Typhoid Fever Fix

8/13/2019 Typhoid Fever Fix

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GROUP O



DEFINITION

Typhoid fever is a bacterial disease,

caused by Salmonella typhi. It is transmitted

through the ingestion of food or drink

contaminated by the faeces or urine of infected

people.(World Health Organization)

Typhoid fever is a syste

the bacterium Salmonella etyphi. This highly adapted

pathogen has evolved remark

for persistence in its host that

survival and transmission.(T

Journal of Medicine)



The data are obtained to estimate the burden of disea

region are difficult to obtained, since many hospitals lack facilitieculture and up to 90 percent of patients with typhoid are t

outpatients. Community-based studies have consistently sho

levels of typhoid than public health figures suggest. Annual incid

of 198 per 100,000 in the Mekong Delta region of Vietnam an

100,000 in Delhi, India, have recently been reported. According

global estimates, there are at least 16 million new cases of typ

each year, with 600,000 deaths.



HISTORY OF TYPHOID FEVER

Antonius Musa, a Roman

physician who achieved fame by

treating the Emperor Augustus 2,000

year ago, with cold baths when he fell

ill with typhoid.

Thomas Willis who is

credited with the first descriptionof typhoid fever in 1659.

French physAlexandre Louisname “typhoid fe



In the late 19th century, typhoid fever mortality rate in Chicago averag

100,000 people a year. The worst year was 1891, when the typhoid death rate

per 100,000 people.

The best known carrier was "Typhoid

Mary“; Mary Mallon was a cook in Oyster Bay,

New York in 1906 who is known to have

infected 53 people, 5 of whom died. Later

returned with false name but detained and

quarantined after infect typhoid outbreak. She

died of pneumonia after 26 years in quarantine.

In 1909, Frederick F. Russell, a U.S. Army

physician, developed an American typhoid

vaccine and two years later his vaccination

program became the first in which an entire

army was immunized.



SIGN AND SYMTOMPS

• Poor appetite

• Headaches

• Lethargy

• Nosebleeds

• Cough

• Diarrhea or Constipation

• Sweating

• Enlarged spleen and liver

• Have a sustained fever as high as 39 to 40 degrees Celsius

• Severe or mild vomiting, slow heartbeat

• Chest aches in many patients, abdominal pain and discomfort are common



1st week of illness

Once signs and symptoms do appear, you're likely to experience:

• Fever, that starts low and increases daily, often to as high as 39.4 or 40 C

• Headache

• Weakness and fatigue

• Dry cough

• Loss of appetite

• Abdominal pain

• Diarrhea or constipation

• Rash



2nd week of illness

If you don't receive treatment for typhoid fever, you may enter a second symt

which you become very ill and experience:

• Continuing high fever

• Either diarrhea or severe constipation

• Considerable weight loss

• Extremely distended abdomen



3rd week of illness

• Become delirious

• Lie motionless and exhausted with your eyes half-closed in what's known astate

• Life-threatening complications often develop at this time.

4th week of illness

Improvement may come slowly during the fourth week. Your feve

decrease gradually until your temperature returns to normal in another wee

But signs and symptoms can return up to two weeks after your fever has subs



CAUSES

Caused by the bacterium Salmonella Typhi .

Ingestion of contaminated food or water or eating food prepared outside the hom

Contact with an acute case of typhoid fever.

Contact with a chronic asymptomatic carrier.

Sometimes also by flying insects feeding on feces.

Use of antimicrobial drugs.

Poor housing with less inadequate facilities for personal hygiene.

Water is contaminated where inadequate sewerage systems and poor sanitation

Eating food or drinking beverages that handled by a person carrying the bacteria

Salmonella enteriditis and Salmonella typhimurium are other salmonella bacteria

cause food poisoning and diarrhoea.



THE BACTERIUM

Salmonella enterica serovar typhimurium

• Member of the genus Salmonel la.

• Infects cattle, poultry, domestic cats,hamsters, humans etc.

• Refrigeration and freezing substantially slow or halt their growth

• Foods prepared in the home from raw eggs can spread salmon

properly cooked before consumption.



Scientific classification

• Kingdom : Eubacteria

• Phylum : Proteobacteria

• Class : Gamma Proteobacteria

• Order : Enterobacteriales

• Family : Enterobacteriaceae

• Genus : Salmonella

• Species : S. enterica

• Subspecies : Enterica



ANTIMICROBIAL RESISTANCE



CLINICAL FEATURES

As the symptoms and signs are often unspecific, it is difficult to diagnose typhoid f

blood culture. We retrospectively reviewed 51 cases of typhoid fever who were all

from 1 June through 31 August 2002. Sixteen cases were positive by blood culture

confirmed as typhoid fever. All cases had Salmonella typhi. Although 16 cases we

negative, they were clinically diagnosed as typhoid fever. The remaining 19 cases

clinically diagnosed without blood culture. The clinical features of the culture-confi

were more severe than the culture-negative cases. Mesenteric lymphadenopathy

frequently detected with ultrasonography, in both culture-confirmed and culture-neThe rates of detecting mesenteric lymphadenopathy were 69% and 63%, respectiv

Meanwhile, the rate in non-typhoid fever patients was 5.5%. It was considered tha

mesenteric lymphadenopathy with ultrasonography was very useful in the diagosis

fever in endemic areas.



DIAGNOSIS

Diagnosis of typhoid fever is made by :

• Blood, bone marrow, or stool cultures test

• Widal test (demonstration of salmonella antibodies

antigens O-somatic and H-flagellar)

• Slide agglutination

• Antimicrobial susceptibility testing



WIDAL TEST

" A test involving agglutination of typhoid bacilli

they are mixed with serum containing typhoid antibodie

an individual having typhoid fever, used to detect the pre

of Salmonella typhi and S. paratyphi.“- Suridar Rao P.N



TREATMENT

Diet :

• Fluids and electrolytes should be monitored and replaced dilige

• Oral nutrition with a soft digestible diet is preferable in the abse

abdominal distension or ileus.

Activity :

• No specific limitations on activity are indicated.

• Rest is helpful, but mobility should be maintained if tolerable.

• The patient should be encouraged to stay home for a while from

until recovery.



Consultations :

An infectious disease specialist or surgeon should be cons

Surgical Care :

• Usually indicated in cases of intestinal perforation.

• Most surgeons prefer simple closure of the perforation with drai

the peritoneum.

• Small-bowel resection is indicated for patients with multiple perf

• If antibiotic treatment fails to eradicate the hepatobiliary carriag

gallbladder should be resected.

• Cholecystectomy is not always successful in eradicating the ca

because of persisting hepatic infection.



PREVENTION

Prevention strategies :

1. Vaccination

• First type of vaccine:

Contains a live but weakened strain of the Salmonella ba

causes typhoid fever. Taken by mouth. Be vaccinated against typ

traveling to a country where typhoid is common. Need to com

vaccination at least one week before travel. Typhoid vaccines

effectiveness after several years so check with your doctor to see

for a booster vaccination.

• Second type of vaccine:

Contains killed Salmonella typhi bacteria with a shot.



2. Avoid risky food and drinks

• Buy bottled drinking water or bring it to a rolling boil for one min

drinking it.• Ask for drinks without ice, unless the ice is made from bottled

water.Avoid Popsicles and flavored ices.

• Eat food that have been thoroughly cooked and that are st

steaming.

• Avoid raw vegetables and food that cannot be peeled like lettuc

• When eat raw fruit and vegetables that can be peeled, pee

Don’t eat the peelings.

• Avoid foods and beverages from street vendors.



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