Download TYPHOID FEVER

TYPHOID FEVER
Abad, Mary Raina Angeli Z.
Iewida, Samira Yaser P.
Lameda, Randall M.
HUB 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.
Color pink therefore
Gram-negative
With peritrichous
flagella
• 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
25000
20000
15000
10000
5000
0
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
25000
20000
15000
Philippines
Japan
10000
5000
0
1982 1985 1988 1991 1994 1997 2000
•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
•
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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%20G
uide-%20Soldiers%20Guide%20in%20the%20Philippines%20(Trifold)%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-butdanger-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-B19EC2E398D4724D/0/PHL.pdf
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