A Simple Guide to Typhoid Fever

A Simple Guide to Typhoid Fever
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What is Typhoid Fever?
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Typhoid Fever is an acute febrile illness caused by the Salmonella typhi bacteria.

What is the cause of Typhoid Fever?
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The bacteria which causes Typhoid Fever is the Salmonella typhi which is an extremely hardy bacteria able to live in polluted water, contaminated food and soiled clothes.
Oral ingestion of the bacteria leads to penetration of the small bowel mucosa and rapid spread to lymphatics, lymph nodes and blood stream.
Once it entered the bloodstream, fever occur.
It then enters the spleen, liver and gallbladder and penetrates into the mucosa of the rest of the intestine, causing thinning of the walls of the bowels.
Incubation period is 5-10 days.

What are symptoms of Typhoid Fever?
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The main symptoms of Typhoid Fever are
1. Fever which becomes higher and higher like a step ladder

2. headache

3. abdominal pain

4. green pea soup type of diarrhea

5. enlarged spleen and liver

6. delirium and disorientation from high fever and dehydration

7. lassitude and tiredness

8. rose spots rash on the body

Symptoms usually appear within 5-10 days after exposure to the germ and last for 3-4 weeks.

How is Typhoid Fever transmitted?
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Typhoid Fever can be highly contagious.
The germs are commonly transmitted by food handlers who are typhoid carriers.
People can get the germs from contaminated food and drinks.

How is the diagnosis of Typhoid Fever made?
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Doctors generally diagnose Typhoid Fever based on the symptoms and a physical examination.
Confirmation is by blood tests(Widal test), blood and stool cultures.

What are the complications of Typhoid Fever?
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Typhoid Fever is a disease which can kill especially through its complications:
1.Intestinal hemorrhage

2.Intestinal perforation

3.Cholecystitis

4.dehydration especially in young children and the very old patients

How is Typhoid Fever treated?
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Thypoid is an infectious disease which can spread to other people through soiled clothes, contaminated food.
It is therefore advisable to quarantine the patient in hospitals.

Antibiotics is the main treatment against typhoid.
The best antibiotic is chloramphenicol but because of its side effects of aplastic anemia it should be avoided especially in pregnant women and young children.
Other antibiotics used are septrin(co-timoxazole) and ampicillin.
Antibiotics should be continued for at least 2 weeks.

Symptomatic treatment includes:
1.Paracetamol for relief of fever and headache
Aspirin is to be avoided to prevent intestinal bleeding.

2.antispasmodic drug to stop abdominal cramps

3.medicine to harden the stools such as kaolin

4.slow down the intestinal movement (lomotil or loperamide).

Prompt treatment may be needed to prevent dehydration:
Dehydration can be caused by diarrhea, excessive sweating from the high fever, or by not drinking enough fluids because of loss of appetite.
Mild dehydration can be treated by drinking liquids.
Severe dehydration may require intravenous fluids.
Untreated severe dehydration can be life threatening especially in babies, young children and the elderly.

Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.
Get plenty of rest.

Complications such as intestinal perforation may require surgical treatment.

How is Typhoid Fever prevented?
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Prevention of typhoid is usually by vaccination of all food handlers and staff working in restaurants.

Food handlers should always wash their hands after going to the toilets and before cooking food.
They should always wear gloves when handling or cooking food.

Treatment of chronic typhoid carriers with antibiotics such as ampicillin for 6 months and removal of gallbladder which may harboured the bacteria.

You can avoid infection by:
Avoid eating or drinking foods or liquids that might be contaminated

Good food hygience

A Simple guide to Whooping Cough

A Simple guide to Whooping Cough
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What is Whooping Cough?
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Whooping cough is an acute infectious childhood disease of the respiratory tract caused by the bacillus Bordetella pertussis.

How is Whooping Cough transmitted?
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Whooping Cough is transmitted by droplets from coughing spells.

It is highly infectious.

The early stage when it appears to be a cold is the most infectious peroid.

Most infections occur in children under six years of age.

One attack usually confers immunity

What are the Signs and Symptoms of Whooping Cough?
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The incubation peroid is usually 10 - 12 days after contact with an infected child.
Symptoms start off with:
1.an ordinary cold (runny nose, sneezing, cough, fever) for 1-2 weeks followed by:

2.uncontrolled coughing that can last 1 - 2 months.

Cough persists and become paroxysmal ending in a noisy inspiration "whoop" sound causing the child to go blue and vomit.

Between the spasms of coughing the child seems relatively well

What are the complications of Whooping Cough?
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The worst affected are children below the 1 year old.
Some serious complications are:
1.pneumonia,

2.seizures,

3.brain damage

4.nose bleeds

5.death can occur during the severe coughing stage.

Serious complications are less with older children or adults.

Adults rarely get whooping cough because their immmunity from vaccination usually last 10 years after the last dose.

When adults get whooping cough, a prolonged, irritating cough may be present instead of whooping type of cough.

What is the Treatment of Whooping Cough?
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Antibiotics (erythromycin) are used in the treatment of Whooping cough.

Once severe coughing has begun, antibiotics are less effective. They can reduce the duration of the illness and stop the spread to others.

Family members should be treated once there is an infected person.

Tetracycline is used if the patient is allergic to erythromycin but should avoided in children because of the staining of the teeth.

Besides antibiotics, the following will help:
1.Steam inhalation

2.cough mixtures

3.oxygen therapy

4.avoid smokes, dust, dry air,sudden temperature change

What is the Prevention for Whooping Cough?
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Vaccination against whooping cough is the best prevention .

Since vaccination began, the worldwide incidence of whooping cough has declined.

Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.

There is a booster vaccination at 18 months.

In very rare cases (1 in 100,000 cases), there has been serious reactions such as seizures to the whooping cough part of the vaccination.

Recently, an improved acellular pertussis vaccine is now available. There are fewer side effects such as high fever and seizureswith this new vaccine.

A Simple Guide to Hand, Foot & Mouth Disease

A Simple Guide to Hand, Foot and Mouth Disease
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What is Hand, Foot and Mouth Disease?
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Hand, Foot and Mouth Disease (HFMD) is an infectious disease usually occurring in children which causes ulcers in the mouth and maculopapular rashes(sometimes blisters) on the palms of the hands and soles of the feet.
Because of the locations of the lesions, the illness is thus called Hand, Foot and Mouth Disease.

What causes Hand, Foot and Mouth Disease?
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Hand, Foot and Mouth Disease is caused by the Coxsackie virus and Enterovirus 71.
Of the 2 viruses the enterovirus is more dangerous with some fatalities in severe cases.
Fatalities are usually due to complications involving the heart and nervous system.
It is usually a mild illness with the rash healing in 5 to 7 days.

How is Hand, Foot and Mouth Disease spread?
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HFMD is usually spread through the direct contact with the nasal discharge, saliva, faeces and fluid from the rash of an infected person.

Both adults and children can be affected.

Young children below five years are more prone to the infection.

What are the Symptoms of Hand, Foot and Mouth Disease?
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The symptoms usually start after a prodromal peroid of 3 days with:

1.fever

2.sore throat

3.ulcers in the throat, mouth and tongue

4.rash with vesicles (small blisters-- 3-7 mm) on hands, feet and buttock area.
The rash are typically on the palm side of the hands, the sole side of the feet and very characteristic (maculopapular then vesicle) in appearance.

5.loss of appetite

6.headache and bodyaches in the older child or adult

What is the Treatment of Hand, Foot and Mouth Disease?
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There is no specific cure for an viral infection other than symptomatic relief of symptoms.

Antibiotics is not effective and is not indicated.
Paracetamol can given to treat fever.

Drinking lots of water and fluids is important even though sometimes swallowing may be painful.
More fluid is required when a fever is present.

Rinsing of mouth with salt water may soothe the pain of mouth ulcers.

A soft or liquid diet should be given rather than solid food.

Avoid sour fruits or their juices which can cause pain to the mouth ulcers.

Rest and adequate sleep is also important in the child's recovery.

Parents should also be alert to any change in their child's normal behaviour, e.g. irritation and sleepiness.
Should they refuse to eat or drink, have persistent vomiting or drowsiness, parents should bring their child immediately to hospital.

What is the Prevention for Hand, Foot and Mouth Disease?
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All infected children should be kept away from crowded public places (such as schools, preschools, play groups, markets and public transport).

All family members should follow good hygiene practices, including frequent hand washing, to limit the spread of the infection.

A Single Attack usually gives lifelong Immunity!