Typhoid

 Food borne

Microbial 


Water borne
Contact
diseases  STD
 Vector borne
 Food  Food infection

borne  Food intoxication

Tox-infection
diseases

  Typhoid Fever is also termed as “enteric fever”.
 Enteric fever includes typhoid fever and
paratyphoid fever.
 The disease may occur sporadically,
epidemically or endemically.
 History : Around 430-424 BC, a devastating
Typhoid plague, which some believe to have been
typhoid fever, killed one third of the population
of Athens, including their leader Pericles
 Typhoid fever, also known as typhoid, is a
common worldwide bacterial disease,
transmitted by the ingestion of food or water
contaminated with the faeces of an infected
person, which contain the bacterium
Salmonella typhi, serotype Typhi.
  Kingdom : Bacteria
 Phylum : Proteobacteria
 Class : Gammaproteobacteria
Causal  Order : Eneterobacteriales

organism 


Family : Enterobacteriaceae
Genus : Salmonella
 Species : Typhi
 Salmonella currently compromise
above 2000 species, all of them
potentially pathogenic. For practical
purposes, they may be divided into 2
groups :
1. The enteric fever group, consisting of
typhoid and paratyphoid bacilli that
are primarily human parasites.
2. The food poisoning group, which are
essentially animal parasites, but which
can also infect human beings,
producing gastroenteritis septicemia or
localized infection.
Pathogenesis
 Signs,  Classically, the untreated typhoid
fever can be divided into four
Symptoms individual stages, each one lasting
approximately one week
and Life  In the first week, the temperature rises
cycle slowly and fever fluctuations are seen
with relative bradycardia, malaise,
headache, and cough.
 In the second week of the infection,
the patient lies with high fever
(around 40 °C or 104 °F) and
bradycardia (sphygmothermic
dissociation), classically with a
dicrotic pulse wave
 The abdomen is distended and
painful in the right lower quadrant.
Diarrhea can occur in this stage: six to
eight stools in a day
 The spleen and liver are enlarged
(hepatosplenomegaly) and tender,
and there is elevation of liver
(transaminases).
 In the third week of typhoid fever,
several complications can occur
❖ Intestinal haemorrhage
❖ Intestinal perforation in the distal
ileum
❖ Encephalitis
❖ Metastatic abscesses like
cholecystitis
By the end of third week the fever
will start reducing (defervescence).
This carries on into the fourth and
final week.
  The bacteria which causes typhoid
fever may be spread through poor
hygiene habits and public sanitation
conditions
 Sometimes also by flying insects
Transmission feeding on feces.
 Many carriers of typhoid were locked
into an isolation ward never to be
released to prevent further typhoid
cases.
  Bacteriological diagnosis of enteric
fever consists of the isolation of the
bacilli from the patient and the
demonstration of antibodies in his
serum.
 A positive blood culture is diagnostic,
while the same significance cannot
Diagnosis be attached to isolation from feces or
urine.
 Demonstration of antibodies is not
conclusive evidence of current
infection.
 A third method consists of the
demonstration of typhoid bacillus
antigen in blood or urine
 Blood culture
 Feces culture
 Urine culture
 Widal test
  Sanitation and hygiene arc the critical
measures that can be taken to prevent
typhoid.
 Typhoid can only spread in environments
where human faeces or urine are able to
encounter food or drinking water.
 Careful food preparation and washing of
hands are crucial to preventing typhoid.
Prevention  There are two vaccines licensed for use for
the prevention of typhoid:
 live, oral Ty21 a vaccine (sold as Vivotif
Bernd)
 Injectable Typhoid polysaccharide vaccine
(sold as Typhim Vi by Sanofi Pasteur and
Typherix by GlaxoSmithKline).
  Where resistance is uncommon, the
treatment of choice is a fluoroquinolone such
as ciprofloxacin
 otherwise a third-generation cephalosporin
such as ceftriaxone or cefotaxime is the first
choice.
 Cefixime is a suitable oral alternative.
 Typhoid fever in most cases is not fatal.
Treatment  Antibiotics, such as ampicillin,
chloramphenicol, trimethoprim-
sulfamethoxazole, amoxicillin and
ciprofloxacin, have been commonly used to
treat typhoid fever.
 Treatment of the disease with antibiotics
reduces the case-fatality rate to
approximately 1%.
Thank you