Typhoid fever

An acute infectious disease caused by bacteria of the genus Salmonella. The pathogen can persist in the soil and water to 1-5 months. It dies when heated, and the action of conventional disinfectants.
The only source of infection - a sick man and bacillicarriers. Sticks typhoid transferred directly dirty hands, flies, sewage. Dangerous outbreaks associated with the consumption of infected food products (milk, cold meats, etc.).
The incubation period lasts from 1 to 3 weeks. In typical cases, the disease begins gradually. Patients noted weakness, fatigue, mild headache. In the following days these phenomena increase, body temperature begins to rise to 39- 40 "C, decreases or disappears appetite, disturbed sleep (insomnia, sleepiness during the day and at night). There is a delay of a chair, phenomena of flatulence. By 7-9 day disease on the skin of the upper sections abdomen and lower parts of the chest, usually on the anterolateral surface, there is a characteristic rash, which is a small red spots with sharp edges, diameter 23 mm, towering above the skin level (roseola). In place of the disappearing roseola may appear new. Characterized by a peculiar lethargy patients . pallor, slowing heart rate and lowering blood pressure over the lungs are heard scattered dry hriny - a manifestation of a specific bronchitis tongue dry, cracked, covered with dirty-brown or brown patina, edge and tip of the tongue free from plaque from the teeth imprints observed rough rumbling blind.. colon and tenderness in the right lower abdomen, liver and spleen were enlarged on palpation. Reduces the number of leukocytes in peripheral blood, particularly neutropenia and eosinophilia.
ESR is normal or increased to 15-20 mm / h. By 4 weeks the condition of patients gradually improved, lowered body temperature, headache disappears, appetite appears. Threatening complication of typhoid fever is intestinal perforation and intestinal bleeding.
In recognition of the disease it is very important the timely detection of the main symptoms: high temperature of the body for longer than a week, headache, weakness - reduced motor activity, lack of energy, sleep disturbances, loss of appetite, a characteristic rash, sensitivity to palpation in the right iliac abdomen, enlarged liver and spleen. From laboratory tests to confirm the diagnosis used bacteriological (immunofluorescent method), blood cultures on Wednesday Rappoport or bile broth; serology - reactions Vidal et al.
The main antimicrobial agent - chloramphenicol. Assign 0,50,75 g, 4 times a day for 10-12 days to normal temperature. Intravenously administered 5% glucose solution, isotonic sodium chloride solution (500-1000 mg). In severe cases - corticosteroids (predpizolon at a dose of 30-40 ml per day). Floor must comply with strict bed rest for at least 7-10 days.
Sanitary supervision of food businesses, water supply, sewerage. Early identification of patients and their insulation. Disinfection of premises, clothes, utensils, which is boiled after drinking, fighting flies. Clinical supervision for convalescents typhoid. Specific vaccination vaccine (unnec- essary tautology).