伤寒英文教案.pptVIP

DEFINITION. Typhoid fever is a bacterial disease caused by Salmonella typhi. It is characterized by prolonged fever, abdominal pain, diarrhea, delirium, rose spots, and splenomegaly and complicated sometimes by intestinal bleeding and perforation.  Typhoid fever * * ETIOLOGY. The typhoid bacillus is a motile gram-negative rod in the family Enterobacteriaceae. It possesses a flagellar (H) antigen, a cell wall (0) lipopolysaccharide antigen, and a polysaccharide virulence (Vi) antigen located in the cell capsule. The polysaccharide side chain of the 0 antigen confers serologic specificity to the organism and is essential in virulence because ellae other than S.typhi and S. enteritidis bioserotype paratyphi A or B do not produce enteric fever in humans. INCIDENCE AND PREVALENCE. Typhoid fever has been almost eliminated from developed countries because of sewage and water treatment facilities but remains a common disease in developing countries. In 1980, the number of cases occurring yearly was estimated as about 7 million in Asia, over 4 million in Africa, and 0.5 million in Latin America. About 500 cases are diagnosed each year in the United States, and over half of these are in recently arrived travelers who contracted their infections abroad. EPIDEMIOLOGY. Adults and children of all ages and both genders appear equally susceptible to infection. In developing countries, most cases occur in school-age children and young adults. Although acquired immunity provides some protection, reinfections have been documented. Typhoid fever occurs during all seasons. Transmission is by the fecal-oral route through contaminated water or food. The main human sources of infection in the community are asymptomatic fecal carriers and cases during either disease or convalescence. Females and older males are prone to become chronic fecal carriers S. typhi is resistant to drying and cooling, Vi-phage typing of S. typhi is a useful epidemiologic tool to trace cases