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INTRODUCTION
TYPHOID FEVER (TF) is an intestinal
disease which is still widely in developing
countries, include in Indonesia.
High incidence depends on many factors,
(In Indonesia 350-810 cases/100.000/years).
Many types of potential sources of
transmission infection.
Mortality is still high, may be caused by
complication.
INTRODUCTION
INTRODUCTION
Hygiene sanitation, personal hygiene
and ignorancy are important role on
transmission.
Any problems on Era PostChloramphenicol treatment :
(1) Relaps
(2) Drug resistency
(3) Clinical picture insidious
(4) Complications >>
In Indonesia : endemic, young adult, sex
ratio no difference.
DEFINITION
DEFINITION OF
OF TF.
TF.
PLAMID (DNA)
CELL WALL
(O ANTIGEN)
CYTOPLASM
MORPHOLOGY OF AGENT
Gram negative bacteriae
Aerobic, Nonsporing, motile coliform
Active motility by spiral
Easily destroyed by sunlight and
desinfectan
Thermal death point in water is 60 o C in
boiling water in 15 minutes
In faecal masses are protected
In septic tank can survived for 14 days.
Bacteria could be identified by antigenetic
EPIDEMIOLOGY OF TF
Word-wide distribution,
Frequency of Paratyphoid fever
A, B and C is 10-30% of TF.
Climate & season are important
role.
No ethnic immune for TF/PTF.
Young Adult is frequent (< 30
EPIDEMIOLOGY OF TF
Global Annual Inc. 33 million
cases; case fatality is 500.000.
In developing countries 4-5
times greater than in developed
countries
Potential sources of infections :
active patients and carriers.
Chronic carriers are dangerous
EPIDEMIOLOGY OF TF
Transmission to a new host
occurs directly or indirectly
Contamination may occurred by
(a) carriers patients,
(b) water supply, milk, ice,
(c) food, flies, fingers and
fomites.
ABSORPTION
MULTIPLICATION IN MESENTRIC
LYMPHATIC GANGLIA
Bacterical lysis
libeation of endotoxin
into the blood
ENDOTOXINS
AUTONOMIC HEART
NERVOUS
SYSTEM
SEPTICEMIA
DIGESTIVE
TRACT
HEMORRHAGE
INTESTINAL PERFORATION
CARDIOVASCULAR INSUFFICIENCY
AUTONOMIC DIISTURBANCES
TYPHOID STATE
DISEMINATION
SPLENIC
BILIARY GLAND
HEPATIC
MENINGEAL
BONE
PULMONARY
Recommended vacccination to :
. Community of TF highly endemic
. Individual travelling to endemic area
. Persons working in laboratories
Lanjutan
Lanjutan
Flora residen
Flora transien
PERDALIN/2010
31
PERDALIN 2010
32
SUMMARY OF TF CONTROL