Parting the Clouds over Typhoid with a New Conjugate Vaccine

New England Journal of Medicine
December 5, 2019 Vol. 381 No. 23


Parting the Clouds over Typhoid with a New Conjugate Vaccine
Florian Marks, Ph.D., and Jerome H. Kim, M.D.
Typhoid fever is caused by fecal–oral transmission of Salmonella enterica serovar Typhi (S. Typhi). It has been a deadly companion to mankind for centuries, affecting 10.9 million persons and resulting in an estimated 116,800 deaths per year.1 Although vaccines against typhoid have been available for more than a century and have been shown to be protective,2,3 the approved vaccines (injectable Vi polysaccharide and oral, live-attenuated Ty21a typhoid vaccines) have not been useful in populations with a high typhoid burden, particularly in young children.4 To address this shortfall, the Bill and Melinda Gates Foundation, as well as other donors, has supported . . .