TYPHOID FEVER Abad, Mary Raina Angeli Z. Iewida, Samira Yaser P. Lameda, Randall M. HUB 42.

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TYPHOID FEVER TYPHOID FEVER Abad, Mary Raina Angeli Z. Abad, Mary Raina Angeli Z. Iewida, Samira Yaser P. Iewida, Samira Yaser P. Lameda, Randall M. Lameda, Randall M. HUB 42 HUB 42

Transcript of TYPHOID FEVER Abad, Mary Raina Angeli Z. Iewida, Samira Yaser P. Lameda, Randall M. HUB 42.

TYPHOID FEVERTYPHOID FEVERTYPHOID FEVERTYPHOID FEVER

Abad, Mary Raina Angeli Z.Abad, Mary Raina Angeli Z.Iewida, Samira Yaser P.Iewida, Samira Yaser P.

Lameda, Randall M.Lameda, Randall M.HUB 42HUB 42

What are Water-Borne Diseases?

• Diseases that are supported, carried or transmitted by water.

• Examples are: Cholera, Hepatitis A, Amoebic Dysentery, Brainerd Diarrhea & Typhoid Fever

What is Typhoid Fever?• Typhoid Fever is an acute

systemic illness characterized by fever, headache and abdominal discomfort.

• Also known as Enteric Fever or commonly just typhoid.

What causes Typhoid Fever?

• Typhoid Fever is caused by the bacterium Salmonella typhi from the family Enterobacteriacea.

• Salmonella typhi is a gram-negative bacteria that is motile due to its peritrichous flagella.

• The bacteria grows best at 37°C.

With peritrichous flagella

Color pink therefore Gram-negative

• It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness known as Paratyphoid Fever.

Epidemiology• Typhoid Fever is common

worldwide but is more prevalent in areas of developing countries lacking adequate waste disposal and clean drinking water facilities.

• Humans are the only host for S. typhi.

• Estimated 16-33 million cases annually resulting in 500,000 to 600,000 deaths in endemic areas

• WHO identifies typhoid as a serious health problem

• Incidence is highest in children and young adults between 5 to 19 years old.

Cases of Typhoid Fever in the Philippines

0

5000

10000

15000

20000

25000

1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002

Data taken from an official report done by the DOH the Republic of the Philippines: http://www2.doh.gov.ph/data_stat/html/fhsis/nd_byear.pdf

Cases of Typhoid Fever in Philippines & Japan

0

5000

10000

15000

20000

25000

1982 1985 1988 1991 1994 1997 2000

Philippines

Japan

•Statistics obtained from: www.WHO.int/en/

Mode of Transmission• S. typhi is most commonly

transmitted through the fecal-oral route.

• It can also be transmitted by ingestion of contaminated food or water.

• Patients with typhoid can contaminate the water supply with their stool, where the bacteria flourish.

• The food supply can become contaminated by infected stool or poor sanitation.

• Some people, known as chronic carriers, still harbor typhoid bacteria, and can still contaminate food and water supplies even after receiving antibiotic treatment and proving to be free of symptoms.

How does the bacteria cause disease?

Come in contact with

infected individual or ingestion of

contaminated food or water

Salmonella bacteria

penetrate the epithelial wall of the small

intestine

Phagocytosed by

macrophages

S. typhi then alters its

structure to resist

destruction and allow

them to exist within the

macrophage

Spread via the lymphatics while inside

the macrophages

Travels to the reticulo

endothelial system and then to the

different organs

throughout the body

Goes back to the

bloodstream accompanied

with development of symptoms

Salmonella bacteria may

be passed out through

the stool

Cycle continues

Signs and Symptoms• Incubation period: around 10 to 14

days• High fever – around 39°C to 40°C• Profuse sweating and headache• Gastroenteritis• Nonbloody diarrhea

• Poor appetite• Lethargy, weakness and fatigue• Generalized aches and pains• Abdominal pain and discomfort• Rash – rose-colored spots on the

lower chest and upper abdomen

Rose Spots

Terminal Stage• Disturbance in consciousness• Muttering delirium• Coma vigil• Typhoid Psychosis• Intestinal bleeding• Death – 10% to 30% of untreated

cases

Typhoid Terminal State

How is Typhoid Fever diagnosed?

• Blood, bone marrow or stool cultures

• Widal Test• ELISA – Enzyme-Linked

Immunoabsorbent Assay• Fluorescent Antibody Test

How is Typhoid Fever treated?

• Antibiotics – ampicillin, trimethoprim-sulfamethoxazole, amoxicillin and ciprofloxacin

• Ceftriaxone, Azithromycin – antibiotics used for MDR typhoid (multidrug-resistant typhoid)

• Chloramphenicol – original drug used to treat typhoid fever but was replaced because of many rare side effects

Vaccine against Typhoid

• Vivotif Berna – oral Ty21a vaccine• Typhim Vi or Typherix – injectable

Typhoid polysaccharide vaccine

How can Typhoid Fever be prevented?

• Proper sanitation and hygiene• Careful food preparation and

washing of hands• Avoid drinking untreated water• Avoid raw fruits and vegetables• Adequately clean household items

• Public education campaigns encouraging people to wash their hands after defecating and before handling food are important components in controlling the spread of the disease.

• According to CDC, chlorination of drinking water had led to dramatic decrease in the transmission of typhoid fever.

References• http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm• http://www.cureresearch.com/t/typhoid_fever/stats-country.htm• http://deploymenthealthlibrary.fhp.osd.mil/products/Staying%20Healthy

%20Guide-%20Soldiers%20Guide%20in%20the%20Philippines%20(Tri-fold)%20(133).pdf

• http://www2.doh.gov.ph/data_stat/html/fhsis/typhoidfever.pdf• http://www.gmanews.tv/story/83222/Typhoid-cases-in-Laguna-decline-but-

danger-not-yet-over---DOH• http://www.medicinenet.com/typhoid_fever/article.htm• http://www.medicalnewstoday/articles/156859.htm• http:// www.merriam-webster.com/dictionary/waterborne • http://pediatrics.uchicago.edu/chiefs/documents/typhoid.pdf• http://www.psmid.org/ph/vol21/vol21num2tpoic2.pdf• http://www.who.int/vaccines-documents/DocsPDF03/www740.pdf• http://www.who.int/vaccine_research/documents/en/typhoid_diagnosis.pdf• http://www.wpro.who.int/NR/rdonlyres/92EC0A38-6EA7-4BDA-B19E-

C2E398D4724D/0/PHL.pdf

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