STEPS INVOLVE IN THE CONTROL OF LARGE EPIDEMICS OF TYPHOID AND PREVENTION OF FURTHER OUTBREAK.
ABSTRACT
Typhoid fever (TF) is still an important public health problem in many eleveloping countries of the world, it is difficult to estimate the exact incidence. In Nigeria, the incidence of TF is estimated about 300-810 cases per 100,000 population per year which mean that the number of cases are 600,000 to 1 ,500,000 per year and the case fatality of TF is estimated 50,000 per year. Typhoid fetter is a systemic infection characterized by continued fever involvement of lymphoid tissues, especially of Peyer’s patches, enlargement of spleen, presence of rose spot on trunk, and constipation more commonly than diarrhea. Mode of transmission of TF is through direct and indirect contact with patients or carrier. Principal vehicles of spread are contaminated water and food. Prevention of TF based of epidemiologic factors influenced, ie. agent approach, environment strategies and host approach Strategies of prevention and control of TF are: disease surveillance, vaccination of persons at risk, detection and treatment of causes (acute and the convalescent) and detection and control of chronic carriers, improvernent of sanitation, protection of animal stocks, promotion of food hygiene and prevention of contamination in food production. Health education in community plays an important role in prevention of TE particularly about personal hygiene, such as washing hands before meal or doing something, to serve of places for washing hands with clean water in public service and restaurant and vaccination of typhoid fever.
INTRODUCTION
Typhoid fever is an acute infectious fever caused by Salmonella typhi and characterized clinically in typical cases by long continued pyrexia, headache, relative bradycardia, moderate enlargement of the spleen, abdominal tenderness, discomfort and rose colour eruption. However, typhoid fever often present atypical picture which hinder its diagnosis and thus makes it more difficult to treat (2).
Salmonella typhi enters to the human body via the gastrointestinal tract through the mouth. The bacilli invade and multiply in the lymphatic tissue of the small intestine and in the neighbouring lymphatic nodes. They enter to the blood stream via the lymphatic vessels. They tend to localize in the spleen and in the bone marrow. Gall bladder is always infected. During illness, the bacilli are disharged, from the body, to the stool and urine (3,5)
The incubation period varies with an average of two weeks, and the usual range is 1 to 3 weeks, although many cases have been reported well outside this range. There is some evidence that when the disease is water-borne, the incubation period is longer, probably due to the small probably number of organisms likely to be present. Shorter period of four to five days only is also not uncommon. The onset of TF is normally insidious, with malaise as a vague aches & pains, anorexia but typical presenting symptoms.
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