Professional Documents
Culture Documents
Incidence of typhoid fever
Strongly endemic
Endemic
Sporadic cases
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What is Typhoid ??
Typhoid fever is an infection caused by a bacteria (Salmonella typhi) found in
contaminated food or water
The disease is commonly associated with eating foods prepared in unsanitary
conditions and with eating uncooked foods or drinking untreated water in areas
where sewage is not disposed of safely
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Fecal‐oral transmission route
The bacteria that cause typhoid fever spread through
contaminated food or water and
occasionally through direct contact with someone who is infected
This means that S. typhi is passed in the feces and sometimes in the urine of infected people.
You can contract the infection if you eat food handled by someone with typhoid fever who
hasn't washed carefully after using the toilet. You can also become infected by drinking
water contaminated with the bacteria.
Typhoid carriers
A small number of people who recover from typhoid fever continue to harbor the
bacteria in their intestinal tracts or gallbladders, often for years.
These people, called chronic carriers, shed the bacteria in their feces and are capable of
infecting others, although they no longer have signs or symptoms of the disease
themselves
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Symptoms
First Stage ‐ Slow rising Fever
‐ Headache
‐ Abdominal pain
‐ Malaise
‐ Cough
Second Stage ‐ High fever
‐ Delirium
‐ Bouts of constipation followed by Diarrhoea
‐ Rash
Third Stage ‐ Intestinal Hemorrhage
‐ Intestinal Perforation
‐ Encephalitis
‐ Cholecystitis etc
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Diagnosis
Blood tests
Complete Blood Count
‐ shows increased white blood cells
‐ low platelet count
Widal test
Blood Culture
Stool cultures
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Complications
The two most common complications are
Haemorrhage (Intestinal Bleeding) and
Perforation of the bowel (intestine)
Other complications :
Jaundice (may be due to hepatitis, cholangitis, cholecystitis)
Pancreatitis with acute renal failure and hepatitis with hepatomegaly are rare
Toxic Myocarditis occurs in 1‐5% of patients (ECG changes may be present)
Toxic confusional states and other neurological and psychiatric disturbances
Death in endemic areas
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Treatment
Oral rehydration therapy Antibiotics
Supportive treatment
Rest
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Prevention
Sanitation and hygiene are the critical measures that can be taken to prevent typhoid
Wash your Hands
Frequent hand‐washing is the best way to control
infection
Wash your hands thoroughly with hot, soapy water,
especially before eating or preparing food and after using
the toilet
Carry an alcohol‐based hand sanitizer for times when
water isn't available
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Avoid drinking untreated water
Drink only bottled water or canned or bottled carbonated beverages in endemic areas
Wipe the outside of all bottles and cans before
you open them
Ask for drinks without ice
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Avoid Street food
It is best to avoid food from street vendors as it's
more likely to be contaminated
Clean household items daily
Clean toilets, door handles, telephone receivers and
water taps at least once a day with a household cleaner
and paper towels or disposable cloths
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Avoid raw fruits and vegetables
Because raw produce may have been washed in
unsafe water, avoid fruits and vegetables that you
can't peel, especially lettuce
Choose hot food
Avoid food that's stored or served at room
temperature
Steaming hot foods are best
Keep personal items separate
Set aside towels, bed linen and utensils for the patient’s use and wash them frequently in
hot, soapy water
Heavily soiled items can be soaked first in disinfectant
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Vaccination against Typhoid
Vaccines are indicated in individuals falling in the high risk group, for e.g.
Food handlers
Travelers to endemic areas
Those who eat outside food too frequently
Those who have suffered from Typhoid
There are two vaccines licensed for use for the prevention of typhoid
V1 Antigen Vaccine Ty 21a Vaccine
Inactivated Injectable vaccine Currently unavailable in India
May cause pain at injection site, swelling, redness Contraindicated in compromised host
(steroids, chronic illnesses)
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Thank you