TYPHOID

COMMUNICABLE DISEASES
PEH 412
TYPHOID FEVER
MEMBERS
JOAN DAMA EVH/3912/21
OSMOND MUDOGA EVH/3929/21
Typhoid fever
Is a threatening infection caused by bacterium bacterium called salmonella typhi.
It mostly affects the but it can also affect the bloodstream.
Typhoid fever is common in places with poor water treatment and sewer system.
Karl Joseph was the first to describe the bacillus suspect to cause typhoid fever in 1880.
Paratyphoid fever is similar to typhoid with more mild symptoms. It’s caused by Salmonella Paratyphi (S. Paratyphi).
S. Typhi and S. Paratyphi are different than the Salmonella bacteria that cause salmonellosis, a common type of food
poisoning.
It once caused deadly outbreaks, but typhoid fever is now uncommon in many places, including the U.S., Canada,
Australia and Western Europe.
Who was Typhoid Mary?
• Mary Mallon was a cook in New York in the late 1880’s. She was not sick
with typhoid fever but instead was a carrier who could still spread the
disease to others. As a danger to public health, the state of New York
quarantined Mallon. They told her she couldn’t work as a cook anymore.
•
• Mallon didn’t understand how she could spread disease without being sick
and continued to work as a cook after her first quarantine. She was
responsible for over 100 people getting sick with typhoid fever and at least
five deaths. She’s thought to be the source of an outbreak of 3,000 cases of
typhoid in New York. She was quarantined a second time, for the rest of
her life, and has since been known as “Typhoid Mary.”
EPIDIOMOLOGY
• It’s estimated that 11 million to 21 million people around the world
get typhoid each year. It’s rare in the U.S., Canada, Japan, Western
Europe and Australia.
• Countries in South and Southeast Asia, Central and South America,
Africa and the Caribbean are most affected by typhoid. Travelers are
most at risk when visiting Pakistan, India or Bangladesh.
• One example of where typhoid fever is rare is the United States. This
is due to their modern sanitation practices. The highest number of
cases or with regular outbreaks are in Africa and South Asia. It is a
serious health threat, especially for children, in places where it is
more common.
Stages of Typhoid fever
• Stage 1. You can start getting typhoid symptoms anywhere from five
to 14 days after coming in contact with S. Typhi. The first symptom is
a fever that gets higher over a few days — called “stepwise” since it
goes up in steps. The bacteria is moving into your blood in this stage.
• Stage 2. Around the second week of fever, the bacteria is multiplying
in your Peyer’s patches (part of your immune system that identifies
harmful invaders). You’ll start experiencing abdominal pain and other
stomach symptoms, like diarrhea or constipation. You might get “rose
spots,” small pink dots on your skin that look like a rash.
• Stage 3. If not treated with antibiotics, the bacteria can cause severe
damage, usually around the third week after your symptoms start.
Some people get serious complications, like internal bleeding and
encephalitis (inflammation in your brain).
• Stage 4. Stage four is when most people begin to recover. Your high
fever begins to come down. S. Typhi can live in your gallbladder
without causing symptoms, which means you may still be contagious
even after you feel better.
Symptoms
• Weakness
• Fever
• Stomach pain
• Headache
• Diarrhea or constipation
• Cough
• Loss of appetite
• Some people may develop a rash
Mode of transmission
• Bacteria are passed in the feces and urine of infected persons or carriers.
• The bacteria can be found in water and soil contaminated with sewage.
• Infected food handlers with poor personal hygiene and traces of feces on their hands may contaminate food.
• Surfaces can also be contaminated.
• Close personal contact with an infected person, for example infants and young children with poor personal
hygiene.
At risk groups
• Works in or those travelling to areas where typhoid fever is
established, especially if you travel to visit family or friends.
• Work as a clinical microbiologist handling Salmonella enterica
serotype typhi bacteria.
• Have close contact with someone who is infected or has recently
been infected with typhoid fever.
• Children are more likely to get typhoid than adults.
Diagnosis
• Blood. Your provider will use a needle to take a small tube of blood from your
arm.
• Poop (stool). Your healthcare provider will give you a sterile container and
instructions on how to collect a sample.
• Pee (urine). You may be asked to pee into a cup given to you by your healthcare
provider.
• Your provider might numb your skin and take a sample with a small razor or
scalpel.
• Bone marrow. Your provider will numb your skin and use a special needle to get a
sample of the inside of your bones. It’s rare that you’d ever need this test for
diagnosis.
• You provider may also take X-rays (pictures of the inside of your body) to look for
changes in your lungs.
Treatment
• Typhoid can be treated with antibiotics, which may include:
• Ciprofloxacin, levoflaxin or ofloxacin.
• Ceftriaxone, cefotaxime or cefixime.
• Azithromycin.
• Carbapenems.
Complications
• Internal bleeding.
• Intestinal perforation (a hole in your intestines).
• Swollen or burst gallbladder.
• Neurological (brain) symptoms, including confusion, delirium and seizures.
• Swelling around your brain (meningitis).
• Bronchitis, pneumonia or other respiratory issues.
• Bone inflammation (osteomyelitis).
• Heart inflammation.
• Kidney failure.
• Miscarriage.
Prevention and control of typhoid
• Wash hands frequently in hot, soapy water. Alcohol-based sanitizer can be used in the absence of hot water.
• Ensure water is bottled or boiled.
• Wash teeth using bottled water and avoid swallowing shower water.
• Avoid ordering drinks with ice, unless you know the ice is made form boiled or bottled water.
• Only eat foods that have been thoroughly cooked and served steaming hot.
• Only eat raw vegetables if they can be peeled.
• Avoid foods sold by street vendors .
• Vaccination of person at risk

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