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(Health) Typhoid Fever Behind Fall of Athens

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PostPosted: Tue Jan 24, 2006 11:34 am    Post subject: (Health) Typhoid Fever Behind Fall of Athens Reply with quote

Typhoid Fever Behind Fall of Athens
By LiveScience Staff
posted: 23 January 2006
10:42 am ET

Athens fell because a plague swept the empire. But scientists have debated what illness was responsible.

A new DNA analysis of teeth from an ancient Greek burial pit indicates typhoid fever caused the epidemic.

The plague began in Ethiopia and passed through Egypt and Libya to Greece in 430-426 B.C. It changed the balance of power between Athens and Sparta, ending the Golden Age of Pericles and Athenian dominance in the ancient world.

An estimated one-third of Athenians died, including Pericles, their leader.

Knowledge of the epidemic had come largely from an account by the Greek historian Thucydides, who was taken ill with the plague but recovered. Despite Thucydides’ description, researchers could only narrow the possibilities down to a range that included the bubonic plague, smallpox, anthrax and measles.

The new study, led by Manolis Papagrigorakis of the University of Athens, found DNA sequences similar to those of the modern day Salmonella enterica serovar Typhi, the organism that causes typhoid fever. The work is detailed online by the International Journal of Infectious Diseases.

Typhoid fever is transmitted by contaminated food or water. It is most common today in developing countries.


Questions to explore further this topic:

What is typhoid fever?

What is Salmonella typhi?

Salmonella, in general, are there others?

What are the other illnesses one can get from food?;nbr=3593

How does one prevent food-borne illnesses?

The Story of Typhoid Mary

Images to promote food safety

Videos for food safety

The typhoid vaccine

Athens of Ancient Greece

Present day Athens

Contrast the above recent article with the 1985 news article posted as a reply (see below). Try to find as well the historical account of the plague in Athens (see one of the links above on Greece and check if the accounts match what would be expected from symptoms caused by typhoid fever)


Last edited by adedios on Sat Jan 27, 2007 4:46 pm; edited 7 times in total
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PostPosted: Tue Jan 24, 2006 12:20 pm    Post subject: SCIENCE WATCH;TOXIC SHOCK AND THE FALL OF ATHENS Reply with quote

October 22, 1985
New York Times

EXAMINING historical accounts with an epidemiological eye, American medical researchers have concluded that the mysterious plague that led to the downfall of ancient Athens was caused by a combination of influenza and toxic shock syndrome.

The plague of Athens, 430 to 427 B.C., was perhaps the most disastrous and fateful epidemic of recorded ancient history. It killed tens of thousands of the 300,000 Athenians, including their great leader, Pericles. Within three decades, the weakened city-state was defeated by Sparta in the Peloponnesian War.

Previous studies have attributed the plague to an assortment of ills, from smallpox and scarlet fever to typhus and typhoid fever. But in a new analysis of descriptions of the plague symptoms by Thucydides, the historian who survived the disease, Dr. Alexander D. Langmuir, retired chief of epidemiology at the Federal Centers for Disease Control, decided the plague ''fits all the criteria, epidemiologically and clinically, for influenza complicated by toxic shock syndrome.''

According to Thucydides, the symptoms of the disease included fever, violent cough, red throat, vomiting, ''watery diarrhea,'' blisters and thirst. Among those who recovered, many suffered from amnesia and gangrene that led to a loss of genitals, fingers and toes.

When Dr. Langmuir read of gangrene, his mind turned to toxic shock syndrome, an affliction only recognized as recently as 1978. The illness, which is produced by a form of staphylococcus bacterium, is often linked with the use of highly absorbent tampons and in a few cases has proved fatal.

In an article in the current issue of The New England Journal of Medicine, Dr. Langmuir and a group of University of Arizona researchers said the complicating staphylococcal infection would account for the high death rate in Athens, a rate that was greater than that of any known influenza epidemic. They suggested that the ''staph'' toxin was absorbed in the skin lesions and damaged respiratory systems caused by influenza.

The researchers said the Athenian illness, which they called the Thucydides syndrome, was probably not identical to the modern toxic shock syndrome. But they raised the possibility that the disease was not extinct. ''It may have occurred in the past and may be present now at such a low frequency that no one has yet identified a sufficient number of cases to make a convincing series worthy of publication,'' Dr. Langmuir's team reported.
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PostPosted: Wed Nov 29, 2006 7:46 am    Post subject: Evolution of typhoid bacteria Reply with quote

Evolution of typhoid bacteria
24 November 2006
Max Planck Society

Researchers investigate the evolution of the bacterium Salmonella typhi and warn of an increased spread of resistant strains

In a study published in the latest issue of Science (24 November, 2006), an international consortium from the Max-Planck Society, Wellcome Trust Institutes in Britain and Vietnam, and the Institut Pasteur in France have elucidated the evolutionary history of Salmonella Typhi. Typhi is the cause of typhoid fever, a disease that sickens 21 million people and kills 200,000 worldwide every year. The results indicate that asymptomatic carriers played an essential role in the evolution and global transmission of Typhi. The rediscovered importance of the carrier state predicts that treatment of acute disease, including vaccination, will not suffice to eradicate this malady. The results also illuminate patterns leading to antibiotic resistance after the indiscriminate use of antibiotics. Fluoroquinolone treatment in southern Asia over two decades has resulted in the emergence of multiple, independent nalidixic acid-resistant mutants, of which one group, H58, has multiplied dramatically and spread globally. The prevalence of these bacteria hampers medical cure of clinical disease via antibiotics.

Typhoid fever remains a major health problem in the developing world and continues to cause disease in Europe and on the american continent. The evolutionary history and population structure of Typhi were poorly understood, partly because these bacteria show little genetic diversity. Now a team led by Mark Achtman and Philippe Roumagnac from the Max Planck Institute for Infection Biology, Berlin, has applied population genetic experience from prior work with Yersinia pestis, Escherichia coli, Helicobacter pylori and Neisseria meningitidis to provide novel insights into the evolution of this pathogen. The team combined its resources to assemble for the first time a globally representative collection of 105 strains of Typhi and investigated the sequence diversity within 90,000 base pairs per strain. Eighty-eight informative sequence differences were detected, showing that the population structure has evolved over the last 10,000 to 43,000 years. Amazingly, the ancestral strain continues to exist today, as do many of its direct descendents, indicating a neutral population structure, whereas normally selective forces lead to extinction of intermediate genotypes. Furthermore, these bacteria are distributed globally, demonstrating that Typhi has spread inter-continentally on multiple occasions.

The authors propose that the unusual population structure of Typhi reflects long-term carriage by asymptomatic carriers, who reached public notoriety at the beginning of the 20th century with "Mr. N the milker" in England and Typhoid Mary (Mary Mallon) in the U.S.A. These individuals infected 100s of people over the decades while they worked in the food production industry. Healthy carriers may have allowed Typhi to survive in hunter-gatherer populations prior to the Neolithic expansion of city states and facilitated its intercontinental spread. Healthy carriers are also consistent with the observation that individual genotypes of Typhi persist for many decades within each country.

Increasing resistance to antibiotics in recent decades has hampered efforts of clinicians to cure typhoid fever. The indiscriminate use of fluoroquinolones, which is a cost-effective, standard treatment for typhoid fever, has been accompanied by a frightening increase in the numbers of resistant Typhi. Investigations of a large strain collection from southern Asia revealed that many different genotypes independently acquired resistance to nalidixic acid, a quinolone. One of these genotypes, H58, has become predominant throughout southern Asia and has even spread to Africa. In Vietnam, up to 95% of Typhi are now resistant to nalidixic acid and many other antibiotics. Although these cases can still be treated with newer antibiotics, those antibiotics are much more expensive than standard fluoroquinolones, which raises the cost of medical treatment. Furthermore, it is likely that Typhi will develop resistance to these antibiotics as well.

The combination of these investigations raises problems for public health measures. Indiscriminate antibiotic usage results in real-time evolution of bacteria that resist treatment. Furthermore, the healthy carrier state provides a safe reservoir for these bacteria which allows them to evade short-term antibiotic treatment and vaccination, indicating that typhoid fever will remain a major health problem for the foreseeable future.

The research was carried out collaboratively by the Max Planck Institute for Infection Biology in Berlin, the Wellcome Trust Sanger Institute, Hinxton Hall, the Institut Pasteur, Paris, and the Oxford University Clinical Research Unit, Ho Chi Minh City, with assistance from hospitals in Ho Chi Minh City and Hanoi and the International Vaccine Institute in Seoul. Financial support was by the Wellcome Trust, UK.

Original work:

Philippe Roumagnac, François-Xavier Weill, Christiane Dolecek, Stephen Baker, Sylvain Brisse, Nguyen Tran Chinh, Thi Anh Hong Le, Camilo J. Acosta, Jeremy Farrar, Gordon Dougan & Mark Achtman.
Evolutionary history of Salmonella Typhi.
Science, November 24 2006.
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PostPosted: Wed Feb 14, 2007 7:38 am    Post subject: Protein discovery targets antibiotic-resistant bacteria Reply with quote

Queen's University
13 February 2007

Protein discovery targets antibiotic-resistant bacteria

Model could be used in new treatments for food poisoning, typhoid
KINGSTON, Ont. – A new type of protein discovered by Queen’s University researchers may be useful in developing treatments for antibiotic-resistant bacteria, such as those that cause food poisoning and typhoid.

By solving the structure and activity of the protein – called YihE or RdoA – a team of professors and students from the departments of Biochemistry and Microbiology & Immunology has opened up possibilities for new drug development.

“Our group is the first to solve the structure and to begin to understand the function of this particular protein,” says Dr. Nancy Martin (Microbiology & Immunology), who coordinated the study with Dr. Zongchao Jia (Biochemistry). “It turns out to be a potentially good target in a wide range of bacteria that cause infectious diseases.” Because of the increasing number of antibiotic-resistant strains of many different types of bacteria, such as salmonella, she notes, new approaches to antibiotic therapy are needed.

The Queen’s findings are published in the on-line edition of the journal Molecular Microbiology. Also on the team, from Biochemistry, are PhD student Jimin Zheng and post-doctoral fellow Vinay Singh; and Microbiology & Immunology Master’s student Chunhua He.

The group is studying sensory pathways used by bacteria that enter our bodies and move from the stomach into the gastro-intestinal tract. “If we can block the sensory pathway, then the bacteria can’t adapt to that change in their environment, and won’t be able to infect,” says Dr. Martin.

In North America, the people treated for food poisoning with drugs tend to be elderly or “immune compromised” where there is a need for antibiotics to clear the infection. Since the organism that causes salmonellosis is related to that responsible for typhoid fever – a huge problem in less developed countries – the model being developed at Queen’s could potentially be a target for treating typhoid as well. The underlying goal is to control, if not clear, the infection.

“It’s basic science that we are doing, but we’re using that as a foundation for trying to develop approaches that will have positive impacts on human health,” says Dr. Martin.

PLEASE NOTE: A PDF copy of the study is available upon request.

Nancy Dorrance, Queen’s News & Media Services, 613.533.2869
Lorinda Peterson, Queen’s News & Media Services, 613.533.3234

Attention broadcasters: Queen’s has facilities to provide broadcast quality audio and video feeds. For television interviews, we can provide a live, real-time double ender from Kingston fibre optic cable. Please call for details.
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PostPosted: Wed Jun 27, 2007 8:53 am    Post subject: Nepalese researchers identify cost-effective treatment for d Reply with quote

Public Library of Science
27 June 2007

Nepalese researchers identify cost-effective treatment for drug-resistant typhoid

New research carried out by researchers in Nepal has shown that a new and affordable drug, Gatifloxacin, may be more effective at treating typhoid fever than the drug currently recommended by the World Health Organisation. The study, funded by the Wellcome Trust, has implications for the treatment of typhoid particularly in areas where drug resistance is a major problem. The results are published in the June 27th issue of the online, open-access journal PLoS ONE.

Enteric fever, of which typhoid fever is the most common form, is a major disease affecting the developing world, where sanitary conditions remain poor. The best global estimates are of at least 22 million cases of typhoid fever each year with 200,000 deaths. Drug resistance is becoming a major problem and treatment is becoming increasingly difficult, leading to patients taking longer to recover, suffering more complications and continuing to spread the disease to their family and to their community.

Clinical investigators based at Patan Hospital Lalitpur in Kathmandu, Nepal, and the Oxford University Clinical Research Unit in Vietnam have completed a study to see if they can improve the treatment for patients with typhoid fever. Kathmandu has been termed the typhoid fever capital of the world as a result of this disease remaining so common.

“Typhoid fever is a major problem in Nepal and in the developing world and drug-resistant strains are making it even more difficult to tackle," says Dr Buddha Basnyat, senior investigator on the study. "The currently recommended treatment, Cefixime, is relatively expensive and must be administered for a longer duration than is ideal. Clearly there is an urgent need for a treatment that is cost-effective and easy to administer."

The results of the study show that despite high levels of drug resistance, a cost-effective new fluoroquinolone drug, Gatifloxacin, may be a better treatment for enteric fever than Cefixime, which is currently recommended by the World Health Organisation.

"We have shown that Gatifloxacin may be better than an established drug used by many doctors around the world," says Dr Basnyat. "There is currently no resistance to the drug, and at just over US$1 dollar for a seven day treatment course is relatively inexpensive."

"This is an important study with major implications for treating disease widespread in the developing world," says Professor Jeremy Farrar from the Oxford University Clinical Research Unit in Vietnam. "It also shows the major contribution that clinical investigators in Nepal, with the experience and knowledge gained from access to thousands of patients, can help make to improving treatment for our patients and to global health.”


The following press release refers to an upcoming article in PLoS ONE. The release has been provided by the article authors and/or their institutions. Any opinions expressed in this are the personal views of the contributors, and do not necessarily represent the views or policies of PLoS. PLoS expressly disclaims any and all warranties and liability in connection with the information found in the release and article and your use of such information.

Citation: Pandit A, Arjyal A, Day JN, Paudyal B, Dangol S, et al (2007) An Open Randomized Comparison of Gatifloxacin versus Cefixime for the Treatment of Uncomplicated Enteric Fever. PLoS ONE 2(6): e542. doi:10.1371/journal.pone.0000542


Notes for editors

1. Patan Hospital Lalitpur serves the community of Kathmandu, Nepal and welcomes all who come in time of need – whether young or old, rich or poor, from Lalitpur or from faraway, whatever their caste or creed.

2. The Wellcome Trust is the largest charity in the UK. It funds innovative biomedical research, in the UK and internationally, spending around £500 million each year to support the brightest scientists with the best ideas. The Wellcome Trust supports public debate about biomedical research and its impact on health and wellbeing.

3. Oxford University’s Medical Sciences Division is one of the largest biomedical research centres in Europe. It represents almost one third of Oxford University’s income and expenditure and two thirds of Oxford University’s external research income. Oxford’s world-renowned global health programme is a leader in the fight against infectious diseases (such as malaria, HIV/AIDS, tuberculosis and avian flu) and other prevalent diseases (such as cancer, stroke, heart disease and diabetes). Key to its success is a long-standing network of dedicated Wellcome Trust-funded research units in Asia (Thailand, Laos and Vietnam) and Kenya, and work at the MRC Unit in The Gambia. Long-term study of patients around the world is supported by basic science at Oxford and has led to many exciting developments, including potential vaccines for tuberculosis, malaria and HIV, which are in clinical trials.
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