An epidemic of a deadly
strain of Salmonella has swept across the whole of Africa by "taking
advantage" of the spread of HIV, according to an international team of
researchers.
Their study,
published in Nature Genetics, said weakened immune systems caused by
HIV allowed it to spread.
One in four people in Africa infected with the strain died.
It is thought to be the first time a bug has spread so widely
in the wake of HIV.
There are hundreds of different strains, or versions, of
Salmonella.
Cases of this form of invasive non-typhoidal Salmonella -
which causes fever, headaches, respiratory problems and sometimes death -
have been recognised in Africa for more than a decade. But researchers
have only just realised they were all part of a single epidemic causing
deaths across a continent.
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It quite clearly parallels the
emergence of HIV in Africa”
End Quote
Prof Gordon Dougan
Sanger Institute
The research team analysed the
genetic code of 179 batches of Salmonella. They traced the spread of the
disease by analysing how closely related bacteria in different
countries were.
It happened in two waves. The first started in south-eastern
Africa about 52 years ago and the second wave started 35 years ago from
the Congo Basin.
Prof Gordon Dougan, from the Sanger Institute in Cambridge in
the UK, told the BBC: "It quite clearly parallels the emergence of HIV
in Africa."
HIV attacks the immune system and leaves people more
vulnerable to other infections. It is thought the strain took advantage
of this weakness and spread. The research team said the bacterium was
given the chance to "enter, adapt, circulate and thrive".
There is poor data for the number of cases across the
continent, but Prof Dougan said it was affecting "thousands and
thousands" of people and that 98% of adult cases were in people with
HIV.
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It's actually quite a huge problem
and it seems to be getting worse because there are many susceptible
people, it's got a grip in Africa”
End Quote
Prof Brendan Wren
London School of Hygiene and Tropical
Medicine
He said this spread had been
different to that of other infections commonly associated with HIV, as
it had been a single epidemic "people were completely unaware" of and
there "were not really any other examples" of that happening.
Dr Melita Gordon, a gastro-enterologist at the University of
Liverpool, said: "It's the first time this has been described right
across a continent in such an obvious way."
She added: "The highest mortality associated with the disease
is 80%. What's happened over the years is mortality has fallen down and
down and down to between 20% and 25% as doctors inside Africa recognise
it."
The genetic analysis also showed the strain was resistant to
the first choice antibiotic, chloramphenicol, which means more expensive
drugs would be needed to treat the infection.
It is thought that improving HIV treatment across Africa
could reduce the prevalence of the Salmonella infection, as it would
reduce the number of people with vulnerable immune systems. However, the
researchers urged "vigilance" in case the Salmonella strain mutated
again to become able to infect people with healthy immune systems.
Commenting on the study, Prof Brendan Wren, from the London
School of Hygiene and Tropical Medicine, told the BBC: "It's actually
quite a huge problem and it seems to be getting worse because there are
many susceptible people, it's got a grip in Africa.
"HIV, I think it's fair to say, provided a springboard for it
to take off."
However, he thought the disease was "near its peak" as HIV
was more controlled in other continents giving it little room to spread.
source of article ;
http://www.bbc.co.uk/news/health-19727630