Typhoid fever

Water Borne Disease (Diseases­ Transmitted Through Water)

Typhoid fever

Definition

Typhoid fever is an acute bacterial infection mainly caused by Salmonella Typhi

Causative Organism - Salmonella Typhi.

Mode of transmission - By water and food contaminated by faeces and urine of patients and carriers. Flies may infect Food which will turn in to source of infection.

Incubation period -10 days to 14 days

Clinical manifestations

·  Fever (High grade 103 - 104F)

·  Cough and sore throat

·  Severe mental confusion

·  Fatigue

·  Weakness

·  Vomiting

·  Weight Loss

·  Headache

·  Abdominal pain

·  Severe Diarrhea

·  Severe Constipation

·  Skin rash ( pink spots)

If the typhoid fever continues untreated for more than two or three weeks, the affected individual may be delirious or unable to stand or move and which will lead to fatal complication.

Diagnosis

Widal Test

Control measures

·  Control of reservoir

·  Sanitation and hygiene.

·  Immunization

1. Control of reservoir - The usual methods of control are their identification

a.  Early Diagnosis : Culture of blood and stools are the important investigation for the confirmation of the diagnosis of cases.

b.  Notification : Notification to the health authority to prevent the spread and control the infection.

c. Isolation  :  Infected  cases  should  be isolated till     three  bacteriologically negative stools and urine.

d. Treatment - Appropriate    treatment to control the infection and prevent complications.

e. Disinfection : Stools and urine should be received in closed containers and disinfected with 5% cresol for at least 2 hours.

·  All soiled clothes and linen should be soaked in 2% chlorine solution and steam sterilized.

·  All health care providers should disinfect their hand(hand washing)

·  Follow-up examination of stools and urine should be done for typhoid 3 to 4 months.

·  Carriers should be identified by cultured and serological examination.

·  The carriers should be kept under surveillance. They should be prevented from handling food, milk or water for others.

·  Health education regarding washing of hands with soap, after defaecation or urination and before preparing food is an essential.

2. Sanitation and Hygiene

·  Protection and purification of drinking water supply.

·  Improvement of basic sanitation and promotion of food hygiene.

3. Immunization - There are two vaccines to prevent typhoid.

·  One is an inactivated (killed) Typhoid vaccine given in injection form.

·  The other is a live, attenuated (weakened) vaccine which is taken orally (by mouth).

Treatment

Appropriate Antibiotics

Nursing care

·  Maintain body temperature to normal.

·  Provide comfort measures.

·  Follow side effects of drugs.

·  Monitor vital signs.

·  Follow strict precautions such as hands washing, wearing gloves and health education to all persons about personal hygiene

·  Observe the patient closely for sign and symptoms of complications such as bowel perforation.

·  Accurately record intake and output.

·  Provide proper skin and mouth care.

Complications

·  Intestinal bleeding

·  Fresh blood in the motion

·  Intestinal perforation (occur in the third week).