3. 1. INTRODUCTION
• Typhoid is a bacterial infection that can affect several
organs in the body. Thyphoid fever and paratyphiod fever
are bacterial infection Occuring work wide. Typhoid fever
are also called enteric fever. Typhoid is caused by
Salmonella typhi, a bacterium from the same genus that
causes salmonell food poisoning.Typhoid fever has been
estimated to cause about 26 million (Typhoid) and 5
million (paratyphiod) illneses, with 190000 enteric fever
deaths in 2010 globally.
4. •WHO estimate Infects roughly 21.6 million people
each year.
•WHO estimate Kills 216000 – 600000 people
each year
•WHO estimate 62% of those occuring in Asia and
35%in Africa.
5. •World largest outbreak of typhoid in SANGLI on
December 1975 to February 1976. This disease endemic
in india
•1992 : 3,52,980 cases with 735 deaths
•1993 : 3,57,452 cases and 888 deaths
•1994 : 2,78,451 cases and 304 deaths
•2011 : 1.06million cases & 346 deatht
6. • Usually 10-14 days but it may be as
short as 3 days or as long as 21days
depending upon the dose of the bacilli
ingested.
7. 2.MODE OF TRANSMISSION
• The disease is transmitted by “faeco-oral route” or “urine–oral
routes” either directly through hands soiled with faeces or urine of
cases or carriers or indirectly by ingestion of contaminated water,
milk, food, or through flies. Contaminated ice, ice-creams, and milk
products are a rich source infection.
8. 3. SYMPTOMS
•Salmonella Typhi lives only in humans. Persons with
typhoid fever carry the bacteria in their bloodstream
and intestinal tract. Symptoms include prolonged
high fever, fatigue, headache, nausea, abdominal
pain, and constipation or diarrhoea. Some patients
may have a rash. Severe cases may lead to serious
complications or even death. Typhoid fever can be
confirmed through blood testing.
9. 4 . DIAGNOSIS
• The culture of Typhi can be done from many body fluids
such as blood, bone marrow, urine, rose spot biopsy
extracts, duodenal aspirates and stool, while the blood
culture remains the mainstay of definitive diagnosis.
• Positive serological tests (such as Widal and TyphiDOT)
are not recommended for diagnosis of enteric fever.
• Blood culture is the gold standard test for the diagnosis
of typhoid and must be sent before starting antibiotics
10. • A blood culture report is available in around 7 days after sample
submission in cases where there is no growth of any
microorganisms.
• In case of a positive blood culture, a report with organism
identification and antibiotic sensitivity testing will be available in as
early as 3 to 4 days.
• A negative culture does not exclude typhoid and may warrant a
repeat blood culture if the fever is not responding in 7-9 days of
commencing treatment.
• The volume of blood cultured is one of the most important factors
in the isolation of Typhi from typhoid patients.
11. 5. PREVENTION
• Drink boiled, bottled or chemically disinfected water:
Unless it has been boiled first, avoid drinking, washing
food or brushing your teeth with tap water. Drink bottled
water where possible or water that has been chemically
disinfected
• Avoid uncooked food: Make sure that any food that you
eat is cooked thoroughly to destroy any harmful germs.
• Practice good hand hygiene: Remember to wash your
hands regularly with a germ protection solution such
as Dettol Liquid Handwash and clean water.
12. 6. TREATMENT
•Typhoid fever can be treated with antibiotics.As
resistance to antibiotics has emerged including to
fluoroquinolones, newer antibiotics such as
cephalosporins and azithromycin are used in the
affected regions. Resistance to azithromycin has
been reported sporadically but it is not common as
of yet.
13. It is important for people being treated for typhoid
fever to do the following:
•Take prescribed antibiotics for as long as the doctor has
prescribed.
•Wash their hands with soap and water after using the
bathroom, and do not prepare or serve food for other
people. This will lower the chance of passing the infection
on to someone else.
•Have their doctor test to ensure that no Salmonella Typhi
bacteria remain in their body.
16. 9. PATHOGENESITY
• Pathogenic salmonella ingested in food, survive passage through
the gastic acid barrier and invade.The mucosaof the small and
large intestine and produce toxins.
• invasion the epithelial cells stimulets the release pro inflammatory
reaction via cytokines which induces an inflammatory reaction.
• The acute inflammatory response causes diarrhea.
• The bacteria can disseminate from the intestine to cause systematic
disease.