TYPHOID FEVER - Acute generalized infection of the reticulo endothelial system, intestinal lymphoid tissue and the gall bladder. - Classified as “enteric fever.” Mode of Transmission Poor hygiene habits Public sanitation conditions Flying insects feeding on feces Ingestion of food or water contaminated with the organism Food or water that has been contaminated with the fecal matter or, less commonly, urine of an infected person or carrier. Shellfish from contaminated beds

2. I. Brief Introduction:
MARY MALLON – the best known carrier of typhoid
fever, known as “Typhoid Mary.”

4. Mode of Transmission
 Poor hygiene habits
 Public sanitation conditions
 Flying insects feeding on
feces
 Ingestion of food or water
contaminated with the
organism
 Food or water that has been
contaminated with the fecal
matter or, less commonly,
urine of an infected person
or carrier.
 Shellfish from contaminated
beds
Incubation Period
- The incubation period for
typhoid fever is usually 8-14
days, with a range of 3 days
to 2 months depending on
the infecting dose.

5. IV. Signs and Symptoms
 Untreated typhoid fever is divided
into three individual stages
symptoms, each lasting about a week:
1st Week of Untreated typhoid
fever
 Body temperature rises slowly
 Fever fluctuations are seen with
relative bradycardia
 Malaise
 Headache
 Cough
 Bloody nose
 Abdominal pain
 A decrease of number of circulating
white blood cells
 Blood cultures are positive
 Widal test is negative in first week
2nd Week of Untreated typhoid fever
 Bradycardia
 Delirium
 Rose spots appear on the lower chest
 The abdomen is distended and painful in
the right lower quadrant
 Diarrhea occur in this stage 6 to 8 stools
in a day, green, comparable to a pea soup
 The spleen and liver enlarged
 The widal test is strongly positive
3rd Week of Untreated typhoid fever
 Intestinal hemorrhage due to bleeding in
congested Peyer’s patches.
 Intestinal perforation in the distal ileum.
 Encephalitis
 Neuropsychiatric symptoms
 Dehydration
 Platelet count goes down

6. V. Period of Communicability
 Typhoid fever is communicable for as long as
the infected person excretes Salmonella Typhi
in the feces or urine.

7. VI. Susceptibility, Resistance
and Occurrence
 Susceptibility: Everyone is susceptible to infection. Immunity
following clinical disease or immunization is insufficient to
protect against a large infectious dose of organisms.
 Resistance: Vaccines
ORAL TY12A VACCINE (sold as
Vivotif by Crucell Switzerland AG)
INJECTABLE TYPHOID
POLYSACCHARIDE VACCINE
(sold as TyphimVi by Sanofi Pasteur and
‘Typherix by GlaxoSmithKline)

8. VI. Susceptibility, Resistance
and Occurrence

9.  Providing clean drinking water
 Protection of water supplies
 Sanitary disposal of human excreta
 Pasteurization
 Safe food preparation
 Better sanitation
 Education of everyone on importance of proper hand
washing
 Vaccination
 Chlorination of drinking water
 Control of contacts
 Control of Environment
 Food industry