TYPHOID FEVER Abad, Mary Raina Angeli Z. Iewida, Samira Yaser P. Lameda, Randall M. HUB 42.
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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.
• 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
Terminal Stage• Disturbance in consciousness• Muttering delirium• Coma vigil• Typhoid Psychosis• Intestinal bleeding• Death – 10% to 30% of untreated
cases
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