Biological Hazards Module 3

Transcription

1 1 - Objectives - Describe salmonellosis and typhoid fever (salmonella) Recognize symptoms of exposure Describe treatments available Develop a response plan 2 - Salmonellosis Definition - Severe lower GI disease Over 40,000 cases 600 deaths Salmonella typhimurium most virulent Drug-resistant strains emerged in 1990 Due to antibiotics fed to animals 3 1

2 - Salmonellosis Transmission - Salmonella in the intestinal tract Animals Reptiles Birds Contracted by eating Raw or undercooked eggs, poultry or meat Milk Uncooked vegetables and fruits Cross-contamination can occur Transfer by food handlers 4 - Symptoms of Salmonellosis - Incubation hours 4-7 days Abdominal cramps Diarrhea Fever Self-limiting 5 - Treatment For Salmonellosis - Antibiotics not recommended Person can become carrier Hydration required 6 2

3 7 - Typhoid Fever Typhoid Fever Definition - Systemic disease Salmonella serogroup typhi Isolated from: Blood Bone marrow Stool or urine 9 3

4 - Typhoid Fever Occurrence - United States annually 400 cases Worldwide annually 21 million cases 200,000 deaths 10 - People at Risk - Low risk in the U.S. 812 cases per 1 million in India Highest in the developing world Central Asia India Asia Pacific Islands 11 - Typhoid Fever Transmission - Contaminated drinking water or food Fecal contamination of water supplies Street-vended foods Carriers excrete organism 5% of infected persons Longer than 1 year Person-to-person transmission Sexual activity Flies depositing fecal matter 12 4

5 - Symptoms of Typhoid Fever - Incubation: 3 days - 3 months Initial flu-like symptoms Fever Headache Constipation Malaise Chills Unlike salmonellosis Diarrhea uncommon Vomiting not severe 13 - Symptoms of Typhoid Fever - Severe cases (continued) Confusion and delirium Intestinal perforation Death Untreated Illness may last for 3 to 4 weeks Death rates 12% to 30% 14 - Treatment For Typhoid Fever - Antimicrobial treatment Fluoroquinolones Ciprofloxacin Cephalosporins Azithromycin Increasing resistant strains Vaccines available but not always effective 15 5

6 - Response to an Outbreak - Safe water Bottled Boiled Drinks without ice Avoid popsicles Eat thoroughly cooked foods Avoid raw vegetables and fruits that cannot be peeled Avoid street vendors Upgrade water supplies 16 - Terrorist Attack - Chemical / conventional weapons When the event is over the attack is over Communicable diseases The attack continues as long as the disease spreads

7 - Typhoid Mary - Mary Mallon was a carrier of typhoid bacteria 5% of those infected do not exhibit symptoms or believe they are ill Typhoid bacteria Found in the gall bladder and intestines Excreted in stool Contaminates food when people have poor hygiene habits 19 - Typhoid Mary - (continued) Typhoid Mary first identified carrier Early 1900s 3,000 to 4,500 new cases per year in NYC 3% became carriers 90 to 135 new carriers per year Tony Labella 122 illnesses 5 deaths Isolated 2 weeks and released 20 - Typhoid Fever Characteristics - Communicable disease Can be spread by carriers with no symptoms Long incubation prior to illness People may spread disease before they become ill Net effect may be significantly more than initial release 21 7

8 - Questions - How could a terrorist use typhoid s characteristics to make an attack more effective? What would be an ideal target for the initial release? How does the incubation period affect the response? 22 -Review- Describe salmonellosis and typhoid fever (salmonella) Recognize symptoms of exposure Describe treatments available Develop a response plan