Typhoid fever.communicabke disease s.pptx

It's about communicable diseases and typhoid fever

1. TYPHOID FEVER

2. TYPHOID FEVER /ENTERIC FEVER Typhoid fever which is caused by S.Typhi. .French physician PIERRE CHARLES ALEXANDRE LOUIS first proposed the name “typhoid fever CARL JOSEPH EBERTH who discovered the typhoid bacillus in 1880. GEORGES WIDAL who described the ‘widal agglutination reaction’ of the blood in 1896.

3. DEFINITION &EPIDEMIOLOGY DEFINITION An acute illness associated with fever caused by the salmonella typhi bacteria. It can also be caused by salmonella paratyphi , a related bacterium that usually causes a less severe illness. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area. EPIDEMIOLOGY It was first originated in the Greece •Typhoid fever is most prevalent in impoverished areas that are overcrowded with poor access to sanitation •In 2010, over 2.18 million episodes occurred, resulting in 216000 deaths, and that more than 90% of this morbidity and mortality occurred in ASIA

4. ETIOLOGY The bacterium Salmonella Typhoid . Ingestion of contaminated food or water. Contact with an acute case of typhoid fever. Water is contaminated where inadequate sewerage systems and poor sanitation. Contact with a chronic asymptomatic carrier. Eating food or drinking beverages that handled by a person carrying the bacteria. Salmonella enteriditis and Salmonella typhimurium are other salmonella bacteria, cause food poisoning and diarrhoea.

5. RESERVOIR OF INFECTION Man is the only reservoir . INCUBATION PERIOD 10-14days MODE OF TRANSMISSION Faecal oral route Directly through soiled hands Indirectly by the ingestion of contaminated water, milk, food, or through flies Faeces and urine from Cases or Carrier water soil flies fingers Foods raw or cooked Mouth of well person

6. CLINICAL MANIFESTATIONS Poor appetite, Headaches, Generalized aches and pains, Fever, Lethargy Diarrhea- Pea soup diarrhoea Have a sustained fever as high as 103 to 104 degrees Fahrenheit (39 to 40 degrees Celsius), Step ladder fever Chest congestion develops in many patients, and abdominal pain and discomfort are common, Constipation, mild vomiting, slow heartbeat. Rose spots High fever Diarrhea Typhoid Meningitis Aches and pains Chest congestion symptoms

7. PATHOPHYSIOLOGY

8. DIAGNOSIS

9. MICROBIOLOGICAL PROCEDURE Definitive diagnosis of the typhoid fever depends on isolation of the S.Typhy fro m blood, bone marrow and stools. Blood culture is the main diagnosis of disease . SEROLOGICAL PROCEDURE Felix- widal test measures agglutinating antibodies levels against O and H antigen. The O antibodies present on day 6-8 and H antibodies on day 8-10. The test is performed at acute serum(at first contact with the patient ). NEW DIAGSTIC TEST The recent advances for quick and reliable tests for typhoid fever are IDL TUBEX - Detect Ig M 09 antibody fro patient with in 2 mts TYPHIDOT - Detect specific Ig M and Ig G antibodies with in 3 hrs. TYPHIDOT M - Detect specific Ig M antibody only.

10. CONTROL OF TYPHOID FEVER

11. CONTROL OF RESERVOIR Usual method of control of reservoir are their identification, isolation, treatment and disinfection. A)CASES 1.early diagnosis culture of blood and stool are important for early diagnosis. 2.isolation case should be isolated till 3 bacteriologically negative stool and urine reports, are obtained on 3 separate days. 3.treatment Flouroquinilone are the drug of choice for typhoid fever. Flouroquinilone example Ofloxacin or Ciprofloxacin - 15 mg/kg for 5-7 days Cefixime - 15-20 mg/kg for 7-14 days For quinilone resistant patients, Azithromycin - 8-10 mg/kg for 7 days or Ceftriaxone - 75mg/kg for 10-14 days Others: Chloramphenicol ,Ampicillin, Amoxicillin ,etc

12. 4.Disinfection Stools and urine are the source of infection so it should be collected in closed container. Disinfected with 5% cresol for at least 2 hrs. All soiled clothes and linen should be soaked in 2%chlorine solution and sterilized. 5.Follow up Follow up examination of the stools and urine should be done for S. Typhi 3 to 4 months after discharge of the patient and again after 12 month to prevent the development of carrier state. B) CARRIER 1.identification Carrier are identified by cultural and serological examination. 2.Treatment Carrier should be given an intensive course of Ampicillin or Amoxicillin - 4-6 gm /day + Probenecid - 2 gm/day for 6 weeks. 3.Surgery Cholecystectomy with Ampicillin therapy.

13. 4.Surviellance The carrier should be kept under surveillance. They should be prevented from handling food,milk,or water 5.Health education Regarding washing hand with soap and water before food and after toilet, before preparing food. CONTROL OF SANITATION Protection and purification of drinking water Improvement of basic sanitation Promotion of food hygiene IMMUNIZATION Can be given: above 2 yr old- single dose Those living in endemic areas Household contacts High risk group such as school children and hospital staff. Travelers proceeding to endemic area.

14. SMALLPOX (VARIOLA)

15. INTRODUCTION An acute contagious viral disease, with fever and pustules that usually leave permanent scars. It was effectively eradicated through vaccination by 1979.an estimated 300 million people died from smallpox in 20 th century alone. The disease is also known by the Latin names variola or variola Vera is a derivative of the Latin varius meaning spotted or varus means pimple. believed to have begun in Africa and spread to India and china USSR weaponized

16. ETIOLOGY Smallpox is caused by the variola virus, which, along with the vaccinia virus , monkeypoxvirus , and cowpox virus , belongs to the genus Orthopoxvirus . There are two species of variola virus — Variola major and Variola minor . The first can lead to life-threatening illness, while the second rarely results in death. Humans are the only known carriers of the variola virus . Other Orthopoxvirus viruses are normally transmitted to humans from infected animals.

17. Single linear double stranded RNA Shaped like bricks. Variola major Classic small pox Predominant form in Asian epidemics Highest mortality rate Variola minor Causes mild disease Discovered in 20 th century Started in south Africa Was most predominant form in North America Incubation period 12-14 days or 7-17 days.

18. TYPES

19. PATHOPHYSIOLOGY Inhalation of air droplet Mucosal replication Dissemination to organ and skin Incubation phase(7-17 days) ( 7days) High viral load in blood viremia TOXEMIC PHASE Rash (2-4 days) high fever ,myalgia (head, arms hands legs trunk). Highly infectious viral shedding lesions

20. Signs and symptoms

21. Stages of rash development Macule Papule Vesicles Pustule scabs

22. MODE OF TRANSMISSION Airborne transmission initially via aerosol Then person to person Infectious material Saliva Vesicular fluid Scabs Urine Conjunctival fluid Possibly blood The virus can cross the placenta Small pox transmission does not occur through animals or insects .

23. PREVENTION

24. TREATMENT

25. VACCINATION