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Typhoid fever ppt.

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sapanathakor

Typhoid fever is a communicable disease caused by Salmonella Typhi bacteria. It primarily affects the reticuloendothelial system, intestinal lymphoid tissue, and gallbladder, causing an acute generalized infection. The disease is most common in children and young adults living in impoverished areas with poor sanitation and water quality. It is transmitted via the fecal-oral route by consuming food or water contaminated by the feces or urine of infected individuals. Symptoms include sustained high fever, headache, abdominal pain, and constipation or diarrhea. Diagnosis involves blood, stool, or bone marrow cultures. Treatment is with antibiotics like chloramphenicol or fluoroquinolones. Prevention relies on improved san

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TYPHOID FEVER Sapana thakor m.sc nursing Community health nursing
The term enteric fever or typhoid fever is a communicable disease, found only in man and includes both typhoid fever caused by S.Typhi and paratyphoid fever caused by S.Paratyphi A, B and C . It is an acute generalized infection of the reticulo endothelial system, intestinal lymphoid tissue, and the gall bladder.
EPIDEMIOLOGY
Typhoid fever ppt.
Typhoid fever ppt.
• HOST • Age group : Typhoid fever may occur at any age but it is considered to be a disease mainly of children and young adults. In endemic areas, the highest attack rate occurs in children aged 8-13 years.
Gender and race : Typhoid fever cases are more commonly seen in males than in females. On the contrary, females have a special predilection to become chronic carriers. Occupation : Certain categories of persons handling the infective material and live cultures of S. typhi are at increased risk of acquiring infection. Socio-economic factors : It is a disease of poverty as it is often associated with inadequate sanitation facilities and unsafe water supplies.
• Environmental factors : Though the cases are observed through out the year, the peak incidence of typhoid fever is reported during July - September. This period coincides with the rainy season and a substantial increase in fly population. • Social factors : pollution of drinking water supplies, open air defecation, and urination, low standards of food and personal hygiene, and health ignorance.
Nutritional status :Malnutrition may enhance the susceptibility to typhoid fever by altering the intestinal flora or other host defences. Incubation period : Usually 10-14 days but it may be as short as 3 days or as long as 21 days depending upon the dose of the inoculums. Reservoir of infection : Man is the only known reservoir of infection - cases or carriers. Period of communicability: A case is infectious as long as the bacilli appear in stool or urine.
Mode of transmission : The disease is transmitted by faeco - oral route or urine – oral routes – either directly through hands soiled with faeces or urine of cases or carriers or indirectly by ingestion of contaminated water, milk, food, or through flies. Contaminated ice, ice-creams, and milk products are a rich source of infection.
Symptoms ■ No symptoms - if only a mild exposure; some people become "carriers" of typhoid. ■ Poor appetite, ■ Headaches, ■ Generalized aches and pains, ■ Fever, Lethargy, Lethargy, ■ Lethargy, ■ Diarrhea, ■ Have a sustained fever as high as 103 to 104 degrees Fahrenheit (39 to 40 degrees Celsius), ■ Chest congestion develops in many patients, and abdominal pain and discomfort are common, ■ Constipation, mild vomiting, slow heartbeat.
• First week: The disease classically presents with step-ladder fashion rise in temperature (40 - 41°C) over 4 to 5 days, accompanied by headache, vague abdominal pain, and constipation. • Second week: Between the 7 th -10 th day of illness, mild hepato- splenomegally occurs in majority of patients. Relative bradycardia may occur and rose-spots may be seen. • Third week: The patient will appear in the "typhoid state" which is a state of prolonged apathy, toxaemia, delirium, disorientation and/or coma. Diarrhoea will then become apparent. If left untreated by this time, there is a high risk (5-10%) of intestinal hemorrhage and perforation. • Rare complications: Typhoid hepatitis,Emphyema, Osteomyelitis, and Psychosis. 2-5% patients may become Gall-bladder carriers
Rose spots
Typhoid fever ppt.
Diagnosis Diagnosis of typhoid fever is made by ■ Blood, bone marrow, or stool cultures test ■ Widal test ■ Slide agglutination ■ Antimicrobial susceptibility testing
Management of typhoid fever: • General: Supportive care includes • Maintenance of adequate hydration. • Antipyretics. • Appropriate nutrition. • Specific: Antimicrobial therapy is the mainstay treatment. Selection of antibiotic should be based on its efficacy, availability and cost. • Chloramphenicol , Ampicillin ,Amoxicillin , Trimethoprim &Sulphamethoxazole ,Fluroquinolones • In case of quinolone resistance – Azithromycin, 3rd generation cephalosporins (ceftriaxone)
Control of Typhoid fever MEASURES DIRECTED TO RESERVOIR a) Case detection and treatment b) Isolation c)Disinfection of stools and urine d)Detection & treatment of carriers MEASURES AT ROUTES OF TRANSMISSION a) Water sanitation b) Food sanitation c) Excreta disposal d) Fly control MEASURES FOR SUSCEPTIBLES a) immunoprophylaxis b)health education
• Keep the premises and kitchen utensils clean. • Dispose rubbish properly. • Keep hands clean and fingernails trimmed. • Wash hands properly with soap and water before eating or handling food, and after toilet or changing diapers. • Drinking water should be from the mains and preferably boiled. • Purchase fresh food from reliable sources. Do not patronize illegal hawkers. • Avoid high-risk food like shellfish, raw food or semi-cooked food. • Wear clean washable aprons and caps during food preparation. • Clean and wash food thoroughly. • Scrub and rinse shellfish in clean water. Immerse them in clean water for sometime to allow self-purification. • Remove the viscera if appropriate HEALTH PROMOTION
• Store perishable food in refrigerator, well covered. • Handle and store raw and cooked food especially seafood separately (upper compartment of the refrigerator for cooked food and lower compartment for raw food) to avoid cross contamination. • Clean and defrost refrigerator regularly and keep the temperature at or below 4ºc • Cook food thoroughly. • Do not handle cooked food with bare hands; wear gloves if necessary. • Consume food as soon as it is done. • If necessary, refrigerate cooked leftover food and consume as soon as possible. Reheat thoroughly before consumption. Discard any addled food items. • Exclude typhoid carrier from handling food and from providing care to children.
Specific protection THREE TYPES OF VACCINES 1. Injectable Typhoid vaccine (TYPHIM –Vi,TYPHIVAX) 2. The live oral vaccine (TYPHORAL) 3. TAB vaccine
Injectable Typhim -Vi 1. This single-dose injectable typhoid vaccine, from the bacterial capsule of S. typhi strain of Ty21a. 2. This vaccine is recommended for use in children over 2 years of age. 3. Sub-cutaneous or intramuscular injection 4. Efficacy : 64% -72%
Typhoral 1. This is a live-attenuated-bacteria vaccine manufactured from the Ty21a strain of S. typhi. 2. The efficacy rate of the oral typhoid vaccine ranges from 50-80% 3. Not recommended for use in children younger than 6 years of age. 4. The course consists of one capsule orally, taken an hour before food with a glass of water or milk (1stday,3rd day &5th day) 5. No antibiotic should be taken during this period 6. Immunity starts 2-3 weeks after administration and lasts for 3 years 7. A booster dose after 3 years
International Classification of Disease Codes for Typhoid fever Disease ICD-9 ICD-10 Typhoid & paratyphoid fevers 002 A01 Typhoid fever 002.0 A01.0
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Typhoid fever ppt.

  • 1. TYPHOID FEVER Sapana thakor m.sc nursing Community health nursing
  • 2. The term enteric fever or typhoid fever is a communicable disease, found only in man and includes both typhoid fever caused by S.Typhi and paratyphoid fever caused by S.Paratyphi A, B and C . It is an acute generalized infection of the reticulo endothelial system, intestinal lymphoid tissue, and the gall bladder.
  • 6. • HOST • Age group : Typhoid fever may occur at any age but it is considered to be a disease mainly of children and young adults. In endemic areas, the highest attack rate occurs in children aged 8-13 years.
  • 7. Gender and race : Typhoid fever cases are more commonly seen in males than in females. On the contrary, females have a special predilection to become chronic carriers. Occupation : Certain categories of persons handling the infective material and live cultures of S. typhi are at increased risk of acquiring infection. Socio-economic factors : It is a disease of poverty as it is often associated with inadequate sanitation facilities and unsafe water supplies.
  • 8. • Environmental factors : Though the cases are observed through out the year, the peak incidence of typhoid fever is reported during July - September. This period coincides with the rainy season and a substantial increase in fly population. • Social factors : pollution of drinking water supplies, open air defecation, and urination, low standards of food and personal hygiene, and health ignorance.
  • 9. Nutritional status :Malnutrition may enhance the susceptibility to typhoid fever by altering the intestinal flora or other host defences. Incubation period : Usually 10-14 days but it may be as short as 3 days or as long as 21 days depending upon the dose of the inoculums. Reservoir of infection : Man is the only known reservoir of infection - cases or carriers. Period of communicability: A case is infectious as long as the bacilli appear in stool or urine.
  • 10. Mode of transmission : The disease is transmitted by faeco - oral route or urine – oral routes – either directly through hands soiled with faeces or urine of cases or carriers or indirectly by ingestion of contaminated water, milk, food, or through flies. Contaminated ice, ice-creams, and milk products are a rich source of infection.
  • 11. Symptoms ■ No symptoms - if only a mild exposure; some people become "carriers" of typhoid. ■ Poor appetite, ■ Headaches, ■ Generalized aches and pains, ■ Fever, Lethargy, Lethargy, ■ Lethargy, ■ Diarrhea, ■ Have a sustained fever as high as 103 to 104 degrees Fahrenheit (39 to 40 degrees Celsius), ■ Chest congestion develops in many patients, and abdominal pain and discomfort are common, ■ Constipation, mild vomiting, slow heartbeat.
  • 12. • First week: The disease classically presents with step-ladder fashion rise in temperature (40 - 41°C) over 4 to 5 days, accompanied by headache, vague abdominal pain, and constipation. • Second week: Between the 7 th -10 th day of illness, mild hepato- splenomegally occurs in majority of patients. Relative bradycardia may occur and rose-spots may be seen. • Third week: The patient will appear in the "typhoid state" which is a state of prolonged apathy, toxaemia, delirium, disorientation and/or coma. Diarrhoea will then become apparent. If left untreated by this time, there is a high risk (5-10%) of intestinal hemorrhage and perforation. • Rare complications: Typhoid hepatitis,Emphyema, Osteomyelitis, and Psychosis. 2-5% patients may become Gall-bladder carriers
  • 15. Diagnosis Diagnosis of typhoid fever is made by ■ Blood, bone marrow, or stool cultures test ■ Widal test ■ Slide agglutination ■ Antimicrobial susceptibility testing
  • 16. Management of typhoid fever: • General: Supportive care includes • Maintenance of adequate hydration. • Antipyretics. • Appropriate nutrition. • Specific: Antimicrobial therapy is the mainstay treatment. Selection of antibiotic should be based on its efficacy, availability and cost. • Chloramphenicol , Ampicillin ,Amoxicillin , Trimethoprim &Sulphamethoxazole ,Fluroquinolones • In case of quinolone resistance – Azithromycin, 3rd generation cephalosporins (ceftriaxone)
  • 17. Control of Typhoid fever MEASURES DIRECTED TO RESERVOIR a) Case detection and treatment b) Isolation c)Disinfection of stools and urine d)Detection & treatment of carriers MEASURES AT ROUTES OF TRANSMISSION a) Water sanitation b) Food sanitation c) Excreta disposal d) Fly control MEASURES FOR SUSCEPTIBLES a) immunoprophylaxis b)health education
  • 18. • Keep the premises and kitchen utensils clean. • Dispose rubbish properly. • Keep hands clean and fingernails trimmed. • Wash hands properly with soap and water before eating or handling food, and after toilet or changing diapers. • Drinking water should be from the mains and preferably boiled. • Purchase fresh food from reliable sources. Do not patronize illegal hawkers. • Avoid high-risk food like shellfish, raw food or semi-cooked food. • Wear clean washable aprons and caps during food preparation. • Clean and wash food thoroughly. • Scrub and rinse shellfish in clean water. Immerse them in clean water for sometime to allow self-purification. • Remove the viscera if appropriate HEALTH PROMOTION
  • 19. • Store perishable food in refrigerator, well covered. • Handle and store raw and cooked food especially seafood separately (upper compartment of the refrigerator for cooked food and lower compartment for raw food) to avoid cross contamination. • Clean and defrost refrigerator regularly and keep the temperature at or below 4ºc • Cook food thoroughly. • Do not handle cooked food with bare hands; wear gloves if necessary. • Consume food as soon as it is done. • If necessary, refrigerate cooked leftover food and consume as soon as possible. Reheat thoroughly before consumption. Discard any addled food items. • Exclude typhoid carrier from handling food and from providing care to children.
  • 20. Specific protection THREE TYPES OF VACCINES 1. Injectable Typhoid vaccine (TYPHIM –Vi,TYPHIVAX) 2. The live oral vaccine (TYPHORAL) 3. TAB vaccine
  • 21. Injectable Typhim -Vi 1. This single-dose injectable typhoid vaccine, from the bacterial capsule of S. typhi strain of Ty21a. 2. This vaccine is recommended for use in children over 2 years of age. 3. Sub-cutaneous or intramuscular injection 4. Efficacy : 64% -72%
  • 22. Typhoral 1. This is a live-attenuated-bacteria vaccine manufactured from the Ty21a strain of S. typhi. 2. The efficacy rate of the oral typhoid vaccine ranges from 50-80% 3. Not recommended for use in children younger than 6 years of age. 4. The course consists of one capsule orally, taken an hour before food with a glass of water or milk (1stday,3rd day &5th day) 5. No antibiotic should be taken during this period 6. Immunity starts 2-3 weeks after administration and lasts for 3 years 7. A booster dose after 3 years
  • 23. International Classification of Disease Codes for Typhoid fever Disease ICD-9 ICD-10 Typhoid & paratyphoid fevers 002 A01 Typhoid fever 002.0 A01.0