The study protocol was approved by the ethics committee of the He

The study protocol was approved by the ethics committee of the Helsinki University Central Hospital and the Finnish Medicines Agency. The study protocol was registered in the International Standard Randomised Controlled Trial Number Register (ISRCTN68125331). Written informed consent was obtained from all study subjects. The patients enrolled in this study were treated in the Division of Infectious Diseases, Helsinki University Central Hospital. Thirty healthy

Finnish born volunteers (18 females, 12 males, aged 18–62 years, mean age 32 years), four patients with typhoid fever (two females, two males, aged 22–29 years) and one with paratyphoid fever (female, 30 years) were enrolled. Of the patients with typhoid fever, two were Finnish born travelers to India and South-America, one was an applicant Kinase Inhibitor Library cell assay BGB324 order for asylum from Sri Lanka and one was an immigrant from Nepal who had visited relatives in his home country. The last patient was having an infection relapse one month after the first episode. The patient with paratyphoid A fever was an immigrant from India who had visited relatives in her home country. Typhoid and paratyphoid fever were diagnosed on the basis of blood cultures. None of the vaccinees had a previous history of receiving typhoid

vaccine or having enteric fever. They were given the oral Salmonella Typhi Ty21a vaccine containing ≥2 × 109 live bacteria/capsule (Vivotif®, Crucell, Leiden, The Netherlands, lot 3001777) administered one capsule per day on days 0, 2 and 4, as recommended by the manufacturer. Peripheral venous blood was drawn on days Amisulpride 0 and 7 after vaccination or 7–10 days after the onset of symptoms of the infection. To include as many antigenic structures as possible, whole bacteria of strains Salmonella Typhi (Vsa61), Salmonella

Paratyphi A (RHS6716), B (RHS6744), C (ATCC-13428) and Salmonella Egusi (RHS6854) were used as antigens in the ELISPOT assay. Salmonella Paratyphi C strain was from the American Type Culture Collection (ATCC, Manassas, VA, USA), while the other strains were from the National Institute for Health and Welfare, Helsinki, Finland. Bacteria were cultured on nutrient agar plates to determine their concentration in the suspension, and formalin-killed as described previously [20]. For ELISPOT assays, the concentration was adjusted to 109 bacteria/ml in PBS (phosphate buffered saline). PBMC were separated using Ficoll-plaque density gradient centrifugation as described previously [20]. The analyses of HR expressions were carried out for 15 vaccinees and for the four patients with enteric fever as a primary infection. Only one strain per person could be analyzed because of limited numbers of PBMC.

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