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Sewage workers with low antibody responses may be colonized successively by several Tropheryma whipplei strains

Abstract : Objectives: Asymptomatic faecal carriage of Tropheryma whipplei, the agent of Whipple's disease, is reported among sewage workers. However, the potential development of such carriage is unknown. A 7-year follow-up of T. whipplei-carrying sewage workers is reported. Methods: Nineteen sewage workers previously detected as faecal carriers of T. whipplei were followed to ascertain the chronicity of their carriage. Faeces were tested by molecular assays using quantitative real-time PCR specifically targeting T. whipplei. Serological anti-T. whipplei Western blotting was also performed. Results: Seventy-nine percent (15/19) of workers exhibited a strong immune response against T. whipplei. Among these, five were followed for more than 1 year. Four maintained a strong response, with three carrying the same strain and one becoming negative. The fifth exhibited a decreased immune response, a negative faeces result, and subsequent carriage of another strain. Three individuals with low immune responses were also followed. Two never developed a response, with one carrying the same strain and one becoming negative and then positive with another strain; the third developed a strong response and became negative. Conclusions: Chronic T. whipplei carriers appear to be protected against reinfection, but those with low or decreasing antibody levels may be re-colonized by another strain.
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Florence Fenollar, Thomas Marth, Jean-Christophe Lagier, Emmanouil Angelakis, Didier Raoult. Sewage workers with low antibody responses may be colonized successively by several Tropheryma whipplei strains. International Journal of Infectious Diseases, Elsevier, 2015, 35, pp.51-55. ⟨10.1016/j.ijid.2015.04.009⟩. ⟨hal-01785415⟩

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