Typhoid fever (also known simply as typhoid) is a symptomatic bacterial infection that is characterized by various mild to severe symptoms, including fever, marked headache, and malaise. Other reported symptoms include anorexia, relative bradycardia, splenomegaly, nonproductive cough in the early stages of the illness, visible rose spots in the trunk, and constipation more often than diarrhea in adults (Heymann, 2015). The causative agent of typhoid is Salmonella enterica serovar typhi. Salmonella organisms penetrate the mucosa of both the small and large bowel, coming to lie intracellularly, where they proliferate. Initially S. typhi proliferates in the lower small intestine from where systemic dissemination occurs to the liver, spleen, and reticuloendothelial system. For a period of one to three weeks the organism multiplies within these organs. (Singh, 2011).
The bacteria prosper in environments with unsanitary condition, contaminated drinking water and poor sanitation. Once in the environment, the pathogen invades a human body (a host) through contaminated drinking water or food. The infection can be contracted through the fecal-oral route by eating food handled by someone with typhoid fever who has not washed carefully after using the toilet or drinking contaminated water with the bacteria (MedlinePlus, 2015).
The diagnosis of carrier status is established by culturing the organism from the relevant specimen of the suspected person. The causal organisms can be isolated from blood early in the disease, and from urine and feces after the first week. Blood culture is the standard for diagnosis for typhoid fever, but bone marrow culture provides the most sensitive method for bacteriological confirmation (Heymann,...
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... macaroni salad to the typhoid outbreak in Schenectady.
The case study states that there were twenty-one known chronic typhoid carriers in the city. Margaret Bennett had 11 consecutive positive stools, even as late as the October following the church supper, but she showed no symptoms of typhoid. She prepared both macaroni salad and potato salad for the supper in May, and all thirteen of the people with symptoms ate either or both the macaroni salad or potato salad from the supper. Two other people prepared potato salad to the supper, but nobody else prepared macaroni salad. Our hypothesis as to what might have caused the outbreak is that M. Bennett was a chronic typhoid carrier and did not properly wash her hands before or while preparing the macaroni salad for the supper, and she spread the bacteria to the other attendees, thereby causing the outbreak.
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