Paratyphoid

Escherichia coli and Klebsiella pneumoniae subsp, aerogenes produce acid from lactose on this medium, altering the colour of the indicator, and also adsorb some of the indicator which may be precipitated around the growing cells. The organisms causing typhoid and paratyphoid fever and bacillary dysentery do not ferment lactose, and colonies of these organisms appear transparent. 

Salmonella typhi is the causal organism of typhoid fever, Sal. paratyphi causes paratyphoid fever, whilst Sal. typhimurium, Sal. enteritidis and very many other closely related organisms are a cause of bacterial food poisoning. 

Bacillus for paratyphoid are destroyed. A residence time of 14 days at >35°C in a small-scale system in a developing country can provide 99+% removal of pathogens, with the exception of roundworm [20, 21]. 

Human disease caused by Salmonella generally falls into four categories acute gastroenteritis (enterocolitis), bacteremia, extraintestinal localized infection, and enteric fever (typhoid and paratyphoid fever), and a chronic carrier state. S. typhimurium is the most common cause of salmonellosis. Salmonellosis is a disease primarily of infants, children, and adolescents. 

Thaver D, Zaidi AK, Critchley J, Madni SA, Bhutta ZA. Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever). Cochrane Database Syst Rev 2005. 

Chloramphenicol remains a major treatment of typhoid and paratyphoid fever in developing countries. However, with increasing resistance to ampicillin, trimethoprim-sulfamethoxazole and, to some extent, chloramphenicol, fluoroquinolones and some third-generation cephalosporins (e.g., ceftriaxone) have become the drugs of choice. Salmonella infections, such as osteomyelitis, meningitis and septicemia, have also been indications for chloramphenicol use. Nevertheless, antibiotic resistance patterns can be a problem. As noted previously, nonty-phoidal salmonella enteritis is not benefited by treatment with chloramphenicol or other antibiotics. 

E. Chloramphenicol is no longer the treatment of choice for any bacterial infection because of the potentially fatal chloramphenicol-induced bone marrow suppression. In the past it has been used against the infections indicated in choices A, B, C, and D. It remains a major treatment for typhoid and paratyphoid fever in some developing countries, since alternative drugs are much more expensive. 

Agafonov VI, Liashenko NI, Novikov NL (1984) Epidemiology of typhoid-paratyphoid infections and their prophylactics. Voenno-Meditsinskii Zhumal (Russian Mriitary-Med J ) 6 36-40... 

Salmonella typhi Bacteremia paratyphoid fever typhoid fever Ceftriaxone, ciprofloxacin, or cefotaxime Trimethoprim-sulfamethoxazole... 

In 58 Japanese patients with typhoid fever, 42 with paratyphoid fever, and one with both typhoid fever and paratyphoid fever, almost 80% of whom were treated with tosufloxacin, there were adverse effects (nausea, urticaria, aphthous stomatitis) in 3.6% and raised serum amylase in 8.3% (1). All the adverse reactions resolved with or without a change in drug therapy. 

Ohnishi K, Kimura K, Masuda G, Tsunoda T, Ghana M, Yoshida H, Goto T, Sakaue Y, Kim YK, Sakamoto M, Sagara H. Oral administration of fluoroquinolones in the treatment of typhoid fever and paratyphoid fever in Japan. Intern Med 2000 39(12) 1044-8. 

Typhoid vaccine (including typhoid-paratyphoid vaccine)... 

There have been individual reports of fatal angio-immunoblastic lymphadenopathy, hemolytic uremic syndrome (after typhoid/paratyphoid/diphtheria vaccination), fatal hyperpyrexia (SED-11, 687), transverse myelitis (SEDA-10, 288), erythema nodosum (SEDA-11,289) (SEDA-14, 281), and Reiter s sjmdrome (SEDA-15, 350). 

Pathogens Pathogenic organisms that can transmit communicable diseases via wastewater. Typical notified infectious diseases reported are cholera, typhoid, paratyphoid fever, salmonellosis, and shigellosis. E. coli and fecal coli are indicators of pathogens. 

Specific Salmonella serotypes produce characteristic human disease. For example S. enterica serotypes Typhimurium or Enteri-tidis causes gastroenteritis, whereas serotypes Typhi or Paratyphi causes enteric fever. Clinical manifestations produced by Salmonella serotypes commonly include acute gastroeuteritis (euterocolitis), bacteremia, extraiutestiual locahzed iufectiou, euteric fever (typhoid aud paratyphoid fever), aud a chrouic carrier state. 

Enteric Eever (Typhoid and Paratyphoid). Enteric fever caused by serotype Typhi is called typhoid fever. If caused by any other serotype, it is referred to as paratyphoid fever. The clinical... 

This is particnlarly the case with the non-typhoid, non-paratyphoid enteric salmonella infections. Morbidity and mortality are high in developing countries, particularly in children. Salmonella infection is the commonest food borne disease causing gastroenteritis in developed countries affecting aU ages and particularly patients with immunodeficiency who are at higher risk. 

---