Fever of Unknown Origin

tuberclin test used to diagnose tuberculosis as cause of fever of unknown origin

tuberculin test

Causes of FUO in Infants and Children

Causes of Fever of Unknown Origin (FUO) in Infants and Children Attending Assiut University Children Hospital (AUCH)

Randa Mohammed Abd El Twab

Principal Investigator

Assiut University

Patients with a non-typhoid Salmonella infection. Blood samples, stool samples and clinical information will be collected.

Patients with acute, infectious diarrhea without non-typhoid Salmonella infection. Blood samples, stool samples and clinical information will be collected.

Healthy individuals with no symptoms of acute or chronic diarrhea. Blood samples, stool samples and clinical information will be collected.

Salmonella Infection Non-Typhoid

Blood samples will be collected and analyzed at different study time points

Blood samples

Stool samples will be collected and analyzed at different study time points

Stool samples

Clinical information will be collected at different study time points using questionnaires

Clinical information

Division of Gastroenterology, University Hospital Zurich

Interaction Between Non-typhoid Salmonella, Host Microbiota, and Immune System During Acute Infection and Remission

Analyze the evolution of non-typhoid Salmonella during acute infection and remission in humans. The primary variable of interest is the number of observed genomic mutations in non-typhoid Salmonella strains.

Total number of Salmonella genes associated with tissue invasion Total number of antibiotic resistance genes Total number of virulence factor genes

Identification of escape mechanisms of non-typhoid Salmonella (i.e. mutation of surface antigens) to avoid specific immune responses (i.e. antibodies) during acute infection and remission.

Identification of Salmonella gene clusters expressed during early phases of infection compared to remission.

Quantification of mutated non-typhoid Salmonella strains that escape specific immune responses.

Composition (i.e. number of bacteria species identified) and relative diversity of the gut microbial community during acute non-typhoid Salmonella infection and remission. Findings will be compared to changes occurring in the microbiota of healthy individuals and individuals with acute, infectious diarrhea caused by microorganisms other than Salmonella.

Composition (i.e. number of antibody-producing cells) and relative diversity of antibody-producing cells specific for non-typhoid Salmonella.

Number of antibody-producing cell clones (and their corresponding antibodies) against non-typhoid Salmonella isolated from peripheral blood B cells of subjects during remission. Measured variable: Number of Salmonella-specific B-cells per ml blood 4 weeks after infection.

Identification of the antibody repertoire against non-typhoid Salmonella during acute infection in peripheral blood. Measured variable: Antibody titers against various non-typhoid Salmonella strains.

Number of antigens of non-typhoid Salmonella recognized by the antibodies isolated from the previous endpoint.

Number of patients who develop an irritable bowel syndrome after a non-typhoid Salmonella infection.

University of Zurich

Volunteers previously immunized with Vivotif, now receiving a Vivotif secondary immunization

Volunteers previously immunized with Typherix, now receiving a Typherix secondary immunization

Volunteers previously immunized with Vivotif and Typherix, now receiving Vivotif and Typherix as secondary immunization

Healthy

Vivotif

Typherix

University of Helsinki, Haartman Institute

Helsinki University Central Hospital

Aava Medical Centre

Cross-reactive Immunity Elicited by Oral and Parenteral Typhoid Vaccines

Cross-reactive Immunity Elicited by Oral and Parenteral Typhoid Vaccines Against Non-typhoid Salmonellae

To study whether cross-reactive immune response is similar
if the two vaccines are given simultaneously
after booster immunization than after primary immunization

To study whether cross-reactive serum immune response is similar
if the two vaccines are given simultaneously
after booster immunization than after primary immunization

Record adverse effects of the vaccines used

Anu Kantele

Associate professor

Determine if the immunogenicity of oral typhoid can be enhanced in children by introducing zinc supplementation: Our recent studies on the interactions of oral cholera vaccine with breast milk and zinc provide some basis for improving immunogenicity, but additional work is needed to improve many of the oral vaccines. In this study we also plan to evaluate if the immune response to Cholera and Vivotif can be enhanced by supplementation with zinc using methods described earlier. We would like to study children, 2-5 years of age for this purpose.

There is a high burden of enteric parasites in the gut of people living in densely populated areas of less developed countries. The effect of concurrent parasitic infestations on immune responses has not been studied widely, although it is an area of utmost importance for natural protection as well as vaccine immuno-prophylaxis. In this study we plan to determine the impact of pretreatment with antiparasitic agents (albendazole and secnidazole) on the immunogenicity of the oral cholera and typhoid vaccines in children, 2-5 years of age

In this study, we aim to evaluate if immunogenicity of the oral cholera vaccine is modified in children living in a high arsenic contaminated area in Bangladesh. The plan is to study children 2-5 year old living in Shahrasti thana near Matlab where the tubewell water is highly contaminated with arsenic and this study will not be randomized double-blind, and compare their responses with responses of age matched children living in arsenic free area, such as in Mirpur area of Dhaka city. We only plan to study the effect of Dukoral vaccinees since this vaccine has been widely studied in Bangladesh. If an impact of arsenic is seen on immune response to this vaccine, future studies could be done with other vaccines including Vivotif.

Cholera

Typhoid

Placebo will be given according to randomization list

Placebo

Control will be selected from the Arsenic non contaminated Area

Control

Zinc Sulphate will be given according to randomization list

Zinc Sulphate

Albendazole and Secnidazole will be given according to randomization list

Albendazole and Secnidazole

Participant will be selected from the Arsenic Contaminated Area

Arsenic

Firdausi Qadri

Studies of Immune Responses to Orally Administered Vaccines in Developing Country

Studies of Acute and Memory Immune Responses to Orally Administered Vaccines in Developing Country Children and Factors That May Augment Such Responses

typhoid fever/diarreia

Causes of FUO in Infants and Children

Interaction Between Non-typhoid Salmonella, Host Microbiota, and Immune System During Acute Infection and Remission

Cross-reactive Immunity Elicited by Oral and Parenteral Typhoid Vaccines

Studies of Immune Responses to Orally Administered Vaccines in Developing Country

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