Enteric fever (Typhoid fever):
Enteric fever is common fever that is seen in India and is common tropical disease caused due to the bacteria salmonella typhi.
Enteric fever is an acute intestinal infection caused by salmonella typhi,characterised by insidious onset of fever,intense headache with relative bradycardia,red coloured eruptions,abdominal discomfort and splenomegaly.
- Enteric fever is commonly seen worldwide,with cases recorded all over the globe.
- Enteric fever is common in summer season.
- Enteric fever is caused due to the bacteria salmonella typhi.
- Source of Enteric fever is asymptomatic carrier(asymptomatic carrier means person who has the infection in his body but without any symptoms and has 100 % chance of spread the disease to others).
- Enteric fever is transmitted by faeco-oral route.
- Enteric fever is spread by 5 F’s(fly,fluid,finger,food and formites).
- Predisposing factors of Enteric fever are poor resistance,overcrowding,poor sanitation,malnutrition,malnutrition.
- Incubation period is 7-21 days.
Clinically Enteric fever is characterised by symptoms which have variations and symptoms lasts in 4 week
In First week,onset of symptoms is insidious,fever more in the evening,frontal headache,bodyache,anorexia,constipation,distension of abdomen,lassitude. Step ladder rise of fever with fever rising at the end of the week.
In second week,fever continous to peak,headache is reduced,marked prostration,apathy,listlessness,delirium,stupor,cough,epitaxis,distension of abdomen. In second week,rashes start appearing especially on the trunk. Rashes are macular,2-4 mm in diameter,appears in crop,fades on pressure.
In third week,with mild infection(with favourable outcome)symptoms like prostration,appetite returns,fever subsides by lysis,abdominal symptoms subside. With severe outcomes,symptoms like marked prostration,fever falls to lysis,delirium stupor,carphology,muscular twitchings,incontinence of urine.
Especially seen in third week of the disease state-intestinal haemorrhage,intestinal perforation,peritonitis,renal failure. In fourth week,symptoms subsides all the generals are normal with appetite normal,fever comes to normal.
Bed rest,cold sponging in high fever,diet-liquid diet consisting of fruit juice,maintain oral hygiene,maiantain electrolyte and fluid balance.
Isolation of Food handlers to be excluded from work till shown as not to be chronic carriers,immunisation is contraindicated in outbreak control,for when it is given in incubation period as it can precipitate the clinical disease.
early detection and treatment of cases and carriers,survillance and education of chronic carriers,hygienic disposal of sewage disposal,pure water supply,pasteurisation of milk.
Immunisation in endemic areas,travellers and laboratory workers.