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Infecting dose and severity of typhoid: analysis of volunteer data and examination of the influence of the definition of illness used

Published online by Cambridge University Press:  15 May 2009

J. R. Glynn ,
R. B. Hornick ,
M. M. Levine  and
D. J. Bradley
J. R. Glynn
Affiliation:
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London WC1E 7HT
R. B. Hornick
Affiliation:
Office of Medical Education, Orlando Regional Medical Center, Orlando, Florida
M. M. Levine
Affiliation:
Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland
D. J. Bradley
Affiliation:
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London WC1E 7HT
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Summary

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Data from volunteers challenged with Salmonella typhi were reanalysed to explore the relationship between challenge dose and severity of disease. Among 120 ill volunteers who received between 105 and 109 organisms, dose was weakly correlated with peak temperature (r = 0·22, 95% CI 0·04–0·39), duration of temperature above 103 °F (39·4 °C: r = 0·13, 95% CI –0·03 to 0·55) and symptom score (r = 0·27, 95% CI 0·09–0·43). The association with symptom score was lost after adjusting for year, and the findings depended on the definition of illness used: with stricter definitions the associations with temperature were also lost. The study shows the need for caution in interpreting the relationship between dose and severity of disease.

Type
Research Article
Information
Epidemiology & Infection , Volume 115 , Issue 1 , August 1995 , pp. 23 - 30
Copyright
Copyright © Cambridge University Press 1995

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