Subjects: Molecular Biology, Microbial Pathogens, Research Article, Molecular Biology Assays and Analysis Techniques, Diagnostic Medicine, Typhoid, Signs and Symptoms, Infectious Diseases, Preventive Medicine, Bacteriophages, Pathology and Laboratory Medicine, Geographical Locations, Vaccination and Immunization, Population Groupings, Phylogenetic Analysis, Salmonella, Pathogens, People and Places, Public and Occupational Health, Molecular Biology Techniques, Thailand, Immunology, Viruses, Biology and Life Sciences, Asia, Research and Analysis Methods, Microbiology, Bacterial Pathogens, Salmonella Typhi, Bacterial Diseases, Medical Microbiology, Ethnicities, RC955-962, RA1-1270, Public aspects of medicine, Organisms, Enterobacteriaceae, Thai People, Medicine and Health Sciences, Fevers, Arctic medicine. Tropical medicine
Classified by OpenAIRE into
bacterial infections and mycoses
, complex mixtures
Vaccines against Salmonella Typhi, the causative agent of typhoid fever, are commonly used by travellers, however, there are few examples of national immunization programs in endemic areas. There is therefore a paucity of data on the impact of typhoid immunization programs on localised populations of S. Typhi. Here we have used whole genome sequencing (WGS) to characterise 44 historical bacterial isolates collected before and after a national typhoid immunization program that was implemented in Thailand in 1977 in response to a large outbreak; the program was highly effective in reducing typhoid case numbers. Thai isolates were highly diverse, including 10 distinct phylogenetic lineages or genotypes. Novel prophage and plasmids were also detected, including examples that were previously only reported in Shigella sonnei and Escherichia coli. The majority of S. Typhi genotypes observed prior to the immunization program were not observed following it. Post-vaccine era isolates were more closely related to S. Typhi isolated from neighbouring countries than to earlier Thai isolates, providing no evidence for the local persistence of endemic S. Typhi following the national immunization program. Rather, later cases of typhoid appeared to be caused by the occasional importation of common genotypes from neighbouring Vietnam, Laos, and Cambodia. These data show the value of WGS in understanding the impacts of vaccination on pathogen populations and provide support for the proposal that large-scale typhoid immunization programs in endemic areas could result in lasting local disease elimination, although larger prospective studies are needed to test this directly.