TYPHOID FEVER

Abad, Mary Raina Angeli Z.

Iewida, Samira Yaser P.
Lameda, Randall M.
HUB 42

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

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.

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 37C.

Color pink therefore

Gram-negative

With peritrichous
flagella

 It can also be caused by Salmonella

paratyphi, a related bacterium that
usually causes a less severe illness
known as Paratyphoid Fever.

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.

 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.

Cases of Typhoid Fever

in the Philippines

Data taken from an official report done by the DOH the

Republic of the Philippines:
http://www2.doh.gov.ph/data_stat/html/fhsis/nd_byear.pdf

Cases of Typhoid Fever

in Philippines & Japan

Statistics obtained from: www.WHO.int/en/

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.

 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.

 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.

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

S. typhi then
alters its
structure to
resist
destruction
and allow
them to exist
within the
macrophage

Spread via the

lymphatics
while inside
the
macrophages

Travels to the
reticulo
endothelial
system and
then to the
different
organs
throughout
the body

Goes back to
the
bloodstream
accompanied
with
development
of symptoms

Salmonella
bacteria may
be passed
out through
the stool

Cycle
continues

Signs and Symptoms

Incubation period: around 10 to 14
days
High fever around 39C to 40C
Profuse sweating and headache
Gastroenteritis
Nonbloody diarrhea

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

Rose
Spots

Terminal Stage

Disturbance in consciousness
Muttering delirium
Coma vigil
Typhoid Psychosis
Intestinal bleeding
Death 10% to 30% of untreated
cases

Typhoid Terminal State

How is Typhoid Fever

diagnosed?
Blood, bone marrow or stool cultures
Widal Test
ELISA Enzyme-Linked
Immunoabsorbent Assay
Fluorescent Antibody Test

How is Typhoid Fever

treated?
Antibiotics ampicillin,
trimethoprim-sulfamethoxazole,
amoxicillin and ciprofloxacin
Ceftriaxone, Azithromycin
antibiotics used for MDR typhoid
(multidrug-resistant typhoid)

 Chloramphenicol original drug used

to treat typhoid fever but was
replaced because of many rare side
effects

Vaccine against Typhoid

Vivotif Berna oral Ty21a vaccine
Typhim Vi or Typherix injectable
Typhoid polysaccharide vaccine

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

 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.

 According to CDC, chlorination of

drinking water had led to dramatic
decrease in the transmission of
typhoid fever.

References

http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm
http://www.cureresearch.com/t/typhoid_fever/stats-country.htm
http://deploymenthealthlibrary.fhp.osd.mil/products/Staying%20Healthy
%20Guide-%20Soldiers%20Guide%20in%20the%20Philippines%20(Tri-fold)
%20(133).pdf
http://www2.doh.gov.ph/data_stat/html/fhsis/typhoidfever.pdf
http://www.gmanews.tv/story/83222/Typhoid-cases-in-Laguna-decline-but-dangernot-yet-over---DOH
http://www.medicinenet.com/typhoid_fever/article.htm
http://www.medicalnewstoday/articles/156859.htm
http:// www.merriam-webster.com/dictionary/waterborne
http://pediatrics.uchicago.edu/chiefs/documents/typhoid.pdf
http://www.psmid.org/ph/vol21/vol21num2tpoic2.pdf
http://www.who.int/vaccines-documents/DocsPDF03/www740.pdf
http://www.who.int/vaccine_research/documents/en/typhoid_diagnosis.pdf
http://www.wpro.who.int/NR/rdonlyres/92EC0A38-6EA7-4BDA-B19EC2E398D4724D/0/PHL.pdf

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