34 -TYPHOID. FEVER.pdf

Typhoid fever

1. TYPHOID FEVER
-34,SAYLI KALEKAR

2. INTRODUCTION
➢TYPHOID is a communicable disease , it is a
systemic infection caused by SALMONELLA
TYPHI .
➢The term ENTERIC FEVER includes both
typhoid and paratyphoid fevers.

3. EPIDERMIOLOGY
➢AGENTS - Salmonella typhi
3 main antigents – O , H , Vi
➢RESERVOIR OF INFECTION –
1] CASES – Male > Female
2] CARRIERS – Female > Male
➢SOURCE OF INFECTION –
Primary – Fecal , urinary
Secondary – Water , food , flies , soil , etc.

4. SALMONELLA TYPHI

5. MODES OF TRANSMISSION
➢DIRECT 1] Faecal oral route
2] Urine oral route
➢INDIRECT - Water , milk , food , flies , etc
➢ENVIRONMENTAL FACTORS - Rainy saeson
Increase in fly population
➢TEMPERATURE - Cold > Heat

8. TYPES OF CARRIERS
➢TEMPORARY
- Excretes bacilli for 6 to 8 weeks , after which their numbers
diminish rapidly.
- 3 months to 1 year.
➢CHRONIC
- The organism persist in the gall bladder and in the biliary tract
.they excretes the bacilli for many years.
- This state may be expected to develop in 2 to 5 % of cases.

9. INCUBATION PERIOD
-Usually 10 to 14 days
- 3 days to 3 weeks – depending on bacilli ingested.

10. CLINICAL FEATURES
➢ONSET – Chills , High fever.
➢PRODORMAL – Headache , cough , sore throat , abdominal pain ,
constipation.
➢COMPLICATIONS – Pea soup dirrhoea , marked constipation, abdominal
distention , etc.
FOR 1 WEEK – Splenomehaly , tenderness , relative bradycardia
,dicrotic pulse , rash ,etc.
FOR 2 WEEK – Intestinal haemorrhage , drop in temperature , dark and
fresh blood in stool , etc.
FOR 3 WEEK – Intestinal perforation
➢LESS FREQUENT COMPLICATIONS – Urine retension , pneumonia ,
nephritis , etc.

12. LABORATORY DIAGNOSIS
➢MICROBIOLOGICAL PROCEDURE
- Isolation of S. typhi from blood , bone marrow and stool.
- Blood culture
➢SEROLOGICAL PROCEDURE
- FELIX WIDAL TEST
- Measures agglutinating antibody level against O and H antigens.
O antigen appear on 6 – 8 day
H antigen appear on 10 – 12 day.

13. CONTROL OF TYPHOID FEVER
➢CONTROL OF RESERVOIR
➢CONTROL OF SANITATION
[ HEALTH EDUCATION ]
➢IMMUNIZATION

14. ANTI TYPHOID VACCINES
1.Vi POLLYSACCHARIDE VACCINE
- Site – subcutaneously , intramuscular
- Dose – 25 microgram og antigen
- Age – more than equal to 2 years.
- only 1 time
2.Ty 21 a VACCINE
- Orally administrated
- 3 Dose regimen – 1 , 3 , 5 days
- more than equal to 5 years.