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{{Whipple's disease}}
{{Whipple's disease}}
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==Overview==
Whipple's disease is a systemic disease among middle-aged white males in North America and western Europe. It affects males 8 times more than females. Few studies were done to evaluate the [[demographics]] of Whipple's disease due to the sparsity of the disease. The [[incidence]] of Whipple's disease is approximately 0.1 per 100,000 individuals and the [[prevalence]] is approximately 0.3 per 100,000 individuals in north-western Italy. Although the [[prevalence]] of [[carrier]] state is higher in Asian and African countries, the [[prevalence]] of the classic Whipple's disease is less than American and western European countries. The [[case-fatality rate]] of Whipple's disease is approximately 100%, if left untreated. The [[case-fatality rate]] of treated Whipple's disease is unknown.


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==Epidemiology and Demographics==
===Incidence===
*The [[incidence]] of Whipple's disease is approximately 0.1 per 100,000 individuals in north-western Italy.<ref name="BiagiBalduzzi2015">{{cite journal|last1=Biagi|first1=F.|last2=Balduzzi|first2=D.|last3=Delvino|first3=P.|last4=Schiepatti|first4=A.|last5=Klersy|first5=C.|last6=Corazza|first6=G. R.|title=Prevalence of Whipple's disease in north-western Italy|journal=European Journal of Clinical Microbiology & Infectious Diseases|volume=34|issue=7|year=2015|pages=1347–1348|issn=0934-9723|doi=10.1007/s10096-015-2357-2}}</ref>
*The [[incidence]] of Whipple's disease is approximately 12 annually worldwide.<ref name="Whipple’s disease">Dobbins W, III. 1987. Whipple’s disease. Charles C Thomas, Publisher,
Springfield, IL.</ref>
*Between 1907 and 1987, the [[incidence]] of Whipple's disease was estimated to be 696 cases worldwide.<ref name="Whipple’s disease">Dobbins W, III. 1987. Whipple’s disease. Charles C Thomas, Publisher, Springfield, IL.</ref>


==Overview==
===Prevalence===


==Epidemiology and Demographics==
==== Classic Whipple's disease ====
*The [[prevalence]] of Whipple's disease is approximately 0.3 per 100,000 individuals in north-western Italy.<ref name="BiagiBalduzzi2015">{{cite journal|last1=Biagi|first1=F.|last2=Balduzzi|first2=D.|last3=Delvino|first3=P.|last4=Schiepatti|first4=A.|last5=Klersy|first5=C.|last6=Corazza|first6=G. R.|title=Prevalence of Whipple's disease in north-western Italy|journal=European Journal of Clinical Microbiology & Infectious Diseases|volume=34|issue=7|year=2015|pages=1347–1348|issn=0934-9723|doi=10.1007/s10096-015-2357-2}}</ref>


===Gender===
==== Carrier state ====
*In Europe, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 1,000-11,000 per 100,000 of general adult population.<ref name="FenollarLaouira2008" /><ref name="FenollarTrani2008" />
*In Senegal, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 75,000 per 100,000 of children under 4 years of age.<ref name="KeitaRaoult2013" />
* In Laos, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 48,000 per 100,000 individuals by using quantitative real-time [[PCR]] (qPCR) of the feces of children.<ref name="SmallKeita2015" />
* In Ghana, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 27,500 per 100,000 individuals by using quantitative real-time [[PCR]] (qPCR) of the feces of children.<ref name=":0" />
===Case-fatality rate===
*The [[case-fatality rate]] of Whipple's disease is approximately 100%, if left untreated.<ref name="pmid9193452">{{cite journal |vauthors=Durand DV, Lecomte C, Cathébras P, Rousset H, Godeau P |title=Whipple disease. Clinical review of 52 cases. The SNFMI Research Group on Whipple Disease. Société Nationale Française de Médecine Interne |journal=Medicine (Baltimore) |volume=76 |issue=3 |pages=170–84 |year=1997 |pmid=9193452 |doi= |url=}}</ref>
*The [[case-fatality rate]] of treated Whipple's disease is unknown.<ref name="MarthRaoult2003">{{cite journal|last1=Marth|first1=Thomas|last2=Raoult|first2=Didier|title=Whipple's disease|journal=The Lancet|volume=361|issue=9353|year=2003|pages=239–246|issn=01406736|doi=10.1016/S0140-6736(03)12274-X}}</ref>


Whipple's disease is significantly more common in men, with a striking 87% of patients being male.<ref name=Fenollar_2007>{{cite journal |author=Fenollar F, Puéchal X, Raoult D |title=Whipple's disease |journal=N Engl J Med |volume=356 |issue=1 |pages=55-66 |year=2007 |pmid=17202456}}</ref>.
===Age===
*Whipple's disease commonly affects individuals between 40 to 60 years of age; the median age at [[diagnosis]] is 50 years.<ref name="Marth2015">{{cite journal|last1=Marth|first1=Thomas|title=<b><i>Tropheryma whipplei</i></b>, Immunosuppression and Whipple's Disease: From a Low-Pathogenic, Environmental Infectious Organism to a Rare, Multifaceted Inflammatory Complex|journal=Digestive Diseases|volume=33|issue=2|year=2015|pages=190–199|issn=0257-2753|doi=10.1159/000369538}}</ref>


===Race===
===Race===
*Whipple's disease usually affects individuals of the caucasian race. Africans and Asians are less likely to develop Whipple's disease.<ref name="DolmansBoel2017">{{cite journal|last1=Dolmans|first1=Ruben A. V.|last2=Boel|first2=C. H. Edwin|last3=Lacle|first3=Miangela M.|last4=Kusters|first4=Johannes G.|title=Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections|journal=Clinical Microbiology Reviews|volume=30|issue=2|year=2017|pages=529–555|issn=0893-8512|doi=10.1128/CMR.00033-16}}</ref>


The disorder mainly affects middle-aged white men.
===Gender===
*Males are more commonly affected by Whipple's disease than females. The male to female ratio is approximately 8 to 1.<ref name="Marth2015">{{cite journal|last1=Marth|first1=Thomas|title=<b><i>Tropheryma whipplei</i></b>, Immunosuppression and Whipple's Disease: From a Low-Pathogenic, Environmental Infectious Organism to a Rare, Multifaceted Inflammatory Complex|journal=Digestive Diseases|volume=33|issue=2|year=2015|pages=190–199|issn=0257-2753|doi=10.1159/000369538}}</ref>
 
===Region===
*The majority of Whipple's disease cases are reported in North America and western Europe.<ref name="FenollarPuéchal2007">{{cite journal|last1=Fenollar|first1=Florence|last2=Puéchal|first2=Xavier|last3=Raoult|first3=Didier|title=Whipple's Disease|journal=New England Journal of Medicine|volume=356|issue=1|year=2007|pages=55–66|issn=0028-4793|doi=10.1056/NEJMra062477}}</ref>
 
=== Developed Countries ===
* In Europe, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 1,000-11,000 per 100,000 of general adult population.<ref name="FenollarLaouira2008">{{cite journal|last1=Fenollar|first1=Florence|last2=Laouira|first2=Sonia|last3=Lepidi|first3=Hubert|last4=Rolain|first4=Jean‐Marc|last5=Raoult|first5=Didier|title=Value ofTropheryma whippleiQuantitative Polymerase Chain Reaction Assay for the Diagnosis of Whipple Disease: Usefulness of Saliva and Stool Specimens for First‐Line Screening|journal=Clinical Infectious Diseases|volume=47|issue=5|year=2008|pages=659–667|issn=1058-4838|doi=10.1086/590559}}</ref><ref name="FenollarTrani2008">{{cite journal|last1=Fenollar|first1=Florence|last2=Trani|first2=Michèle|last3=Davoust|first3=Bernard|last4=Salle|first4=Bettina|last5=Birg|first5=Marie‐Laure|last6=Rolain|first6=Jean‐Marc|last7=Raoult|first7=Didier|title=Prevalence of AsymptomaticTropheryma whippleiCarriage among Humans and Nonhuman Primates|journal=The Journal of Infectious Diseases|volume=197|issue=6|year=2008|pages=880–887|issn=0022-1899|doi=10.1086/528693}}</ref>
=== Developing Countries ===
* In Senegal, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 75,000 per 100,000 of children under 4 years of age.<ref name="KeitaRaoult2013">{{cite journal|last1=Keita|first1=Alpha Kabinet|last2=Raoult|first2=Didier|last3=Fenollar|first3=Florence|title=Tropheryma whippleias a commensal bacterium|journal=Future Microbiology|volume=8|issue=1|year=2013|pages=57–71|issn=1746-0913|doi=10.2217/fmb.12.124}}</ref>
* In Laos, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 48,000 per 100,000 individuals by using quantitative real-time [[PCR]] (qPCR) of the feces of children.<ref name="SmallKeita2015">{{cite journal|last1=Small|first1=Pamela L.|last2=Keita|first2=Alpha Kabinet|last3=Dubot-Pérès|first3=Audrey|last4=Phommasone|first4=Koukeo|last5=Sibounheuang|first5=Bountoy|last6=Vongsouvath|first6=Manivanh|last7=Mayxay|first7=Mayfong|last8=Raoult|first8=Didier|last9=Newton|first9=Paul N.|last10=Fenollar|first10=Florence|title=High Prevalence of Tropheryma whipplei in Lao Kindergarten Children|journal=PLOS Neglected Tropical Diseases|volume=9|issue=2|year=2015|pages=e0003538|issn=1935-2735|doi=10.1371/journal.pntd.0003538}}</ref>
* In Ghana, the [[prevalence]] of [[chronic]] [[carrier]] of [[Tropheryma whipplei]] is 27,500 per 100,000 individuals by using quantitative real-time [[PCR]] (qPCR) of the feces of children.<ref name=":0">Vinnemeier CD, Klupp EM, Krumkamp R, Rolling T, Fischer N, OwusuDabo E, Addo MM, Adu-Sarkodie Y, Kasmaier J, Aepfelbacher M, Cramer
JP, May J, Tannich E. 2016. Tropheryma whipplei in children with
diarrhoea in rural Ghana. Clin Microbiol Infect 22:65.e1– 65.e3</ref>


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
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Latest revision as of 00:44, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Overview

Whipple's disease is a systemic disease among middle-aged white males in North America and western Europe. It affects males 8 times more than females. Few studies were done to evaluate the demographics of Whipple's disease due to the sparsity of the disease. The incidence of Whipple's disease is approximately 0.1 per 100,000 individuals and the prevalence is approximately 0.3 per 100,000 individuals in north-western Italy. Although the prevalence of carrier state is higher in Asian and African countries, the prevalence of the classic Whipple's disease is less than American and western European countries. The case-fatality rate of Whipple's disease is approximately 100%, if left untreated. The case-fatality rate of treated Whipple's disease is unknown.

Epidemiology and Demographics

Incidence

  • The incidence of Whipple's disease is approximately 0.1 per 100,000 individuals in north-western Italy.[1]
  • The incidence of Whipple's disease is approximately 12 annually worldwide.[2]
  • Between 1907 and 1987, the incidence of Whipple's disease was estimated to be 696 cases worldwide.[2]

Prevalence

Classic Whipple's disease

  • The prevalence of Whipple's disease is approximately 0.3 per 100,000 individuals in north-western Italy.[1]

Carrier state

Case-fatality rate

Age

  • Whipple's disease commonly affects individuals between 40 to 60 years of age; the median age at diagnosis is 50 years.[10]

Race

  • Whipple's disease usually affects individuals of the caucasian race. Africans and Asians are less likely to develop Whipple's disease.[11]

Gender

  • Males are more commonly affected by Whipple's disease than females. The male to female ratio is approximately 8 to 1.[10]

Region

  • The majority of Whipple's disease cases are reported in North America and western Europe.[12]

Developed Countries

Developing Countries

References

  1. ↑ 1.0 1.1 Biagi, F.; Balduzzi, D.; Delvino, P.; Schiepatti, A.; Klersy, C.; Corazza, G. R. (2015). "Prevalence of Whipple's disease in north-western Italy". European Journal of Clinical Microbiology & Infectious Diseases. 34 (7): 1347–1348. doi:10.1007/s10096-015-2357-2. ISSN 0934-9723.
  2. ↑ 2.0 2.1 Dobbins W, III. 1987. Whipple’s disease. Charles C Thomas, Publisher, Springfield, IL.
  3. ↑ 3.0 3.1 Fenollar, Florence; Laouira, Sonia; Lepidi, Hubert; Rolain, Jean‐Marc; Raoult, Didier (2008). "Value ofTropheryma whippleiQuantitative Polymerase Chain Reaction Assay for the Diagnosis of Whipple Disease: Usefulness of Saliva and Stool Specimens for First‐Line Screening". Clinical Infectious Diseases. 47 (5): 659–667. doi:10.1086/590559. ISSN 1058-4838.
  4. ↑ 4.0 4.1 Fenollar, Florence; Trani, Michèle; Davoust, Bernard; Salle, Bettina; Birg, Marie‐Laure; Rolain, Jean‐Marc; Raoult, Didier (2008). "Prevalence of AsymptomaticTropheryma whippleiCarriage among Humans and Nonhuman Primates". The Journal of Infectious Diseases. 197 (6): 880–887. doi:10.1086/528693. ISSN 0022-1899.
  5. ↑ 5.0 5.1 Keita, Alpha Kabinet; Raoult, Didier; Fenollar, Florence (2013). "Tropheryma whippleias a commensal bacterium". Future Microbiology. 8 (1): 57–71. doi:10.2217/fmb.12.124. ISSN 1746-0913.
  6. ↑ 6.0 6.1 Small, Pamela L.; Keita, Alpha Kabinet; Dubot-Pérès, Audrey; Phommasone, Koukeo; Sibounheuang, Bountoy; Vongsouvath, Manivanh; Mayxay, Mayfong; Raoult, Didier; Newton, Paul N.; Fenollar, Florence (2015). "High Prevalence of Tropheryma whipplei in Lao Kindergarten Children". PLOS Neglected Tropical Diseases. 9 (2): e0003538. doi:10.1371/journal.pntd.0003538. ISSN 1935-2735.
  7. ↑ 7.0 7.1 Vinnemeier CD, Klupp EM, Krumkamp R, Rolling T, Fischer N, OwusuDabo E, Addo MM, Adu-Sarkodie Y, Kasmaier J, Aepfelbacher M, Cramer JP, May J, Tannich E. 2016. Tropheryma whipplei in children with diarrhoea in rural Ghana. Clin Microbiol Infect 22:65.e1– 65.e3
  8. ↑ Durand DV, Lecomte C, Cathébras P, Rousset H, Godeau P (1997). "Whipple disease. Clinical review of 52 cases. The SNFMI Research Group on Whipple Disease. Société Nationale Française de Médecine Interne". Medicine (Baltimore). 76 (3): 170–84. PMID 9193452.
  9. ↑ Marth, Thomas; Raoult, Didier (2003). "Whipple's disease". The Lancet. 361 (9353): 239–246. doi:10.1016/S0140-6736(03)12274-X. ISSN 0140-6736.
  10. ↑ 10.0 10.1 Marth, Thomas (2015). "Tropheryma whipplei, Immunosuppression and Whipple's Disease: From a Low-Pathogenic, Environmental Infectious Organism to a Rare, Multifaceted Inflammatory Complex". Digestive Diseases. 33 (2): 190–199. doi:10.1159/000369538. ISSN 0257-2753.
  11. ↑ Dolmans, Ruben A. V.; Boel, C. H. Edwin; Lacle, Miangela M.; Kusters, Johannes G. (2017). "Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections". Clinical Microbiology Reviews. 30 (2): 529–555. doi:10.1128/CMR.00033-16. ISSN 0893-8512.
  12. ↑ Fenollar, Florence; Puéchal, Xavier; Raoult, Didier (2007). "Whipple's Disease". New England Journal of Medicine. 356 (1): 55–66. doi:10.1056/NEJMra062477. ISSN 0028-4793.

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