Transcript Salmonella Typhi - faculty development

TYPHOID FEVER
By: Jessica Flewelling
&
Desiree May
WHAT IS TYPHOID FEVER??
TYPHOID FEVER IS A SYSTEMIC INFECTION
CAUSED BY THE BACTERIUM SALMONELLA
TYPHI.
 Symptoms
may include:
A fever of103-104
degrees F !!
 Weakness
 Stomach pains
 Loss of appetite
 Persistent headache






Diarrhea
Constipation
Bloody stools
Typhoid ulcers
In some cases there
may be a flat rose
colored rash
spotting the body.
HOW DO YOU GET TYPHOID
FEVER?
 Fecal-oral
route transmission
 Poor food hygiene
 Inadequate sanitation.
 School
children/Young adults are most
frequently affected.
 Controlled
in most industrialized areas of
the world through methods of public
sanitation and chlorination of drinking
water.
Global Instances
HOW IS TYPHOID FEVER SPREAD?
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Any infected person constantly sheds the bacteria
in feces which can infect a nearby water supply .
Most people that contract Salmonella typhi are
treated with antibiotics and fully recover from
the infection.
HOWEVER!! Some people continue to harbor the
bacteria in their body.These people are
considered Carriers.
SALMONELLA TYPHI CARRIERS
S.
typhi has a preference for the
gallbladder, and if present will
colonize the surface of gallstones,
which is how people become long
term carriers of the disease.
TYPHOID MARY: THE MOST DANGEROUS
WOMAN IN AMERICA.

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Mary Mallon (1870?1938)
She was the first
known “healthy
carrier” of the S.
typhi bacteria.
Continued working
after firm Typhoid
diagnosis.
MARY MALLON
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She worked as a cook
and servant
throughout her life.
Infected as many as
50 people, 3 of which
where fatal cases.
Mary Mallon was
taken into custody
and held in isolation
until she died in 1938.
IS IT TYPHOID FEVER ??

Stool or blood levels only definitive test for
Salmonella typhi!!

Most developing countries have little to no resources
to perform these tests.

Typhoid fever is commonly treated with three types
of antibiotics:
Ampicillin
 Septra
 Cipro


strains have developed resistant to drug therapy.
AMPICILLIN

Pharmacologic Class: Aminopenicillin
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Indications: GI infections

Actions: Inhibits cell-wall synthesis during
bacterial multiplication
(2009 Nursing Drug Handbook p. 254-255)
SEPTRA

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Pharmacological Class: Sulfonamide and folate
agonist
Indication: Traveler’s Diarrhea
Action: Inhibits formation of dihydrofolic acid
from PABA; inhibits dihydrofolate reductase
formation and decreases bacterial folic acid
synthesis. This medication is a bactericidal.
(2009 Nursing Drug Handbook p. 276-277)
CIPRO

Pharmacologic Class: Fluoroquinolone

Indication: Complicated intra-abdominal Infection

Actions: Inhibits bacterial DNA synthesis, mainly by
blocking DNA gyrase; bactericidal.
((2009 Nursing Drug Handbook p. 211-212)
SO WHAT IS SALMONELLA
TYPHI?
Human-specific
 Motile
 Rod shaped
 Flagellated
 Gram-negative
 Facultative anaerobe


The bacteria is an obligate parasite an has no
known host other than humans.

Currently, 107 strains of this bacteria have been
isolated.
WHAT ARE THE STATISTICS??

In the US there are about 400 reported cases
annually, of these cases 75% are acquired during
international travel. An estimated 16 million
people are annually affected worldwide by
Typhoid Fever with as many as 600,000 deaths.
HOW DOES S. TYPHI INFECT
IT’S VICTIM?
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Spreads from the intestines to the deeper tissues
of the liver, spleen and even bone marrow.
Once they start division, they divide about once
every 20 minutes!!
The bacteria enters the small intestine via the
microfold cells of the Peyer’s patches.The bacteria
is then released into the blood stream where it
can then circulate systemically.
PEYER’S PATCH
GET VACCINATED OR GET
TYPHOID!!

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Anyone traveling out of the
country should be vaccinated
against Typhoid.
There is two forms of
vaccination available in the
US today.
OTHER THINGS TO KNOW…
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Little is known about the origin of S. typhi.
The cause of death for historical figures such as the inventor of the
airplane, Wilbur Wright, and the Greek Empire’s Alexander the
Great.

The earliest recorded epidemic occurred in Jamestown, VA. 6,000
people died of typhoid fever in the early 17th Century.

This disease is rare in the U.S. and developed nations, but always
poses the risk of emergence.
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The first person to isolate the bacteria was Karl J. Erberth, in 1880.
WHO KNEW??!!
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Did you know that lowering the pH inside of the
bacterial cell stops it’s “motor.” Motor referring to
the cells ability to use it’s flagella to swim to
nutrients OR away from toxins.
The cells use the energy of charged H ions to fuel
this biological motor!!
A REALLY QUICK REVIEW!!

S. typhi is the bacteria
responsible for Typhoid Fever.
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Transmitted mainly by the
fecal oral route.

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Once ingested the bacteria
multiply and spread into the
bloodstream causing a
systemic infection.
Hand washing is the single
most important prevention.
BIBLIOGRAPHY
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Ochiai, R., Acosta, C., Danovaro-Holliday, M., Bhattacharya, S.,
Agtini,
M., Bhutta, Z., et al. (2008, April). A study of
typhoid fever in five
Asian countries: disease burden and
placations for controls. Bulletin of the World Health Organization,
86(4), 260-268.
Retrieved April 5, 2009, from CINAHL
Plus with Full Text database.
Ruben, J. (2003, 2003 Jan-Mar). Typhoid fever. Topics in
Emergency
Medicine, 25(1), 44-48. Retrieved April 5, 2009,
from CINAHL Plus
with Full Text database.
Crump, J., Luby, S., & Mintz, E. (2004, May). The global burden
of
typhoid fever. Bulletin of the World Health Organization,
82(5), 346353. Retrieved April 5, 2009, from CINAHL Plus
with Full Text
database.
Nursing 2009 Drug handbook. (29th ed.). (2009). Philadelphia:
Lippincott,
Williams & Wilkins.
Black, Jacquelyn G. 2008. Microbiology: Principles and
Explorations. 7th
ed. New Jersey: Prentice Hall.
BIBLIOGRAPHY CONT.
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Minamino, T. Imae, Y., Oosawa, F., Kobayashi, Y. & Oosawa, K.
Effect of intracellular pH on rotational speed of bacterial flagellar
motors. Journal of Bacteriology, 185, 1190-1194,
(2003).
Typhoid Fever. (24 October 2005). Retrieved 4 April 2009 from
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g. htm
Pollack, David V. (30 September 2003). Salmonella enterica
Typhi. Retrieved 4 April 2009, from
http://web.uconn.edu/mcbstaff/graf/student%20presentations/salmo
nellatyphi/salmonellatyphi.com
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Leavitt, J. W. (2000). Typhoid Mary: Captive to the Public’s
Boston, MA: Beacon Books,1996.
Health.
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A Weekly epideliological record: Typhoid Vaccines. No. 32 (2000). World
Health Organization, 75, 257-264.