Paratyphoid A and Paratyphoid B

These are acute infectious diseases which are similar to typhoid fever.  Causing agent is bacteria belonging to Salmonella group resistant in external environment. Detergents kill them in several minutes. The only source of infection in Paratyphoid A are diseased people, and in paratyphoid B may be animals (cattle, etc) It may be transmitted orally or via objects.

Symptoms and course
As a rule, paratyphoid  A and B start gradually with symptoms of intoxication (fever, weakness), then appear nausea, vomiting, diarrhea, cough, cold, rash, helcoid damage of bowels lymphatic system.

Paratyphoid A Symptoms
Disease starts acutely in comparison with paratyphoid B. Incubation period lasts from 1 to 3 weeks. Is characterized with nausea, vomiting, diarrhea, cough, cold with possible face reddness and herpes appearing. Rash appears on 4 – 7 day. In the course of the disease are possible several waves of rashing. Temperature is remittent. Spleen increases rarely. In peripheral blood often are found lymphopenia, leucocytosis, eosinocyte. Here is maintained high possibility of backsets.

Paratyphoid B Symptoms
Incubation period is shorter than in haratyphoid A. It may course differently. In transmission of infection via water the disease starts gradually and its course is mild. When salmonella enters human body with foods occurs its massive entry in the body with prevailing gastroenteric conditions (gastroenteritis) with its further spread in other organs. Paratyphoid B may course in mild or severe forms. Backsets occur rarely. Rash may appear and sometimes it is heavy enough. Spleen and liver increase in the very onset of disease.

Treatment
Must be complex and includes care, diet, etiotropic and nosotropic medications, and in some cases immune stimulants. Is recommended bed regimen up to 6-7th day of normal body temperature, since 7th day is permitted to get seated and since 10th day to walk. Food must be digestible reducing impact on digestive tract. Doctors prescribe laevomycetin (0,5g four times a day) up to 10th day of normal temperature. To increase effectiveness of casual treatment in order to prevent patient from backsets and chronic forms, it must be performed along with medications that stimulate body defences and increasing body resistance (vaccine)

Preventive Measures:

• improvement of water supply quality
• sanitary purification of conglomerations and canalization
• fighting with flies

Typhoid Fever

Typhoid fever is an acute contagious disease associated with bacteria of the genius Salmonella. The agent can be kept in the ground and in the water from 1 to 15 months. It dies when healed and under the action of the usual detergents.

The only source of incidence is infected person and the carrier. The rods of Typhoid fever are transmitted directly by dirty hands, flies, waste waters. Most dangerous are outbreaks connected with taking infected foods (milk, cold meat, etc).

Symptoms and course
Incubation period lasts from 1 to 3 weeks. In typical cases the Typhoid fever starts gradually. The diseased experience such symptoms as weakness, rapid fatigability, moderate headache. In the next days those symptoms do increase, the temperature of the body raises up to 39-40 "С, appetite do lowers or totally disappears, the sleep is interrupted (sleepiness by day and insomnia by night). Also patient can have stool retention and windiness. Till 7-9 day of the disease rush may appear on the upper parts of abdomen skin or on lower parts of the chest. The rush is represented by small red spots with sharp edge having diameter 23mm rising over skin surface and are called roseolas. A new roseola may appear in the place where a roseola disappeared.

The next symptoms are common for patients: restraint, face paleness, decrease in heart rate, lower blood pressure. Also may appear specific bronchitis. The tongue  may be dry and cracky, covered with muddy brown fur, edges and tip of the tongue having no fur. Also may appear rude curmurring of the intestinum cecum and pain of right iliac region, liver and spleen may get increased. The number of leukocytes in peripheral blood is lowered.

To recognize the Typhoid fever is very important to detect early symptoms such as high body temperature lasting more than one week, headache, lowering of physical activity, breakdown, sleeping disorders, appetite disorders, specific rush, sensitivity during palpation of the right part of the abdomen, the increase of the liver and spleen. In laboratory are used next analysis for diagnosis updating: immunofluorescence method and serologic testing.  

Treatment
For the treatment is used antimicrobial agent called laevomycetin which is prescribed 0,5-0,75gr 4 times per day for 10-12 days. Intravenous is injected 5% glucose solution or normal saline 500-1000gr. In severe cases are injected corticosteroids. Patients should remain at bed rest minimum 7-10 days.

Preventive Measures
1. sanitary inspection of food processors, water systems, canalization
2. early detection of patients and their isolation
3. disinfection of rooms, clothes, utensils
4. fight with flies
5. after disease dispensary observation
6. specific vaccination