1. Abad, Mary Raina Angeli Z.
TYPHOID FEVER
Abad, Mary Raina Angeli Z.
Iewida, Samira Yaser P.
Lameda, Randall M.
HUB 42

2. What are Water-Borne Diseases?
Diseases that are supported, carried or transmitted by water.
Examples are: Cholera, Hepatitis A, Amoebic Dysentery, Brainerd Diarrhea & Typhoid Fever

3. What is Typhoid Fever?
Typhoid Fever is an acute systemic illness characterized by fever, headache and abdominal discomfort.
Also known as Enteric Fever or commonly just typhoid.

4. What causes Typhoid Fever?
Typhoid Fever is caused by the bacterium Salmonella typhi from the family Enterobacteriacea.
Salmonella typhi is a gram-negative bacteria that is motile due to its peritrichous flagella.
The bacteria grows best at 37°C.

6. Color pink therefore Gram-negative
With peritrichous flagella

7. It can also be caused by Salmonella paratyphi, a related bacterium that usually causes a less severe illness known as Paratyphoid Fever.

8. Epidemiology
Typhoid Fever is common worldwide but is more prevalent in areas of developing countries lacking adequate waste disposal and clean drinking water facilities.
Humans are the only host for S. typhi.

9. Estimated 16-33 million cases annually resulting in 500,000 to 600,000 deaths in endemic areas
WHO identifies typhoid as a serious health problem
Incidence is highest in children and young adults between 5 to 19 years old.

11. Cases of Typhoid Fever in the Philippines
Data taken from an official report done by the DOH the Republic of the Philippines:

12. Cases of Typhoid Fever in Philippines & Japan
Statistics obtained from:

13. Mode of Transmission
S. typhi is most commonly transmitted through the fecal-oral route.
It can also be transmitted by ingestion of contaminated food or water.

14. Patients with typhoid can contaminate the water supply with their stool, where the bacteria flourish.
The food supply can become contaminated by infected stool or poor sanitation.

15. Some people, known as chronic carriers, still harbor typhoid bacteria, and can still contaminate food and water supplies even after receiving antibiotic treatment and proving to be free of symptoms.

16. How does the bacteria cause disease?
Come in contact with infected individual or ingestion of contaminated food or water
Salmonella bacteria penetrate the epithelial wall of the small intestine
Phagocytosed by macrophages

17. Spread via the lymphatics while inside the macrophages
S. typhi then alters its structure to resist destruction and allow them to exist within the macrophage
Travels to the reticulo endothelial system and then to the different organs throughout the body
Spread via the lymphatics while inside the macrophages

18. Goes back to the bloodstream accompanied with development of symptoms
Salmonella bacteria may be passed out through the stool
Cycle continues

19. Signs and Symptoms Incubation period: around 10 to 14 days
High fever – around 39°C to 40°C
Profuse sweating and headache
Gastroenteritis
Nonbloody diarrhea

20. Poor appetite
Lethargy, weakness and fatigue
Generalized aches and pains
Abdominal pain and discomfort
Rash – rose-colored spots on the lower chest and upper abdomen

21. Rose Spots

22. Terminal Stage Disturbance in consciousness Muttering delirium
Coma vigil
Typhoid Psychosis
Intestinal bleeding
Death – 10% to 30% of untreated cases

23. Typhoid Terminal State

24. How is Typhoid Fever diagnosed?
Blood, bone marrow or stool cultures
Widal Test
ELISA – Enzyme-Linked Immunoabsorbent Assay
Fluorescent Antibody Test

25. How is Typhoid Fever treated?
Antibiotics – ampicillin, trimethoprim-sulfamethoxazole, amoxicillin and ciprofloxacin
Ceftriaxone, Azithromycin – antibiotics used for MDR typhoid (multidrug-resistant typhoid)

26. Chloramphenicol – original drug used to treat typhoid fever but was replaced because of many rare side effects

27. Vaccine against Typhoid
Vivotif Berna – oral Ty21a vaccine
Typhim Vi or Typherix – injectable Typhoid polysaccharide vaccine

28. How can Typhoid Fever be prevented?
Proper sanitation and hygiene
Careful food preparation and washing of hands
Avoid drinking untreated water
Avoid raw fruits and vegetables
Adequately clean household items

29. Public education campaigns encouraging people to wash their hands after defecating and before handling food are important components in controlling the spread of the disease.

30. According to CDC, chlorination of drinking water had led to dramatic decrease in the transmission of typhoid fever.

31. References

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35. SECOND DAY

37. THANK YOU!!!