation revealed a veteran of that war living nearby, and sewage from his house entered an open drain that passed in front of the pub. The most famous carrier was Mary Mellon, immortalised in The ballad of Typhoid Mary (see later). Carriers can excrete large numbers of bacilli – one in Islington produced enough to be detected at the north London sewage outfall.","PeriodicalId":265443,"journal":{"name":"British Journal of Infection Control","volume":"121 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2007-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Infection Control","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/14690446070080020501","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1

Abstract

Introduction Typhoid or enteric fever has been known for centuries – although the final stages of the illness (the typhoid state) are almost indistinguishable from those of typhus fever, another scourge of the ancient world. The Emperor Augustus who as we saw was cured by his Greek doctor (Antonius Musa) was said to have had typhoid. Queen Victoria’s husband Albert was among many notables who died of the disease. The clinical picture of epidemic typhoid was documented by Thomas Willis (better known for describing the ‘circle of Willis’ formed by cerebral blood vessels) in 1659. The worldwide incidence is estimated at six million cases, with 600,000 deaths a year – mainly in Africa and Asia. Like polio and cholera, it is a strictly human infection, and spread via the faecal-oral route. The Communicable Disease Surveillance Centre (CDSC) recorded only 248 cases in England and Wales in 2006, 122 of which were imported, reflecting the value of good sanitation (recently awarded the most important advance in health since 1840 by readers of the British Medical Journal – out of 15 ‘medical milestones’). Such improvements are within living memory as my grandmother died of typhoid in 1940. My interest in the epidemiology was sparked off in 1946, when by chance we drove through Aberystwyth on the very day an outbreak started – spread by ice cream. Luckily for me, we didn’t stop. The reservoir of infection is the human carrier (a word first used by Robert Koch – typhusbazillentrgerin). Carriers may have recovered from the disease, or be entirely ‘silent’. Carriage can persist for ages. Four senior officers planning the D-Day invasion of France in 1944 who went to stay at the pub in a remote Devon village caught typhoid. The organism was of an unusual type, last seen in the Boer War 40 years earlier. Investigation revealed a veteran of that war living nearby, and sewage from his house entered an open drain that passed in front of the pub. The most famous carrier was Mary Mellon, immortalised in The ballad of Typhoid Mary (see later). Carriers can excrete large numbers of bacilli – one in Islington produced enough to be detected at the north London sewage outfall.
伤寒:一个持续的问题
伤寒或肠热病已为人所知几个世纪了——尽管疾病的最后阶段(伤寒状态)与斑疹伤寒几乎无法区分,后者是古代世界的另一种祸害。正如我们所看到的,奥古斯都皇帝被他的希腊医生安东尼乌斯·穆萨治好了,据说他得了伤寒。维多利亚女王的丈夫阿尔伯特是许多死于这种疾病的名人之一。1659年,托马斯·威利斯(Thomas Willis)记录了流行性伤寒的临床症状(以描述脑血管形成的“威利斯圈”而闻名)。据估计,全世界的发病率为600万例,每年有60万人死亡,主要发生在非洲和亚洲。与脊髓灰质炎和霍乱一样,它是一种严格意义上的人类感染,并通过粪-口途径传播。2006年,传染病监测中心(CDSC)在英格兰和威尔士仅记录了248例病例,其中122例是进口的,反映了良好卫生设施的价值(最近被《英国医学杂志》的读者评为自1840年以来卫生领域最重要的进步——在15个"医学里程碑"中)。我的祖母在1940年死于伤寒,人们对这些改善还记忆犹新。我对流行病学的兴趣是在1946年激发的,当时我们偶然开车经过阿伯里斯特威斯,正好是疫情爆发的那天——由冰淇淋传播的。幸运的是,我们没有停下来。感染的宿主是人类携带者(这个词最早由罗伯特·科赫使用——斑疹伤寒病毒)。携带者可能已经从疾病中恢复过来,或者完全“沉默”。马车可以持续很长时间。1944年,四名计划诺曼底登陆法国的高级军官去德文郡一个偏远村庄的酒吧过夜,结果得了伤寒。这种生物是一种不寻常的类型,最后一次出现是在40年前的布尔战争中。调查显示,附近住着一位二战老兵,他家的污水流入了酒吧门前的一个露天排水沟。最著名的承运人是玛丽·梅隆,她在《伤寒玛丽》的歌谣中永垂不朽。携带者可以排出大量的杆菌——在伊斯灵顿的一个细菌产生的数量足以在伦敦北部的排污口检测到。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信