Typhus fever is caused by Rickettsia bacteria and is transmitted by body lice. It includes epidemic typhus caused by R. prowazekii and transmitted by body lice. According to WHO, there are an estimated 11-20 million cases of typhoid fever annually resulting in 128,000-161,000 deaths per year. Typhus fever most commonly occurs in people living in unhygienic conditions such as refugee camps or mountainous regions. The bacteria are transmitted through the feces of infected body lice. Symptoms include high fever, headache, muscle pain and rash. Treatment involves antibiotics such as doxycycline. Prevention focuses on proper hygiene, disposal of waste,

1. Typhus fever
Presentar
sharada pakhrin
And
Shreedev sharma
Fig:-1(Body louse)

2. Typhus fever
• Gaol Fever, Tabradillo,War Fever, Jail Fever.
It includes
• Epidemic typhus
Caused by rikkettsial agent- R.prowazekii
Vector=Body louse
• Murine typhus
Causative agent-R.typhi
Vector-Flea
• Scrub typhus
Causative agent-R.tsutsugamushi
Vector-mite

3. Overview
• Organism
• History
• WHO Data
• Epidemology
• Transmission
• Incubation period
• Clinical symptoms
• Diagnosis
• Differential diagnosiss
• Treatment
• Complication
• Prevention and Control

4. The Organism
1. Rickettsia prowazekii
• Obligate intracellular bacteria
• Pleiomorphic rods
• Susceptible to moist heat and dry heat Fig:-2(Rickettsia
prowazekii)

5. History
• 1489: Arrival in Europe
-Soldiers returning from Cyprus
• 1557-59: Outbreak in England
-Killed 10% of the population
- Poor sanitation
• 1880 Typhoid bacillus identified
Fig:-3

6. WHO DATA
• According to WHO"It is estimated that global typhoid fever disease
burden about 11- 20 million cases anually,reasulting 128000-161000
death per year
Fig:-4(Histogram)

7. Epidemiology
• Most common in people living under unhygienic conditions
-----Refugee camp
• It also occurs in people living in the cool mountaneous region of asia
,africa,and cental south america
Fig:-5(Refugee camp)

8. Transmission
• Human body louse
• Pediculus humanus corporis(Only body louse responsinle for
transmiting typhus)
• Infective for 2-3 days
• Infection acquired by feeding on infected person
• Excrete R. prowazeki in feces at time of feeding
Fig:-6(body louse)

9. Transmission
• Inhalation of feces
• No person-to-person transmission

10. Incubation period
• 7-15 days( generally 1-2weeks)
• O.tsutugamushi is maintained by transovarian transmission in
tromboculid bodylouse
• -After hatching,infected larval mites inculate organism into skin.

11. Clinical Symptoms
• High fever
• Escar at the site of bite
• Headache
• Muscle pain
• Cough
• Regionally lymphodenopathy and progresses to generalized
lymphodenopathy
• Pneumonitis,encephalitis,and myocarditis occurs in the late phase of
illness

12. Fig:-7(Lymphodenopathy)

13. Fig:-8(Escar at site of bite)

14. Fig:-9(Escar)

15. Diagnosis
• Initial diagnosis
• Clinical signs and history
• Laboratory tests not diagnostic
• Confirmatory diagnosis
• Culture
• Serology
• Biopsy
• PCR

16. Differential diagnosis
• Tuberculosis
• Kalazar
• Lymphoma
• Malaria
• Mumps
• Infective mononucleosis
Fig:-10(mononucleosis)

17. Treatment
General treatment
• Bed rest
• Good nursing care
• Care of mouth ,eye and skin
Medication
• Doxycycline(100 mg bid orally or chloramphenicol 500 mg qid for 7-15
days)
• Rifampicin, azithromycin arealternatives
• Azithromycin is alternative in children

18. Complication
• Pneumonia
• Myocarditis
• GI bleeding
• Meningitis
• Osteomyetits
• Bowel perforation
Fig:-11(Osteomyetitis)

19. Prevention and control
• Avoiding over crowed areas
• Educate people regarding importance of hand wash
• Proper disposal ofhuman excreta
• Control fly breeding by spaying with insecticides
• Vaccine
• Typhoid vaccine
• Monovalent and b-valent typhoid vaccine

20. Thank you

21. Reference
Website:-Slideshare.com
Dr.Mohed shaker
Book:-Medicine-I
Tilak pathak
Revised edittion2018