The problem of this thesis consists of a bacterial analysis of twenty-five representative wells within a radius of thirty miles of Canyon, Texas. An attempt has been made to determine the possible presence of the typhoid organism in these wells.

A bacterial analysis of the water from thirty-six sources of consumption by the white population of Trinidad, Henderson County, Texas, was made to determine the potability of each of these in regard to infection from typhoid or related organisms.

Jane Addams and Ellen Gates Starr opened Hull House, Chicago’s first settlement house, in 1889 as a means of confronting poverty, poor housing conditions, disease, discouragement, and other ills that flourished in the predominately immigrant Halstead neighborhood. Because Hull House volunteers lived at the House, in the center of the community, they were well-equipped to respond knowledgeably to the neighborhood conditions. Hull House residents worked for reform in areas such as education, labor, juvenile protection, immigration, welfare, housing, and suffrage and they provided the community with a plethora of activities and services during the Progressive Era. As the community expressed their needs, Hull House volunteers responded to them. This dissertation provides evidence that social activism did not just take the form of political engagement and occupational health efforts but that it also included disease and illness prevention efforts. An examination of activist work of the Hull House Woman’s Club helps create an understanding of the intersection of activism and disease and illness prevention, and how activists used strategies to improve the health and wellbeing of people at the turn of the century. Specifically, three groups of women—the neighborhood women, the club women, and public health knowledge-holders—came together to address public health issues in the Nineteenth Ward. Each of these three groups played an integral role in the success of Hull House public health activism; it was their coming together that enabled them to create such powerful change. This dissertation specifically examines the women’s efforts in 1894 to improve garbage collection and sanitation and their 1902 efforts to eliminate typhoid in their neighborhood. This dissertation argues that, despite a lack of formal public health education or training, Woman’s Club members utilized local knowledge to improve health conditions in the Nineteenth Ward in Chicago. Woman’s Club activists acquired public health knowledge and developed activist strategies and techniques inductively, through trial and error, as they were carrying out their activist work. This dissertation helps fill in the historical gaps by exploring the strategies Hull House volunteers used to prevent disease and illness prevention.

Before the consolidation of the germ theory of human diseases at the end of the nineteenth century, medical explanations about disease causation were dominated by the environmental notions of medical geography. This dissertation explores how nineteenth-century Colombian physicians transformed the medical geographical approach using the early concepts and technologies of the emerging Pasteurian germ theory. I follow this transformation in the cases of periodic fevers (yellow fever and malaria), continuous fevers (typhoid fever and typhus) and leprosy. The analysis reveals that by mid century physicians had incorporated neo-Hippocratic versions of disease causation and French medical geographical ideas in order to make sense of disease of the warm, temperate and cold lands. Their conceptual network revolved around the specific, predisposing and occasional causes in which climate and geography played a determinant role. Evidence indicates that this was the case of periodic fevers of the warm lands (yellow fever and malaria). I argue that the “parasitic” hypothesis of yellow fever was accepted during the controversy around the prophylactic inoculations inspired by Pasteurism that were applied in Colombia in 1887. However, doctors struggled to reconcile the medical geographical and the bacteriological perspective of both yellow fever and malaria. Continuous fevers, on the other hand, were also framed within the medical geography scheme of disease causation. I show how during the debates about typhoid fever and typhus happening in the Colombian highlands during the 70s, 80s and 90s, doctors used medical geographical notions and developed anti-pasteurian arguments, while the international scientific community had identified the specific bacilli for typhoid fever. Finally, I argue that the strong interest of Colombian doctors on leprosy –also understood in neo-Hippocratic terms- that foster the search for local treatments based on Pasteurism (antiseptics in the 1880s and serotherapy in the 1890s) also prompted the extension of the bacteriological model and techniques to other diseases in those decades.

Typhoid fever remains an important public health problem globally. Cluster randomized effectiveness trials with typhoid Vi polysaccharide vaccine were conducted in Kolkata, India and Karachi, Pakistan, to provide evidence for vaccine introduction. While efficacy trials are limited to estimate vaccine's performance on the vaccine recipients, effectiveness trials consider the public health impact, notably the herd protection, or indirect effect, which can only be seen when vaccines are administered to groups rather than to individuals. The observed total protection by the Vi polysaccharide vaccine in school-aged children was consistent in Kolkata and Karachi (61% and 56%, respectively), and was associated with minimal side-effects. The total protection in young children, however, was different (80% in Kolkata and no protection in Karachi). The Kolkata trial demonstrated significant herd protective effects, as demonstrated by indirect protection of non-vaccinees (45%), which was not shown in the Karachi trial. The difference in the effectiveness estimates between the trials may be due to the difference in study design and the population characteristics. Immunogenicity studies were undertaken for randomly selected persons from both sites at pre-vaccination, 6 weeks, and 2 years post-vaccination. Serum Vi antibody titres (IgG) were measured through ELISA. At baseline, the GMTs were below the protective level for both sites. At six weeks after vaccination, though there is a significant increase in the GMTs in children from both site, the level of GMTs were significantly lower from those in Karachi (2,307.0 ELU vs. 1,189.1 ELU). GMT declined from 6 week to 2 year testing points for both sites but maintained the protective level. These effectiveness trials gave a conclusive evidence of the protection conferred by the Vi polysaccharide vaccine in children older than 5 years of age. Targeted vaccination programme in high endemic areas, as stipulated in the WHO Position Paper, suggest the potential for effective control of typhoid fever in places like India and Pakistan with the school-based Vi vaccination.

Thesis (Ph. D.)--Georgia State University, 2007. / Title from file title page. Wendy H. Venet, committee chair; Stuart Galishoff, Charles G. Steffen, committee members. Electronic text (338 p.) : digital, PDF file. Description based on contents viewed Feb. 4, 2008. Includes bibliographical references (p. 308-338).

p. 1-69 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-11T19:49:38Z No. of bitstreams: 1 MP Cristiane Penaforte MP.pdf: 718797 bytes, checksum: c2cc2e88d1b7f14401ea20964a258cdf (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:21:05Z (GMT) No. of bitstreams: 1 MP Cristiane Penaforte MP.pdf: 718797 bytes, checksum: c2cc2e88d1b7f14401ea20964a258cdf (MD5) / Made available in DSpace on 2013-05-04T17:21:05Z (GMT). No. of bitstreams: 1 MP Cristiane Penaforte MP.pdf: 718797 bytes, checksum: c2cc2e88d1b7f14401ea20964a258cdf (MD5) Previous issue date: 2005 / A febre tifóide (FT) é uma doença de distribuição universal, associada às precárias condições higiênico-sanitárias. Nas regiões Norte e Nordeste do Brasil a doença é endêmica, com ocorrência freqüente de surtos. A vigilância epidemiológica (VE) da FT representa importante ferramenta para detecção oportuna de surtos visando impedir ou dificultar a sua propagação. Objetivos: Avaliar o sistema de vigilância da febre tifóide no Brasil, entre os anos de 2001 a 2003. Métodos: Um estudo descritivo foi realizado baseado nas Diretrizes dos Centers for Disease Control and Prevention (CDC, EUA) publicado em 1988. A fonte de dados incluiu informações do Sistema de Informação de Agravos de Notificação (Sinan) e o Sistema de Informação sobre Mortalidade (SIM). Os atributos avaliados foram qualitativos (simplicidade, flexibilidade, aceitabilidade) e quantitativos (sensibilidade, valor preditivo positivo- VPP, representatividade, oportunidade). Resultados: O sistema de vigilância é complexo envolvendo vários níveis de gestão para transferência dos dados, com mais de 30 mil unidades notificadoras vários formulários para notificação de caso ou surto. A ficha individual de investigação apresenta mais de 70 campos. A aceitabilidade é baixa pela ausência de preenchimento de campos importantes para a VE: 54% das variáveis estavam incompletas em mais de 50% dos dados. A flexibilidade do sistema não foi possível avaliar pela ausência de informações. A sensibilidade do Sinan para óbitos foi baixa (19%) e ambos os sistemas detectaram apenas 54% dos óbitos estimados (N=52). O VPP dos casos encerrados pelo critério laboratorial foi abaixo: 29% em 2001, 44% em 2002 e 41% em 2003. O sistema foi oportuno, com uma mediana de 07 dias para a notificação após o início dos sintomas, < de 01 dia para a investigação e 25 dias para o encerramento dos casos. O sistema é representativo pela alta cobertura do Sinan e SIM no país, no entanto, há limitações quanto ao subregistro de casos. Conclusão: Apesar do baixo desempenho, o sistema de vigilância da FT é útil para análise das informações de morbidade e mortalidade e o efeito das medidas de controle e prevenção. Porém, o sistema precisa melhorar a sensibilidade e aceitabilidade para alcançar seus objetivos mais eficientemente. Desta forma, recomendamos capacitação dos profissionais de saúde na detecção, notificação e investigação de FT. / Salvador

Made available in DSpace on 2014-06-11T19:27:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-23Bitstream added on 2014-06-13T20:57:22Z : No. of bitstreams: 1 garcia_ko_me_jabo.pdf: 1338222 bytes, checksum: 3ae3f6dbbedafe616111a3bd7c911731 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Este trabalho objetivou avaliar a anatomopatologia, o hemograma e o perfil bioquímico sérico de aves de postura inoculadas por Salmonella Gallinarum (SG) contendo os genes cobS e cbiA inoperantes (SGcobScbiA) que mostrou ser avirulenta em trabalhos anteriores, comparando-a com cepas virulentas SGNalr e SGcobS, para mostrar se SGcobScbiA pode ser componente de vacina contra cepas selvagens de SG e S.Enteritidis. 280 pintainhas foram distribuídas em 4 grupos (G); G1 (SGcobS), G2 (SGNalr), G3 (SGcobScbiA) e G4 (controle). Com exceção do G4, os grupos receberam 0,2 mL de suas respectivas cepas contendo aproximadamente 108 UFC/mL de inóculo, aos 5 dias de idade. A eutanásia foi realizada 24h antes (1DAI) e após a inoculação (1DPI), e 3 (3DPI), 5 (5DPI), 7 (7DPI), 10 (10DPI) e 15 (15DPI) dias após a administração do inóculo, sacrificando-se, em cada momento, dez aves de cada grupo. As aves foram sacrificadas, obtendo-se amostras de sangue utilizadas para os exames hematológicos e bioquímicos. Fragmentos de fígado, baço, timo, bursa de Fabricius, rins e coração foram destinados aos exames histológicos. As aves inoculadas com a cepa SGcobS tiveram comportamento semelhante às aves inoculadas por SGNalr, porém com algumas respostas diferentes nos exames hematológicos e bioquímicos. As aves inoculadas com a cepa SGcobScbiA tiveram comportamento semelhante ao grupo controle, entretanto foi verificado alterações brandas em alguns parâmetros, mostrando que estudos futuros devem ser feitos, verificando se as alterações constatadas não irão interferir no desempenho de aves vacinadas com a cepa SGcobScbiA. / The aim of the present study was to evaluate anatomopathology, hemogram and blood serum components of commercial layers experimentally inoculated with SGcobScbiA, which is a Salmonella Gallinarum (SG) strain it shows attenuation of the virulence in previous research and it was compared with high virulence SGNalr and SGcobS strains in order to show if SGcobScbiA has potential to be use as a vaccine against SG and S. Enteritidis wild strains. 280 commercial layers were divided into 4 groups (G); G1 (SGcobS), G2 (SGNalr), G3 (SGcobScbiA) and G4 (control group). With exception of G4, all the other groups received 0,2 mL of their respective strain containing about 108 CFU/mL of the inoculum with five days of age. Birds were sacrificed 24 hours before (1DBI) and 24 hours after the inoculation (1DAI), and three (3DAI), five (5DAI), seven (7DAI) ten (10DAI), and fifteen (15DAI) days after the administration of the inoculum, slaughtering ten birds at a time in each group. Birds were submitted to euthanasia and blood samples were collected in order to make the hematological and blood serum components test. Samples of liver, spleen, thymus, bursa of Fabricius, kidneys and heart were collected for the histological test. The birds inoculated with SGcobS strain had similar behavior when compared with that ones who received SGNalr strain, however some different responses in the hematological and blood serum components were found. On the other hand, the birds inoculated with SGcobScbiA strain had similar behavior when compared with the control group, however, lower alterations in some parameters were found. Further studies must be done to verify if these alterations will not interfere in the performance of the vaccinate birds with SGcobScbiA strain.

Salmonella enterica is a common foodborne, facultative intracellular enteropathogen. The ty-phoidal S. enterica serovars Paratyphi A (SPA) and Typhi (STY) are human-restricted, and cause severe systemic diseases, while many S. enterica serovars like Typhimurium (STM) have a broad host range and in human hosts usually lead to self-limiting gastroenteritis. There are key differences between typhoidal (TS) and non-typhoidal (NTS) Salmonella in pathogenesis, but research on TS is challenging due to host restriction. Since STM causes a typhoid-like disease in mice, it was widely used as model organism to mimic human TS infection. Although results gained by research on STM could provide major insights in Salmonella virulence in general, the specific virulence mechanisms of TS are far from being understood. Both TS and NTS are able to invade mammalian cells and to replicate within host cells, including epithelial cells and macrophages. After invasion or phagocytic uptake, Salmonella resides in a membrane-bound compartment, the Salmonella-containing vacuole (SCV). The subsequent in-tracellular lifestyle is dependent on the translocation of effector proteins via a type 3 secretion system (T3SS) which is encoded by genes on Salmonella pathogenicity island 2 (SPI2). During the intracellular lifestyle, vesicular compartments of host cells are manipulated by effector pro-teins of the SPI2-T3SS and Salmonella-induced filaments (SIF) are formed. It is currently un-known if observations regarding the molecular pathogenesis made for STM are applicable to TS serovars SPA and STY. In this work, the intracellular lifestyles of TS were investigated on single cell level. Analyses of intracellular activities of STY and SPA in various host cells showed that STY and SPA deploy SPI2-T3SS to actively manipulate their host cells, but with far lower frequency than STM. A role of SPI2-T3SS for proliferation of STY and SPA in epithelial cells was observed, but not for sur-vival or proliferation in phagocytic host cells. Reduced intracellular activities and pronounced SCV integrity of STY and SPA might contribute to the stealth strategy of STY and SPA, facilitat-ing systemic spread and persistence. Furthermore, by analyses of intracellular transcriptomic architecture during human epithelial cell infection of SPA and STM, different gene expression patterns in key virulence and metabolic pathways were identified. Elevated expression of SPI1 and flagella-chemotaxis genes by intracellular SPA results in cytosolic, flagella-mediated motility and increased invasiveness of SPA. Distinct gene expression patterns of carbon utilization path-ways, flagella-chemotaxis and SPI1 genes might contribute to the invasive and systemic disease developed following SPA infection in humans. Live cell imaging revealed that SPA invades host cells in a cooperative manner with multiple bacteria per invasion site, leading to error-prone macropinocytosis with increased membrane damage of the early SCV. After release into the cytosol, motile bacteria showed reduced autophagosomal capture. The results provide new insights into the virulence profile of STY and SPA by unravelling pre-viously unknown intracellular phenotypes and virulence traits. The established 3D and 2D intes-tinal organoid models offer new tools for analyses of human-restricted pathogens in a more in vivo relevant context.

M.S.