Investigation of the role of typhoid toxin in acute typhoid fever in a human challenge model

The typhoid toxin is postulated to have a central role in disease pathogenesis, the establishment of chronic infection and human host restriction2,3,4,5,6. However, its precise role in typhoid disease in humans is not fully defined.

We studied the role of typhoid toxin in acute infection using a randomized, double-blind S. Typhi human challenge model7. Forty healthy volunteers were randomized (1:1) to oral challenge with 104 colony-forming units of wild-type or an isogenic typhoid toxin deletion mutant (TN) of S. Typhi. We observed no significant difference in the rate of typhoid infection (fever ≥38 °C for ≥12 h and/or S. Typhi bacteremia) between participants challenged with wild-type or TN S. Typhi (15 out of 21 (71%) versus 15 out of 19 (79%); P = 0.58).