Bibliography

 NCERT – textbook
 www.wikipedia.com
 www.answers.com
 Typhoid

Typhoid fever is an acute illness

associated with fever caused by the Salmonella enterica serotype
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.

The incidence of typhoid fever in the United States has markedly decreased since the early
1900s, when tens of thousands of cases were reported in the U.S. Today, less than 400 cases are
reported annually in the United States, mostly in people who have recently traveled to Mexico
and South America. This improvement is the result of better environmental sanitation. India,
Pakistan, and Egypt are also known as high-risk areas for developing this disease. Worldwide,
typhoid fever affects more than 21 million people annually, with about 200,000 people dying
from the disease.

How Do People Get

Typhoid Fever?
Typhoid fever is contracted by drinking or eating
the bacteria in contaminated food or water. People
with acute illness can contaminate the surrounding
water supply through stool, which contains a high
concentration of the bacteria. Contamination of the water supply can, in turn, taint the food
supply. The bacteria can survive for weeks in water or dried sewage.

About 3%-5% of people become carriers of the bacteria after the acute illness. Others suffer a
very mild illness that goes unrecognized. These people may become long-term carriers of the
bacteria -- even though they have no symptoms -- and be the source of new outbreaks of typhoid
fever for many years.

How Is Typhoid Fever Diagnosed?

After the ingestion of contaminated food or water, the Salmonella bacteria invade the small
intestine and enter the bloodstream temporarily. The bacteria are carried by white blood cells in
the liver, spleen, and bone marrow, where they multiply and reenter the bloodstream. People
develop symptoms, including fever, at this point. Bacteria invade the gallbladder, biliary system,
and the lymphatic tissue of the bowel. Here, they multiply in high numbers. The bacteria pass
into the intestinal tract and can be identified in stool samples. If a test result isn't clear, blood or
urine samples will be taken to make a diagnosis.
 Symptoms
Symptoms normally begin between 6 and 30 days after exposure to the bacteria.The two major
symptoms of typhoid are fever and rash. Typhoid fever is particularly high, gradually increasing
over several days up to 104 degrees Fahrenheit, or 39 to 40 degrees Celsius.The rash, which does
not affect every patient, consists of rose-colored spots, particularly on the neck and abdomen.

Other symptoms can include:

 weakness
 abdominal pain
 constipation
 headaches
Rarely, symptoms might include confusion, diarrhea, and vomiting, but this is not normally
severe.In serious, untreated cases, the bowel can become perforated. This can lead to peritonitis,
an infection of the tissue that lines the inside of the abdomen, which has been reported as fatal in
between 5 and 62 percent of cases.Another infection, paratyphoid, is caused by Salmonella
enterica. It has similar symptoms
 Treatment
The only effective treatment for typhoid is antibiotics. The most commonly used are
ciprofloxacin (for non-pregnant adults) and ceftriaxone.Other than antibiotics, it is important to
rehydrate by drinking adequate water.In more severe cases, where the bowel has become
perforated, surgery may be required.

Typhoid antibiotic resistance

As with a number of other bacterial diseases, there is currently concern about the growing
resistance of antibiotics to S. typhi.This is impacting the choice of drugs available to treat
typhoid. In recent years, for example, typhoid has become resistant to trimethoprim-
sulfamethoxazole and ampicillin.Ciprofloxacin, one of the key medications for typhoid, is also
experiencing similar difficulties. Some studies have found Salmonella typhimurium resistance
rates to be around 35 percent.

Treatment at home
If typhoid fever is diagnosed in its early
stages, a course of antibiotic tablets may be
prescribed for you. Most people need to
take these for 7 to 14 days.Some strains of
the Salmonella typhi bacteria that cause
typhoid fever have developed a resistance
to one or more types of antibiotics.This is
increasingly becoming a problem with
typhoid infections originating in southeast
Asia.Any blood, poo (stool) or pee (urine)
samples taken during your diagnosis will
usually be tested in a laboratory to
determine which strain you're infected with, so you can be treated with an appropriate antibiotic.

Your symptoms should begin to improve within 2 to 3 days of taking antibiotics. But it's very
important you finish the course to ensure the bacteria are completely removed from your
body.Make sure you rest, drink plenty of fluids and eat regular meals. You may find it easier to
eat smaller meals more frequently, rather than 3 larger meals a day.You should also maintain
good standards of personal hygiene, such as regularly washing your hands with soap and warm
water, to reduce the risk of spreading the infection to others.Contact your GP as soon as possible
if your symptoms get worse or you develop new symptoms while being treated at home.In a
small number of cases, the symptoms or infection may recur. This is known as a relapse.
 Hospital treatment
Hospital admission is usually recommended if you have severe symptoms of typhoid fever, such
as persistent vomiting, severe diarrhoea or a swollen stomach.As a precaution, young children
who develop typhoid fever may be admitted to hospital.In hospital, you'll have antibiotic
injections and you may also be given fluids and nutrients directly into a vein through an
intravenous drip.Surgery may be needed if you develop life-threatening complications of typhoid
fever, such as internal bleeding or a section of your digestive system splitting.But this is very
rare in people being treated with antibiotics.Most people respond well to hospital treatment and
improve within 3 to 5 days, but it may be several weeks until you're well enough to leave
hospital.

Relapses
Some people who are treated for typhoid fever experience a relapse, which is when symptoms
return .In these cases, the symptoms usually return around a week after antibiotic treatment has
finished .The second time around, symptoms are usually milder and last for a shorter time than
the original illness, but further treatment with antibiotics is usually recommended.

Causes
Typhoid is caused by the bacteria S. typhi and spread through food, drinks, and drinking water
that are contaminated with infected fecal matter. Washing fruit and vegetables can spread it, if
contaminated water is used.Some people are asymptomatic carriers of typhoid, meaning that they
harbor the bacteria but suffer no ill effects. Others continue to harbor the bacteria after their
symptoms have gone. Sometimes, the disease can appear again.
People who test positive as carriers may not be allowed to work with children or older people
until medical tests show that they are clear.
 Prevention
Countries with less access to clean water and washing facilities typically have a higher number
of typhoid cases.

Vaccination
[Typhoid vaccine]
If traveling to an area where typhoid is prevalent, vaccination is recommended .Before traveling
to a high-risk area, getting vaccinated against typhoid fever is
recommended .This can be achieved by oral medication or a one-off
injection:
Oral: a live, attenuated vaccine. Consists of 4 tablets, one to be taken
every second day, the last of which is taken 1 week before travel.
Shot, an inactivated vaccine, administered 2 weeks before travel.
Vaccines are not 100 percent effective and caution should still be
exercised when eating and drinking .Vaccination should not be
started if the individual is currently ill or if they are under 6 years of
age. Anyone with HIV should not take the live, oral dose.
The vaccine may have adverse effects. One in 100 people will experience a fever. After the oral
vaccine, there may be gastrointestinal problems, nausea, and headache. However, severe side
effects are rare with either vaccine.

There are two types of typhoid vaccine available, but a more powerful vaccine is still needed.
The live, oral version of the vaccine is the strongest of the two. After 3 years, it still protects
individuals from infection 73 percent of the time. However, this vaccine has more side effects.
The current vaccines are not always effective, and because typhoid is so prevalent in poorer
countries, more research needs to be done to find better ways of preventing its spread.

Eliminating typhoid
Even when the symptoms of typhoid have passed, it is still possible to be carrying the
bacteria.This makes it hard to stamp out the disease, because carriers whose symptoms have
finished may be less careful when washing food or interacting with others.People traveling in
Africa, South America, and Asia, and India in particular, should be vigilant.
 DIAGNOSIS
Testing for typhoid fever
A diagnosis of typhoid fever can usually be confirmed by analysing samples of blood, poo
(stools) or pee (urine).These will be examined under a microscope for the Salmonella typhi
bacteria that cause the condition.The bacteria aren't always detected the first time, so you may
need to have a series of tests.Testing a sample of bone marrow is a more accurate way of
diagnosing typhoid fever.But getting the sample is both time-consuming and painful, so it's
usually only used if other tests are inconclusive.If typhoid fever is confirmed, other members of
your household may also need to be tested in case you have passed the infection on to them.

CONCLUSION
Typhoid is spread by contact and ingestion of infected human feces. This
can happen through an infected water source or when handling food.

The following are some general rules to follow when traveling to help minimize the chance of
typhoid infection:

 Drink bottled water, preferably carbonated.

 If bottled water cannot be sourced, ensure water is heated on a rolling boil for at least one
minute before consuming.
 Be wary of eating anything that has been handled by someone else.
 Avoid eating at street food stands, and only eat food that is still hot.
 Do not have ice in drinks.
 Avoid raw fruit and vegetables, peel fruit yourself, and do not eat the peel.
 ACKNOWLEDGEMENT
This is to acknowledge that this investigatory
project would not have been successful without the
help of the source that are mentioned below.
It was a great opportunity making this
investigatory project so at the onset a very great
thanks to our principal Mr.jeyakanth sir and to
our subject teachers Mrs.Amaravathy and
Mrs.Gnanamani(ma’am) without their guidance this
investigatory project would not have been possible.
Lastly I would like to thank our parents,who really
helped us in each and every moment, friends and
everyone who is directly or indirectly associated
with the completion of this investigatory project of
biology.
Last, but not the least, I would like to thank CBSE for
giving me the opportunity to undertake this project.

By,
Sugashini.K
 CERTIFICATE
This is to certify that “ Sugashini.K”,a student
of class12 (bio) has successfully completed the
biology investigatory project on the selected topic
“TYPHOID FEVER” assigned by the biology subject
teacher of SAV institute as a part of the practical
section class 12 annual exam for the year 2018-
2019.
 SRI AMBAL VIDHYALAYA(CBSE)

VILATHIKULAM

BIOLOGY PROJECT

Regd. No . M /2/19/46286/0025 Certified Bonafide Record of Project work done by

Sugashini.K . During the year 2018-19

Date: ………………… Teacher In-charge.

Submitted for the practical examination held at SRI AMBAL VIDHYALAYA(CBSE)

SCHOOL, centre , Vilathikulam on ……………………………………

Internal Examiner External Examiner

Principal