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EPIDEMIOLOGY 
OF 
TYPHOID
EPIDEMIOLOGY OF TYPHOID 
• STUDY ABOUT TYPHOID 
• APPLYING THE STUDY TO 
CONTROL TYPHOID
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
AGENT 
SALMONELLA TYPHI 
SALMONELLA PARATYPHI A 
SALMONELLA PARATYPHI B PARATYPHOID 
SALMONELLA PARATYPHI C FEVER
• THEY GET KILLED BY 
DRYING 
PASTEURIZATION 
COMMON DISINFECTANTS 
• THEY CAN SURVIVE WELL IN ICE
• 3 ANTIGENS 
O ANTIGEN 
H ANTIGEN 
Vi ANTIGEN
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
HOST 
AFFECTS ANY AGE 
OFTEN 5-20 YRS
•AFFECTS BOTH SEX 
• MALES MORE THAN FEMALES
IMMUNITY 
• GASTRIC ACIDITY AND INTESTINAL 
IMMUNE SYSTEMS 
• CELL-MEDIATED IMMUNITY PLAYS 
THE MAJOR ROLE
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
ENVIROMENTAL FACTOR 
• SEEN COMMONLY DURING JULY – 
SEPTEMBER 
• BACILLI CAN SURVIVE WELL IN ICE 
CREAMS , MILK , SEWAGE 
• POLLUTION OF WATER AND SOIL BY 
DEFECATION AND URINATION
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
MODE OF TRANSMISSION 
• FAECAL-ORAL ROUTE 
• URINE-ORAL ROUTE
• DIRECTLY 
• INDIRECTLY
• 
CONTAMINATED 
FOOD 
CONTAMINATION OF SOIL AND WATER 
FLIES
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
PATHOGENESIS
1. TYPHOID BACTERIA ENTER THE MOUTH REACHES 
ILEUM SEGMENT OF SMALL INTESTINE 
2. BACTERIA PIERCES THROUGH THE MUCOSAL CELL 
AND GETS ENGULFED BY THE MACROPHAGE IN 
THE PEYERS PATCHES 
3. THESE MARCROPHAGES WILL ENTER THE BLOOD 
STREAM FROM SMALL INTESTINE AND GOES TO 
ORGANS LIKE LIVER , SPLEEN AND BONE MAROW 
4. BACTERIA STARTS MULTIPLYING INSIDE THESE 
MACROPHAGES AND BURSTS OUT . THEN 
INVADES MORE MACROPHAGES IN THESE 
ORGANS . AFTER A POINT SPILLAGE OF BACTERIA 
INTO THE BLOOD STREAM HAPPENS CAUSING 
SYMPTOMS
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
CLINICAL FEATURES 
INCUBATION PERIOD 10-14 DAYS 
• FIRST WEEK 
• SECOND WEEK 
• THIRD WEEK
CLINICAL FEATURES 
• First week 
FEVER 
HEADACHE 
CONSTIPATION OR DIARRHOEA
CLINICAL FEATURES 
• SECOND WEEK 
ROSE SPOTS 
COUGH 
SPLENOMEGALY 
HEPATOMEGALY
CLINICAL FEATURES 
• THIRD WEEK 
COMPLICATIONS: 
PERFORATION 
HAEMORRHAGE 
MENINGITIS 
MYOCARDITIS 
NEPHRITIS 
& 
DEATH
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
CARRIERS 
• INCUBATORY CARRIER 
• CONVALESCENT CARRIER 
• CHRONIC CARRIER
MARY MALLON / TYPHOID MARY / 
MARY BROWN
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTOR 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
LAB DIAGNOSIS 
• CULTURE – BLOOD, BONE MARROW, 
STOOL 
• WIDAL’S TEST – O & H ANTIBODIES 
ESTIMATION
• NEW DIAGNOSTIC TESTS 
IDL TUBES TEST 
TYPHIDOT 
TYPHIDOT M
STUDY OF TYPHOID 
• AGENT 
• HOST 
• ENVIROMENTAL FACTORS 
• MODE OF TRANSMISSION 
• PATHOGENESIS 
• CLINICAL FEATURES 
• CARRIERS 
• LAB DIAGNOSIS 
CONTROL OF TYPHOID
CONTROL OF TYPHOID 
• CONTROL OF RESERVOIRS (TYPHOID 
CASES AND CARRIERS) 
• CONTROL OF SANITATION 
• IMMUNIZATION
CONTROL OF RESERVOIR 
• TYPHOID CASES 
1. DIAGNOSIS 
2. NOTIFICATION 
3. ISOLATION 
4. TREATMENT –FLUROQUINOLONES , 
AMPICILLIN , AMOXYCILLIN , 
TRIMETHOPRIM-SULFAMETHOXAZOLE 
5. DISINFECTION 
6. FOLLOW UP
CONTROL OF RESERVOIR 
• CARRIERS 
1. IDENTIFICATION 
2. TREATMENT – AMOXYCILLIN, 
AMPICILLIN , SURGERY 
3. SURVEILLANCE 
4. HEALTH EDUCATION
CONTROL OF TYPHOID 
• CONTROL OF RESERVOIRS (CASES 
AND CARRIERS) 
• CONTROL OF SANITATION 
• IMMUNIZATION
CONTROL OF SANITATION 
• PROVIDING CLEAN WATER TO PUBLIC 
• PROPER DISPOSAL OF EXCRETA 
• PROTECTION OF WATER SOURCES FROM 
CONTAMINATION
CONTROL OF TYPHOID 
• CONTROL OF RESERVOIRS (CASES 
AND CARRIERS) 
• CONTROL OF SANITATION 
• IMMUNIZATION
IMMUNISATION 
• 2 VACCINES 
Vi VACCINE 
LIVE ORAL VACCINE / 
Ty21a VACCINE
Vi VACCINE 
• CONTAINS Vi CAPSULAR ANTIGEN 
• ADMINISTERED S.C OR I.M 
• GIVEN FOR ≥ 2 YRS 
SCHEDULE 
• ONLY 1 DOSE REQIURED 
• RE VACCINATION AFTER 3 YRS 
• NO ADVERSE EFFECTS NOR 
CONTRAINDICATIONS
LIVE ORAL VACCINE / Ty21a VACCINE 
• CONTAINS LIVE ATTENUATED Ty21 STRAIN 
• ADMINISTERED ORALLY 
• GIVEN AS CAPSULES ( 5 YRS ) OR LIQUID FORM ( 2 YRS ) 
SCHEDULE 
• GIVEN ON 1ST 3RD AND 5TH DAY 
• REVACCINATION SHOULD BE DONE 
EVERY 3 YRS FOR PEOPLE LIVING IN ENDMEC AREA 
EVERY 1 YR IN TRAVELLERS 
CONTRAINDICATIONS 
• NO ANTIBIOTICS SHOULD BE TAKEN WITH IT 
• SHOULD NOT BE GIVEN DURING DIARRHOEA 
• NOT TO BE GIVEN IN IMMUNO DEFICIENT PATIENTS
CONTROL OF TYPHOID 
• CONTROL OF RESERVOIRS (CASES 
AND CARRIERS) 
• CONTROL OF SANITATION 
• IMMUNIZATION
Typhoid

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Typhoid

  • 2.
  • 3. EPIDEMIOLOGY OF TYPHOID • STUDY ABOUT TYPHOID • APPLYING THE STUDY TO CONTROL TYPHOID
  • 4. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 5. AGENT SALMONELLA TYPHI SALMONELLA PARATYPHI A SALMONELLA PARATYPHI B PARATYPHOID SALMONELLA PARATYPHI C FEVER
  • 6. • THEY GET KILLED BY DRYING PASTEURIZATION COMMON DISINFECTANTS • THEY CAN SURVIVE WELL IN ICE
  • 7. • 3 ANTIGENS O ANTIGEN H ANTIGEN Vi ANTIGEN
  • 8. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 9. HOST AFFECTS ANY AGE OFTEN 5-20 YRS
  • 10. •AFFECTS BOTH SEX • MALES MORE THAN FEMALES
  • 11. IMMUNITY • GASTRIC ACIDITY AND INTESTINAL IMMUNE SYSTEMS • CELL-MEDIATED IMMUNITY PLAYS THE MAJOR ROLE
  • 12. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 13. ENVIROMENTAL FACTOR • SEEN COMMONLY DURING JULY – SEPTEMBER • BACILLI CAN SURVIVE WELL IN ICE CREAMS , MILK , SEWAGE • POLLUTION OF WATER AND SOIL BY DEFECATION AND URINATION
  • 14. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 15. MODE OF TRANSMISSION • FAECAL-ORAL ROUTE • URINE-ORAL ROUTE
  • 16. • DIRECTLY • INDIRECTLY
  • 17. • CONTAMINATED FOOD CONTAMINATION OF SOIL AND WATER FLIES
  • 18.
  • 19. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 21. 1. TYPHOID BACTERIA ENTER THE MOUTH REACHES ILEUM SEGMENT OF SMALL INTESTINE 2. BACTERIA PIERCES THROUGH THE MUCOSAL CELL AND GETS ENGULFED BY THE MACROPHAGE IN THE PEYERS PATCHES 3. THESE MARCROPHAGES WILL ENTER THE BLOOD STREAM FROM SMALL INTESTINE AND GOES TO ORGANS LIKE LIVER , SPLEEN AND BONE MAROW 4. BACTERIA STARTS MULTIPLYING INSIDE THESE MACROPHAGES AND BURSTS OUT . THEN INVADES MORE MACROPHAGES IN THESE ORGANS . AFTER A POINT SPILLAGE OF BACTERIA INTO THE BLOOD STREAM HAPPENS CAUSING SYMPTOMS
  • 22. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 23. CLINICAL FEATURES INCUBATION PERIOD 10-14 DAYS • FIRST WEEK • SECOND WEEK • THIRD WEEK
  • 24. CLINICAL FEATURES • First week FEVER HEADACHE CONSTIPATION OR DIARRHOEA
  • 25. CLINICAL FEATURES • SECOND WEEK ROSE SPOTS COUGH SPLENOMEGALY HEPATOMEGALY
  • 26. CLINICAL FEATURES • THIRD WEEK COMPLICATIONS: PERFORATION HAEMORRHAGE MENINGITIS MYOCARDITIS NEPHRITIS & DEATH
  • 27. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 28. CARRIERS • INCUBATORY CARRIER • CONVALESCENT CARRIER • CHRONIC CARRIER
  • 29. MARY MALLON / TYPHOID MARY / MARY BROWN
  • 30. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTOR • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 31. LAB DIAGNOSIS • CULTURE – BLOOD, BONE MARROW, STOOL • WIDAL’S TEST – O & H ANTIBODIES ESTIMATION
  • 32. • NEW DIAGNOSTIC TESTS IDL TUBES TEST TYPHIDOT TYPHIDOT M
  • 33. STUDY OF TYPHOID • AGENT • HOST • ENVIROMENTAL FACTORS • MODE OF TRANSMISSION • PATHOGENESIS • CLINICAL FEATURES • CARRIERS • LAB DIAGNOSIS CONTROL OF TYPHOID
  • 34. CONTROL OF TYPHOID • CONTROL OF RESERVOIRS (TYPHOID CASES AND CARRIERS) • CONTROL OF SANITATION • IMMUNIZATION
  • 35. CONTROL OF RESERVOIR • TYPHOID CASES 1. DIAGNOSIS 2. NOTIFICATION 3. ISOLATION 4. TREATMENT –FLUROQUINOLONES , AMPICILLIN , AMOXYCILLIN , TRIMETHOPRIM-SULFAMETHOXAZOLE 5. DISINFECTION 6. FOLLOW UP
  • 36. CONTROL OF RESERVOIR • CARRIERS 1. IDENTIFICATION 2. TREATMENT – AMOXYCILLIN, AMPICILLIN , SURGERY 3. SURVEILLANCE 4. HEALTH EDUCATION
  • 37.
  • 38. CONTROL OF TYPHOID • CONTROL OF RESERVOIRS (CASES AND CARRIERS) • CONTROL OF SANITATION • IMMUNIZATION
  • 39. CONTROL OF SANITATION • PROVIDING CLEAN WATER TO PUBLIC • PROPER DISPOSAL OF EXCRETA • PROTECTION OF WATER SOURCES FROM CONTAMINATION
  • 40. CONTROL OF TYPHOID • CONTROL OF RESERVOIRS (CASES AND CARRIERS) • CONTROL OF SANITATION • IMMUNIZATION
  • 41. IMMUNISATION • 2 VACCINES Vi VACCINE LIVE ORAL VACCINE / Ty21a VACCINE
  • 42. Vi VACCINE • CONTAINS Vi CAPSULAR ANTIGEN • ADMINISTERED S.C OR I.M • GIVEN FOR ≥ 2 YRS SCHEDULE • ONLY 1 DOSE REQIURED • RE VACCINATION AFTER 3 YRS • NO ADVERSE EFFECTS NOR CONTRAINDICATIONS
  • 43. LIVE ORAL VACCINE / Ty21a VACCINE • CONTAINS LIVE ATTENUATED Ty21 STRAIN • ADMINISTERED ORALLY • GIVEN AS CAPSULES ( 5 YRS ) OR LIQUID FORM ( 2 YRS ) SCHEDULE • GIVEN ON 1ST 3RD AND 5TH DAY • REVACCINATION SHOULD BE DONE EVERY 3 YRS FOR PEOPLE LIVING IN ENDMEC AREA EVERY 1 YR IN TRAVELLERS CONTRAINDICATIONS • NO ANTIBIOTICS SHOULD BE TAKEN WITH IT • SHOULD NOT BE GIVEN DURING DIARRHOEA • NOT TO BE GIVEN IN IMMUNO DEFICIENT PATIENTS
  • 44. CONTROL OF TYPHOID • CONTROL OF RESERVOIRS (CASES AND CARRIERS) • CONTROL OF SANITATION • IMMUNIZATION