Enteric fever: current issues in effective management and control

Typhoidal salmonella is the causative agent of enteric fever. All are strict human pathogens. It spread through the consumption of contaminated food and water. It presents with high-grade fever, rigors, headache, malaise, some abdominal discomfort, leukopenia, thrombocytopenia, and relative bradycardia/tachycardia. None of them is diagnostic for enteric fever. Antibiotics are the mainstay in the treatment. The management of the disease has become problematic due to the development and spread of MDR genes among the bacterial populations. Efficient laboratory support is required for appropriate antibiotic administration. Among the laboratory tests, the only one to be relied upon for definitive diagnosis is blood or bone marrow culture. It is highly specific, but specificity is low, so a number of false negatives can result. Nucleic acid-based tests are not standardized and are resource-intensive, so they cannot be made available to all patients in all areas. Serological methods also lack standardization, so false positives and negatives cannot be ruled out. Vaccination too does not provide good protection, especially in the adults where it has not been extensively studied. The majority of the patients are treated on clinical suspicion, and antibiotics are administered.