TYPHOID FEVER

By: Jessica Flewelling&Desiree May

WHAT IS TYPHOID FEVER??

TYPHOID FEVER IS A SYSTEMIC INFECTION CAUSED BY THE BACTERIUM SALMONELLA TYPHI. Symptoms may

include: A fever of103-104

degrees F !!WeaknessStomach painsLoss of appetitePersistent headache

DiarrheaConstipationBloody stoolsTyphoid ulcers In some cases

there may be a flat rose colored rash spotting the body.

HOW DO YOU GET TYPHOID FEVER?

Fecal-oral route transmission Poor food hygiene Inadequate sanitation. School children/Young adults are most frequently affected. Controlled in most industrialized areas of the world

through methods of public sanitation and chlorination of drinking water.

Global Instances

HOW IS TYPHOID FEVER SPREAD? Any infected person constantly sheds the

bacteria in feces which can infect a nearby water supply .

Most people that contract Salmonella typhi are treated with antibiotics and fully recover from the infection.

HOWEVER!! Some people continue to harbor

the bacteria in their body.These people are considered Carriers.

SALMONELLA TYPHI CARRIERSS. typhi has a preference for the gallbladder, and if present will colonize the surface of gallstones,

which is how people become long

term carriers of the disease.

TYPHOID MARY: THE MOST DANGEROUS WOMAN IN AMERICA.

Mary Mallon (1870?-1938)

She was the first known “healthy carrier” of the S. typhi bacteria.

Continued working after firm Typhoid diagnosis.

MARY MALLON She worked as a cook

and servant throughout her life.

Infected as many as 50 people, 3 of which where fatal cases.

Mary Mallon was taken into custody and held in isolation until she died in 1938.

IS IT TYPHOID FEVER ?? Stool or blood levels only definitive test for

Salmonella typhi!! Most developing countries have little to no resources to perform these tests. Typhoid fever is commonly treated with three types of antibiotics:

Ampicillin Septra Cipro

strains have developed resistant to drug therapy.

AMPICILLIN Pharmacologic Class: Aminopenicillin

Indications: GI infections

Actions: Inhibits cell-wall synthesis during bacterial multiplication

(2009 Nursing Drug Handbook p. 254-255)

SEPTRA Pharmacological Class: Sulfonamide and

folate agonist

Indication: Traveler’s Diarrhea

Action: Inhibits formation of dihydrofolic acid from PABA; inhibits dihydrofolate reductase formation and decreases bacterial folic acid synthesis. This medication is a bactericidal.

(2009 Nursing Drug Handbook p. 276-277)

CIPRO Pharmacologic Class: Fluoroquinolone

Indication: Complicated intra-abdominal Infection

Actions: Inhibits bacterial DNA synthesis, mainly by blocking DNA gyrase; bactericidal.

((2009 Nursing Drug Handbook p. 211-212)

SO WHAT IS SALMONELLA TYPHI? Human-specific Motile Rod shaped Flagellated Gram-negative Facultative anaerobe

The bacteria is an obligate parasite an has no known host other than humans.

Currently, 107 strains of this bacteria have been isolated.

WHAT ARE THE STATISTICS?? In the US there are about 400 reported cases

annually, of these cases 75% are acquired

during international travel. An estimated 16

million people are annually affected

worldwide by Typhoid Fever with as many as

600,000 deaths.

HOW DOES S. TYPHI INFECT IT’S VICTIM?

Spreads from the intestines to the deeper tissues of the liver, spleen and even bone marrow.

Once they start division, they divide about once every 20 minutes!!

The bacteria enters the small intestine via the microfold cells of the Peyer’s patches.The bacteria is then released into the blood stream where it can then circulate systemically.

PEYER’S PATCH

GET VACCINATED OR GET TYPHOID!!

Anyone traveling out of the country should be vaccinated against Typhoid.

There is two forms of vaccination available in the US today.

OTHER THINGS TO KNOW… Little is known about the origin of S. typhi.

The cause of death for historical figures such as the inventor of the airplane, Wilbur Wright, and the Greek Empire’s Alexander the Great.

The earliest recorded epidemic occurred in Jamestown, VA. 6,000 people died of typhoid fever in the early 17th Century.

This disease is rare in the U.S. and developed nations, but always poses the risk of emergence.

The first person to isolate the bacteria was Karl J. Erberth, in 1880.

WHO KNEW??!! Did you know that lowering the pH inside of

the bacterial cell stops it’s “motor.” Motor referring to the cells ability to use it’s flagella to swim to nutrients OR away from toxins.

The cells use the energy of charged H ions to fuel this biological motor!!

A REALLY QUICK REVIEW!! S. typhi is the bacteria

responsible for Typhoid Fever.

Transmitted mainly by the

fecal oral route.

Once ingested the bacteria multiply and spread into the bloodstream causing a systemic infection.

Hand washing is the single most important prevention.

BIBLIOGRAPHY Ochiai, R., Acosta, C., Danovaro-Holliday, M., Bhattacharya,

S., Agtini, M., Bhutta, Z., et al. (2008, April). A study of typhoid fever in five Asian countries: disease burden and placations for controls. Bulletin of the World Health Organization, 86(4), 260-268. Retrieved April 5, 2009, from CINAHL Plus with Full Text database.

Ruben, J. (2003, 2003 Jan-Mar). Typhoid fever. Topics in Emergency Medicine, 25(1), 44-48. Retrieved April 5, 2009, from CINAHL Plus with Full Text database.

Crump, J., Luby, S., & Mintz, E. (2004, May). The global burden of typhoid fever. Bulletin of the World Health Organization, 82(5), 346- 353. Retrieved April 5, 2009, from CINAHL Plus with Full Text database.

Nursing 2009 Drug handbook. (29th ed.). (2009). Philadelphia: Lippincott, Williams & Wilkins.

Black, Jacquelyn G. 2008. Microbiology: Principles and Explorations. 7th ed. New Jersey: Prentice Hall.

BIBLIOGRAPHY CONT. Minamino, T. Imae, Y., Oosawa, F., Kobayashi, Y. & Oosawa, K. Effect

of intracellular pH on rotational speed of bacterial flagellar motors. Journal of Bacteriology, 185, 1190-1194, (2003).

Typhoid Fever. (24 October 2005).  Retrieved 4 April 2009 from http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g. htm

Pollack, David V. (30 September 2003). Salmonella enterica Typhi.

 Retrieved 4 April 2009, from http://web.uconn.edu/mcbstaff/graf/student%20presentations/salmonellatyphi/salmonellatyphi.com

Leavitt, J. W. (2000). Typhoid Mary: Captive to the Public’s Health. Boston, MA: Beacon Books,1996.

A Weekly epideliological record: Typhoid Vaccines. No. 32 (2000). World Health Organization, 75, 257-264.