Typhoid, Non-Typhoid Salmonella, Pertussis and Rabies

Typhoid Fever

Caused by Salmonella enterica serovar Typhi.

Feco-oral transmission through contaminated food/water.

Typhoid Fever

•Gradual onset of fever, abdominal pain, rose spots, hepatosplenomegaly.

•Complications: intestinal perforation, hemorrhage.

Blood Culture

Gold Standard for Typhoid Fever

Typhoid Conjugate Vaccine (TCV)

Vaccine for Typhoid Fever

Non-Typhoid Salmonella (NTS)

• Salmonella enterica serovars other than Typhi/Paratyphi (e.g., Enteritidis, Typhimurium).

• Foodborne: undercooked poultry, eggs, dairy.

Non-Typhoid Salmonella (NTS)

•Acute gastroenteritis: diarrhea, fever, vomiting.

•Risk of invasive disease in immunocompromised, children, elderly.

Non-Typhoid Salmonella (NTS)

common cause of foodborne illness in the Philippines, often linked to the consumption of contaminated poultry, eggs, and dairy products.

Pertussis (Whooping Cough)

•Caused by Bordetella pertussis

•Highly contagious; spread via droplets.

• PCR

• Culture from Nasopharyngeal swab

• Lymphocytosis in CBC

Diagnostic test for Pertussis (Whooping Cough)

Cocooning Strategy

vaccinating those in close contact with infants, helps protect vulnerable populations from pertussis.

Pertussis

A 2-month-old infant presents with bouts of coughing, apnea, and

vomiting after feeding. Older siblings had a recent cold.

What is the likely diagnosis?

Lyssavirus

Rabies is caused by what virus

Furious Rabies

hydrophobia, agitation

1-3months

Incubation period for Rabies

Paralytic Rabies

Flaccid Paralysis

Negri bodies, RT-PCR

Post Mortem Confirmation for Rabies (2)

Rabies

endemic in the Philippines, with dog bites being the primary mode of transmission to humans.

Rabies Control Program

guidelines on the utilization of funds for rabies prevention and control activities.

Category III (single or multiple transdermal bites or scratches, licks on

broken skin).

A 17-year-old boy is bitten by a neighbor’s dog. He cleans the wound with soap but does not seek medical care for 5 days. The dog is unvaccinated and later disappears.

Q1: What is the risk classification for this exposure?

Typhoid Fever

Following a typhoon, an evacuation center housing 500 residents reports multiple cases of high-grade fever with abdominal pain and diarrhea. Most evacuees rely on a single temporary water source and communal toilet facilities.

What is most likely etiology of the outbreak?

Non-Typhoidal Salmonella

A barangay health center reports a cluster of acute gastroenteritis cases. All patients report eating kwek-kwek (battered quail eggs) from the same street vendor. Symptoms included fever, diarrhea, and abdominal cramping.

Q1: What is the likely organism?

Street food

common source of NTS in low-resource settings.

Pertussis (whooping cough)

A 3-month-old infant, partially immunized, develops paroxysmal cough and apnea. Investigation reveals that the teenage cousin had a "bad cold" 2 weeks prior. The mother reports fear of vaccine side effects as the reason for delay.

What is the most probable diagnosis?

27-36 weeks

Pertussis in infants can be fatal. WHO and DOH recommend maternal Tdap at _______ weeks gestation and routine DTP immunization starting at 6 weeks.