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Investigation

Microbiological procedures
Culture: Blood, stool or rectal
swab
Colony characteristic :
MacConkey agar
Serological procedures
Serological identification of
Salmonella
Slide Agglutination test
Felix-Widal test

Blood Cultures in Typhoid Fevers


Bacteremia occurs early in
the disease
Blood Cultures are positive
in
1st week in 90%
2nd week in 75%
3rd week in 60%
4th week and later in 25%

Identification of Salmonella
Sub cultures are done after overnight incubation at
370c,and subcultures are done on Mac Conkey's agar
Subcultures are repeated upto 10 days after futher
incubation.

Salmonella on Mac Conkey's agar

Salmonella on XLD agar

Slide agglutination tests


In slide agglutination tests
a known serum and
unknown culture isolate is
mixed, clumping occurs
within few minutes
Commercial sera are
available for detection of A,
B,C1,C2,D, and E.

Investigation

The Widal test is commonly used to diagnose Typhoid.

Looks for salmonella


antibodies against antigens
O-somatic and H-flagellar)
antibodies in the blood of an
infected individual cause the
bacteria to bind together into
clumps (the Widal reaction).

Treatment
In most cases typhoid fever is not
fatal.
Antibiotics such as ampicillin,
chloramphenicol, trimethethoprimsulfamethoxazole, and
ciprofloxican.
These antibiotics have been used
in most developed countries.

Chloramphenicol
Chloramphenicol was the
original prescribed drug to
patients with Typhoid Fever.
However due to certain
side effects, this drug has
been replaced by others.
Chloramphenicol

Resistance
Resistance to ampicillin,
chloramphenicol, trimethoprimsulfamethoxazole and streptomycin
are common drugs used against
Typhoid but have now become
resistant.
These drugs have not been used in
over 20 years.
Typhoid that is resistant to multiple
drugs is known as multidrug-resistant
typhoid (MDR typhoid).

How can Typhoid be avoided?


Avoid risky foods or drinks
Get vaccinated
Use only clean water
Ask for drinks without ice
unless you know where its
coming from
Only eat foods that have
been thoroughly cooked
Avoid raw fruits and
vegetables
Avoid food and drinks from
street vendors

Attention Travelers!

Vaccines are now available to those who are traveling abroad to


underdeveloped countries.

Who should get typhoid vaccine?

Travelers to parts of the world where Typhoid Fever is very


common.

People who work with or come in contact with a carrier of the


disease.

Laboratory analysts who work with the Salmonella Typhi


bacteria.

Vaccinations
The vaccine was discovered in
1897 by Almroth Edward
Wright.
There are two types of
vaccinations available:
Inactive (killed) vaccine in a shot
(Vi capsular polysaccharide
vaccine)
Live, attenuated (weakened)
vaccine taken orally (Ty21a)
Typhoid Vaccination

Vaccinations
Vaccine Name

Ty21a (Vivotif
Berna,
Swiss
Serum
and
Vaccine
Institute)
ViCPS
(Typhim
Vi,
Pasteur
Merieux)

How given

Number of
doses
necessary

Time between
doses

Total time
needed to
set aside
for
vaccinatio
n

Minimum age
for
vaccination

Booster needed
every...

1 capsule
by mouth

2 days

2 weeks

6 years

5 years

Injection

N/A

2 weeks

2 years

2 years