Typhoid fever is caused by Salmonella typhi bacteria. It presents with a sustained fever for 2-3 weeks and can lead to serious complications involving the intestines or other organs if left untreated. Humans are the only reservoir, transmitting the bacteria through feces and urine. Controlling transmission requires identifying infected individuals and carriers, providing proper treatment, ensuring sanitary conditions for food and water, and implementing vaccination programs. Identifying and managing chronic carriers who can shed bacteria for many years remains a challenge to fully eliminating typhoid.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
This ppt contains all the information about the epidemiology of typhoid fever. It is useful for students of the medical field learning Preventive and social medicine, Swasthavritta (Ayurved), and everyone who is interested in knowing about it.
This ppt contains all information about epidemiology of Diptheria. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
Brief and easily understandable description on measles along with images for undergraduate students. this presentation would help in picturising what measles is.
This ppt contains all the information about the epidemiology of typhoid fever. It is useful for students of the medical field learning Preventive and social medicine, Swasthavritta (Ayurved), and everyone who is interested in knowing about it.
This ppt contains all information about epidemiology of Diptheria. It is useful for students of medical field learning preventive and social medicine, Swasthavritta (Ayurved), nursing and everyone who is interested in knowing about it.
Typhoid fever, also known as enteric fever, is a potentially fatal multisystemic illness caused primarily by Salmonella enterica, subspecies enterica serovar typhi and, to a lesser extent, related serovars paratyphi A, B, and C.
The protean manifestations of typhoid fever make this disease a true diagnostic challenge. The classic presentation includes fever, malaise, diffuse abdominal pain, and constipation. Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within 1 month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications.
“Patient Education is an individualized, systematic, structured process to assess and impart knowledge or develop a skill in order to effect a change in behavior. The goal is to increase comprehension and participation in the self-management of health care needs.”
“A restraint is any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his/her arms, legs, body or head freely” (e.g. -Safe keeper bed, Posey bed, safety mitt, soft limb restraint), or a restraint is a drug or medication when it is used as a restriction to manage the patient's behavior or restrict the patient's freedom of movement and is not standard treatment or dosage for the patient's condition A restraint does not include devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of a patient for the purpose of conducting routine physical examinations or tests, or to protect the patient from falling out of bed, or to permit the patient to participate in activities without the risk of physical harm., side rails, airways, trapeze etc.
Unit 10 Promoting Safety in Health Care Enevronment (FON).pdfKULDEEP VYAS
Healthcare environments need to provide a balance between the need for practical and clinical activities or procedures to take place within them, while creating an environment that can contribute to a good experience.
International Nurses Day
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Fluorosis is a cosmetic condition that affects the teeth. It's caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed. After the teeth come in, the teeth of those affected by fluorosis may appear mildly discolored.
Evaluation is a process used to determine what has happened during a given activity or in an institution.Evaluation requires many skills that are as important as other elements of the instructional process.
Human resource management in hospital and community servicesKULDEEP VYAS
HRM is the function within an organization that focuses on recruitment ,managing and providing direction for the people working in that organization.
*It is the organizational function dealing with issues related to people such as hiring, compensation, performance management ,safety, organization development, wellness, benefits, employee motivation, communication, administration and training.
Moulding or training of the mind and character to bring about desired behaviour is known as discipline.it helps a person to have some control over another person.
Patient ASSIGNMENT does not only mean that dividing the patient among available staff nurses but it is assigning an individual patient or group of patients to nurses according to the required nursing care needs and nurses capability to provide the quality care
Directing leading in hospital and community servicesKULDEEP VYAS
Directing is the fourth phase of the management process, it can also be called as coordinating or activating
*Here the leadership and the management skills are both required in order to accomplish the goal of the organization.
*It consists of 2 major components like guidance and supervision which is to be done during job process which help the nurses to utilize their total skills and knowledge in providing the quality care.
Commonly used Insecticides and Pesticides KULDEEP VYAS
Pesticides include insecticides, herbicides and fungicides. There are several thousand different types in use and almost all of them are possible causes of water pollution. For example, DDT, malathion, parathion, delthametrine and others have been sprayed in the environment for long periods of time for the control of disease vectors such as mosquitoes, and to control the growth of weeds and other pests.
Material management in hospital and community servicesKULDEEP VYAS
Material management is a methodical technique that includes planning strategies, systemizing and regulating the flow of material from procurement till the point of disembarkation.
It is the process of coordination and controlling the activities in an organization. It includes the responsibility of purchasing the materials, their scheduling from supply or from other internal sources, their handling, storage and movement through the organization, and their delivery.
-It is a statement of anticipated results during a designated
time period expressed financial and nonfinancial terms.
-Three essential steps in the control process are establishing standards, comparing results with standards and taking corrective action.
-Budgeting process starts when top-level management establishes the strategies and goals for the organization.
The client classification system or patient classification system is the cluster of clients that has been categorized on the specific characteristics, needs ,requirements and their severity of the disease conditions based on which patient assignment is made to provide nursing care.
The prostate is an exocrine gland of the male mammalian reproductive system
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A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. TYPHOID
• Typhoid fever is due to systemic
infection mainly by Salmonella
typhi
• Salmonella typhi infection is
found only in men
3. • The disease is clinically
characterized by a typical
continuous fever for 2-3 weeks,
with relative bradycardia with
involvement of lymphoid tissues
and considerable constitutional
symptoms
4. • The term “ENTERIC FEVER”
includes both typhoid and para
typhoid fevers
• The disease may occur
sporadically, epidemically or
endemically
8. • S.typhi has three main antigens :
O, H & Vi and a number of phage
types
• S.typhi survives intra cellularly in
the tissues of various organs
9. • It is readily killed by drying,
pasteurization and common
disinfectants
• The factors which influence the
onset of typhoid fever in man
are the infecting dose and
virulence of the organism
10. • RESERVOIR OF INFECTION: Man
is the only known reservoir of
infection (via cases & carriers)
• CASES: A case is infectious as
long as bacilli appears in stools
or urine
11. • CARRIERS: The carriers may be
temporary (incubatory,
convalescent) or chronic
• Convalescent carriers excrete
bacilli for 6-8 weeks (after which
their numbers diminish rapidly
by the end of three months)
12. • Persons who excrete bacilli for
more than one year are after
clinical attack are called chronic
carriers
13. • In most chronic carriers the
bacilli exists in gall bladder and
in the billiary tract. A chronic
carrier may excrete the bacili for
several years (may be as long as
50 years)
14. • A famous case of “Typhoid
Mary” who gave raise to 1300
cases in her life time is an
example for a chronic carrier
state
• Faecal carriers are more common
than urinary carriers
15.
16. SOURCE OF INFECTION
• The primary sources of infection
are faeces and urine of cases or
carriers
• The secondary sources include
contaminated water, food, fingers
and flies
17. HOST FACTORS
• AGE: Typhoid fever may occur at
any age
• GENDER: Males are more
affected than females
18. • IMMUNITY: All ages are
susceptible to infection
• The host factors that contributes
to resistance to the bacilli are
gastric acidity & local intestinal
immunity
19. ENVIRONMENTAL & SOCIAL
FACTORS
• Enteric fevers are observed all
throughout the year
• The peak incidence is reported
during July-September
20. • Vegetables grown in sewage
farmlands or washed in
contaminated water are positive
health hazard
21. • Typhoid bacilli grow rapidly in
milk without altering in taste or
appearance in anyway, in which
case ingestion of such raw milk
poses a threat to the consumer
22. • These factors are compounded
by such social factors as
pollution of drinking water
supplies, open air defecation and
urination, low standards of food
and personal hygiene and health
ignorance
23. • Therefore typhoid fever may be
regarded as an index of general
sanitation in any country
24. INCUBATION PERIOD
• Usually 10-14 days
• But the it can be as short as 3
days or as long as 3 weeks,
depending on the dose of bacilli
ingested
25. MODE OF TRANSMISSION
• Typhoid fever is transmitted via
the faecal-oral route or urine-
oral routes
26. • This may take place directly
through soiled hands
contaminated with faeces or
urine of cases or carriers or
indirectly by the ingestion of
contaminated water, milk, food
or through flies
28. CLINICAL FEATURES
• The onset is insidious, but in
children may be abrupt with
chills and high fever
29. • During the prodromal stage ,
there is malaise, headache,
cough and sore throat often with
abdominal pain and constipation
• The fever ascends in step ladder
fashion
30. • After about 7-10 days, the fever
reaches a plateau and the patient
looks toxic appearing exhausted
and often prostrated
• There may be marked constipation,
especially in the early stages or
“pea soup diarrhoea”
31. • There is marked abdominal
distension
• There is leukopenia and blood,
urine and stool culture is positive
for salmonella
32. • If there are no complications the
patient’s condition improves
over 7-10 days
• However relapse may occur for
up to 2 weeks after termination
of therapy
33. • During early phase, physical
findings are few
• Later splenomegaly, abdominal
distension and tenderness,
relative bradycardia, dicrotic
pulse and ocassionaly
meningsmus appear
34. • The rash (rose spots)commonly
appear during the second week of
the disease
• The individual spot , found
principally on the trunk, is a pink
papule 2-3 mm in diameter that
fades on pressure. It disappears in
in 3-4 days
36. • Serious complication occur in up
to 10 percent of patients
(especially those who have been
ill for longer than 2 weeks and
who have not received proper
treatment)
37. • Intestinal haemorrhage is
manifested by a sudden drop in
temperature and signs of shock,
followed by dark or fresh blood
in the stool
• Intestinal perforation is most
likely to occur during the third
week
38. • Less frequent complications are
urinary retention, pneumonia,
thrombophlebitis, myocarditis,
psychosis, cholecystitis, nephritis
and oeteomyelitis
39. LABORATORY DIAGNOSIS
• MICROBIOLOGICAL PROCEDURES
The definitive diagnosis of
typhoid fever depends on the
isolation of the bacilli from
blood, bone marrow and stools.
Blood culture is the mainstay of
diagnosis of this disease
40. SEROLOGICAL PROCEDURE
• Felix-Widal test measures
agglutinating antibody levels
against O & H antigens
• Usually “O” antibodies appear
on day 6-8 and “H” antibodies on
day 10-12 after the onset of
disease
41. • The test is usually performed on
an acute serum (at first contact
with the patient)
• The test has moderate sensitivity
and specificity
42. • It can be negative up to 30% of
culture – proven case of typhoid
fever
• This may be because of prior
antibiotic therapy, that has
blunted the antibody response
43. NEW DIAGNOSTIC TESTS
• The IDL tubex test can detect
specific IgM antibodies in
samples to S. Typhi
liposaccharide (LPS) antigen and
the staining of bound antibodies
by anti-human IgM antibody
conjugated to colloidal dye
particles
45. CONTROL OF TYPHOID
FEVER
• The control or elimination of the
typhoid fever is well within the
scope of modern public health
46. • There are generally three lines of
defence against typhoid fever:
• 1. Control of reservoir
• 2. Control of sanitation
• 3. Immunization
47. CONTROL OF RESERVOIR
• The usual methods of control of
reservoir are their identification,
isolation, treatment &
disinfection
48. • CASES: EARLY DIAGNOSIS –This is
of vital importance as the early
symptoms are non-specific
• Culture of blood and stools are
important investigations in the
diagnosis of cases
49. NOTIFICATION:
Notification must be done in areas
where it is mandatory
ISOLATION:
Since typhoid is an infectious
disease the cases are to be
transferred to hospital
50. • As a rule cases should be
isolated till three
bacteriologically negative
stools and urine reports are
obtained on three separate
days
53. • They are relatively inexpensive
and well tolerated and more
reliably and effectively than
chloremphenicol, ampicillin,
amoxicillin, and trimethoprim &
sulphamethoxazole
54. • Patients seriously ill and
profoundly toxic should be given
Inj of hydrocortisone 100 mg daily
for 3-4 days
• DISINFECTION: stools and urine
are the sole sources f infection.
They should be received in in
closed containers and disinfected
with 5% cresol for at least 2 hours
55. • All soiled clothes and linen
should be soaked in a solution
of 2% chlorine and be stream
sterilized
• Doctors and nurses should
disinfect their hands
56. FOLLOW UP
• Examination of stools and urine
should be should be done for
S.typhi 3-4 months after
discharge and again 12 months
to prevent development of
carrier state
57. CARRIERS:
• Since carriers are the ultimate
source of infection, their
identification and treatment is
one of the most radical ways of
controlling typhoid fever
• The following are the measures
recommended:
58. • IDENTIFICATION: Carriers are
identified by cultural and serological
examinations. Duodenal drainage
establishes the presence of
salmonella in the biliary tract of
carriers
• The antibodies are present in about
80% of chronic carriers
59. TREATMENT OF CARRIERS:
• The carriers should be given an
intensive course of ampicillin or
amoxycillin (4-6 g a day)
together with probenecid
(2g/day) for 6 weeks
60.
61. • These drugs are concentrated in
the bile and may achieve
eradication
• Chloromycetin is considered
worthless for clearing the carrier
state
63. • Urinary carriers are eassy to treat,
but refractory cases may need
nephrectomy when one kidney is
damaged and the other is healthy
• SURVEILLANCE: The carriers
should be kept under surveillance.
They should be prevented from
handling food, milk or water for
others
64. HEALTH EDUCATION
• Health education regarding
washing of hands with soap after
defecations or urination and
before preparing food is an
essential element
65. • In short, the management of
carriers continues to be an
unsolved problem
• This is the crux of the problem,
in the elimination of typhoid
66. CONTROL OF SANITATION
• Protection and purification of
drinking water supplies,
improvement of basic sanitation
and promotion of food hygiene
are essential measures to
interrupt transmission of typhoid
fever
67. IMMUNIZATION
• Immunization is a
complimentary approach in the
prevention of typhoid
• It yields the highest benefit to
the money spent
68. • Immunization against typhoid
does not give 100% protection,
but it definitely lowers both the
incidence and seriousness of the
infection
• It can be given at any age
upwards 2 years
69. • Immunization is recommended
to those who live in endemic
areas, house hold contacts and
groups at risk of infection such
as school children and hospital
staff, travellers proceeding to
endemic areas and those
attending melas and yatras
70. ANTI TYPHOID VACCINES
• Two vaccines are available:
1. Vi polyssaccharide vaccine
2. The Type 21a vaccine
71.
72. Vi POLYSSACCHARIDE VACCINE
• The vaccine is composed of
purified Vi capsular
polysaccharide from the Ty2 S
typhi strain and elicits a T-cell
independent IgG response that is
not boosted by additional doses
73. • The vaccine is administered sub
cutaneously or intra muscularly .
The target value of each single
human dose is about 25 micro
gram of antigen
• The vaccine is stable for 6 months
at 370 C and for 2 years at 220 C
74. • The recommended storage
temperature is 2-8oC.The Vi vaccine
does not elicit adequate immune
responses in children aged less than
2 yrs
• Only one dose is required and the
vaccine confers protection after 7
days of vaccination
75. • Tomaintain protection
revaccination is recommended
every three years.
• The vaccine can be co-
administered with other vaccines
(such as yellow fever, and
hepatitis A and with routine
childhood vaccinations)
76. • No serious adverse events and
minimum of local effects are
associated with Vi vaccination
• There are no contra indications
to the vaccine other than
previous hypersensitivity
reaction to vaccine components
77. THE TYPE 21a VACCINE
• Is an orally administered live
attenuated Ty2 strain of S.typhi.
The lyophilized vaccine is
available as enteric coated
capsules
79. • The vaccine has to be stored at
2-80C, it retains potency for
approximately 14 days at 250 C
• The capsules are licensed for use
in individuals aged above 5 yrs
80. • The vaccine is administered
every other day (on 3 and 5 day)
a 3-dose regimen is
recommended
• Protective immunity is achieved
7 days after the last dose
81. • The recommendation is to
repeat the series every 3 years
for people living in endemic
areas and every year for
individuals travelling from non
endemic to endemic areas