Terzhienn-domm : diforc'h etre ar stummoù

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[[File:Salmonella typhi typhoid fever PHIL 2215 lores.jpg|thumb|upright=1.2|Pikoù roz degaset gant an derzhienn-domm]]
An '''derzhienn-domm''' pe '''terzhienn-alter''' zo ur c'hleñved degaset gant [[bakteri]] ar [[Salmonella typhi|''Salmonella enterica serovar typhi'']]. <!-- NOTE: This "odd" nomenclature is, in fact, correct. See [[Salmonella enterica]] entry for details.-->
An '''derzhienn-domm''' pe '''terzhienn-alter''' zo ur c'hleñved degaset gant [[bakteri]] ar [[Salmonella typhi|''Salmonella enterica serovar typhi'']].<br>
Tapet e vez pa lonker boued pe evajoù, dour peurgetket, saotret gant [[feilhañs]].
*{{en}} LONGe, Jacqueline L. : ''Gale's Encyclopedia of Medicine'', Gale Group, 2001 {{ISBN|978-0-7876-5494-8}}
<!-- {{for|a similar disease with a similar name|typhus}}
{{for|a related disease which is caused by a different bacterium|Paratyphoid fever}}
{{for|the character in the 2005 film [[Elektra (2005 film)|Elektra]]|Typhoid (Elektra)}}
{{Infobox_Disease |
Name = {{PAGENAME}} |
Image = Salmonella typhi.jpg |
Caption = ''[[Salmonella]]'' typhi bacteria |
DiseasesDB = 27829 |
ICD10 = {{ICD10|A|01|0|a|00}} |
ICD9 = {{ICD9|002}} |
ICDO = |
OMIM = |
MedlinePlus = |
eMedicineSubj = oph |
eMedicineTopic = 686 |
eMedicine_mult = {{eMedicine2|med|2331}} |
MeshID = D014435 |
<!-- Common worldwide, it is transmitted by the [[fecal-oral route]] — the ingestion of food or water contaminated with [[feces]] from an infected person.<ref name=Baron>{{cite book | author = Giannella RA | chapter = Salmonella | title = Baron's Medical Microbiology ''(Baron S ''et al'', eds.)| edition = 4th ed. | publisher = Univ of Texas Medical Branch | year = 1996 | url = http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.1221 | isbn = 0-9631172-1-1 }}</ref> The bacteria then multiply in the blood stream of the infected person and are absorbed into the digestive tract and eliminated with the waste.
The organism is a Gram-negative short bacillus that is motile due to its peritrichous flagella. Optimal temperature is 37 degrees Celsius. --> <!-- ==Symptoms==
Typhoid fever is characterized by a sustained [[fever]] as high as 40°C (104°F), profuse sweating, [[gastroenteritis]], and [[diarrhea]]. Less commonly a [[rash]] of flat, rose-colored spots may appear.<ref> {{cite web|url=http://www.cdc.gov/ncidod/dbmd/diseaseinfo/typhoidfever_g.htm |title=CDC Typhoid Fever |accessdate=2007-10-02 |date=2005-10-25 |publisher=Center for Disease Control }}</ref>
Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. In the first week, there is a slowly rising temperature with relative [[bradycardia]], malaise, headache and cough. [[Epistaxis]] is seen in a quarter of cases and abdominal pain is also possible. There is [[leukopenia]] with [[eosinopenia]] and relative [[lymphocytosis]], a positive diazo reaction and blood cultures are positive for Salmonella typhi or paratyphi. The classic [[Widal test]] is negative in the first week.
In the second week of the infection, the patient lies prostrated with high fever in plateau around 40°C and bradycardia (Sphygmo-thermic dissociation), classically with a dicrotic pulse wave. Delirium is frequent, frequently calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". Rose spots appear on the lower chest and abdomen in around 1/3 patients. There are [[rhonchi]] in lung bases. The abdomen is distended and painful in the right lower quadrant where [[borborygmi]] can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green with a characteristic smell, comparable to pea-soup. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly) and tender and there is elevation of liver [[transaminases]]. The Widal reaction is strongly positive with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage.
In the third week of typhoid fever a number of complications can occur:
* Intestinal hemorrhage due to bleeding in congested [[Peyer's patches]]; this can be very serious but is usually non-fatal.
* Intestinal perforation in distal [[ileum]]: this is a very serious complication and is frequently fatal. It may occur without alarming symptoms until [[septicaemia]] or diffuse [[peritonitis]] sets in.
* [[Encephalitis]]
* Metastatic abscesses, [[cholecystitis]], [[endocarditis]] and [[osteitis]]
The fever is still very high and oscillates very little over 24 hours. Dehydration ensues and the patient is delirious (typhoid state). By the end of third week [[defervescence]] commences that prolongs itself in the fourth week.
Diagnosis is made by [[blood culture|blood]], [[bone marrow]] or [[stool]] cultures and with the [[Widal test]] (demonstration of salmonella [[antibody|antibodies]] against [[antigens]] [[O-somatic]] and [[H-flagellar]]). In [[epidemic]]s and less wealthy countries, after excluding [[malaria]], [[dysentery]] or [[pneumonia]], a therapeutic trial time with [[chloramphenicol]] is generally undertaken while awaiting the results of Widal test and blood cultures.<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | isbn = 0838585299 }}</ref>
[[Image:John Vachon Inoculation.jpg|right|thumb|Doctor administering a typhoid vaccination at a school in San Augustine County, Texas. Photograph by [[John Vachon]], April 1943.]]
Typhoid fever in most cases is not fatal. [[Antibiotics]], such as [[ampicillin]], [[chloramphenicol]], [[trimethoprim-sulfamethoxazole]], and [[ciprofloxacin]], have been commonly used to treat typhoid fever in developed countries. Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%.
When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. [[Vaccine]]s for typhoid fever are available and are advised for persons traveling in regions where the disease is common (especially [[Asia]], [[Africa]] and [[Latin America]]). [[Typhim Vi]] is an intramuscular killed-bacteria vaccination and [[Vivotif]] is an oral live bacteria vaccination, both of which protect against typhoid fever. Neither vaccine is 100% effective against typhoid fever and neither protects against unrelated [[typhus]].
Resistance to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole and [[streptomycin]] is now common, and these agents have not been used as first line treatment now for almost 20 years. Typhoid that is resistant to these agents is known as multidrug-resistant typhoid (MDR typhoid).
Ciprofloxacin resistance is an increasing problem, especially in the [[Indian subcontinent]] and [[Southeast Asia]]. Many centres are therefore moving away from using ciprofloxacin as first line for treating suspected typhoid originating in India, Pakistan, Bangladesh, Thailand or Vietnam. For these patients, the recommended first line treatment is [[ceftriaxone]].
There is a separate problem with laboratory testing for reduced susceptibility to ciprofloxacin: current recommendations are that isolates should be tested simultaneously against ciprofloxacin (CIP) and against [[nalidixic acid]] (NAL), and that isolates that are sensitive to both CIP and NAL should be reported as "sensitive to ciprofloxacin", but that isolates testing sensitive to CIP but not to NAL should be reported as "reduced sensitivity to ciprofloxacin". However, an analysis of 271 isolates showed that around 18% of isolates with a reduced susceptibility to ciprofloxacin ([[Mean inhibitory concentration|MIC]] 0.125–1.0 mg/l) would not be picked up by this method.<ref>{{cite journal | title=Fluoroquinolone resistance in ''Salmonella'' Typhi (letter) | author=Cooke FJ, Wain J, Threlfall EJ | journal=Brit Med J | year=2006 | volume=333 | issue=7563 | pages=353–4 }}</ref> It not certain how this problem can be solved, because most laboratories around the world (including the West) are dependent disc testing and cannot test for MICs .
[[Image:Typhoid stats.gif|thumb|right|Death rates for Typhoid Fever in the U.S. 1906-1960]]
Flying insects feeding on feces may occasionally transfer the bacteria through poor hygiene habits and public sanitation conditions. Public education campaigns encouraging people to wash their hands after toileting and before handling food are an important component in controlling spread of the disease. According to statistics from the United States [[Center for Disease Control]], the [[chlorination]] of drinking water has led to dramatic decreases in the transmission of typhoid fever in the U.S..
A person may become an [[asymptomatic carrier]] of typhoid fever, suffering no symptoms, but capable of infecting others. According to the [[Centers for Disease Control]] approximately 5% of people who contract typhoid continue to carry the disease after they recover. The most famous asymptomatic carrier was [[Typhoid Mary]]. She was a young cook that was responsible for infecting about 25 people (killing three) in Oyster Bay, New York, in 1915. This was the first time a perfectly healthy person was known to be responsible for an "epidemic".
[[Image:Typhoid feverI.gif|thumb|right|Locations of typhoid outbreaks worldwide]]
With an estimated 16-33 million cases of typhoid annually resulting in 500,000 to 600,000 deaths In endemic areas, the [[World Health Organisation]] identifies typhoid as a serious public health problem. Its incidence is highest in children between the ages of 5 and 19 years.<ref name="who">{{cite web | title = Typhoid Fever | publisher = World Health Organisation | url = http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index7.html | accessdate = 2007-08-28}}</ref>
==Heterozygous advantage==
It is thought that [[cystic fibrosis]] may have risen to its present levels (1 in 1600 in UK) due to the [[heterozygous advantage]] that it confers against typhoid fever. The [[Cystic fibrosis transmembrane conductance regulator|CFTR protein]] is present in both the lungs and the intestinal epithelium, and the mutant cystic fibrosis form of the CFTR protein prevents entry of the typhoid bacterium into the body through the intestinal epithelium.
Around 430–426 B.C., a devastating [[pandemic|plague]], which some believe to have been typhoid fever, killed one third of the population of [[History of Athens|Athens]], including their leader [[Pericles]]. The balance of power shifted from Athens to [[Sparta]], ending the [[Golden Age of Pericles]] that had marked Athenian dominance in the ancient world. Ancient historian [[Thucydides]] also contracted the disease, but he survived to write about the plague. His writings are the primary source on this outbreak. The cause of the plague has long been disputed, with modern academics and medical scientists considering [[epidemic typhus]] the most likely cause. However, a 2006 study detected [[DNA]] sequences similar to those of the bacterium responsible for typhoid fever.<ref name=Papagrigorakis_2006>{{cite journal | author=Papagrigorakis MJ, Yapijakis C, Synodinos PN, Baziotopoulou-Valavani E | title=DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens | journal=Int J Infect Dis | year=2006 | pages=206–14 | volume=10 | issue=3 | id=PMID 16412683} }}</ref> Other scientists have disputed the findings, citing serious methodologic flaws in the dental pulp-derived DNA study.<ref name=Shapiro_2006>{{cite journal |author=Shapiro B, Rambaut A, Gilbert M |title=No proof that typhoid caused the Plague of Athens (a reply to Papagrigorakis et al.) |journal=Int J Infect Dis |volume=10 |issue=4 |pages=334–5; author reply 335–6 |year=2006 |id=PMID 16730469}}</ref> The disease is most commonly transmitted through poor hygiene habits and public sanitation conditions; during the period in question, the whole population of [[Attica]] was besieged within the [[Long Walls]] and lived in tents.
In the late 19th century, typhoid fever mortality rate in [[Chicago]] averaged 65 per 100,000 people a year. The worst year was 1891, when the typhoid death rate was 174 per 100,000 persons.<ref name=CPL>{{cite web | title=1900 Flow of Chicago River Reversed | work=Chicago Timeline | url=http://www.chipublib.org/004chicago/timeline/riverflow.html | publisher = Chicago Public Library | accessdate=2007-02-08}}</ref> The most notorious carrier of typhoid fever—but by no means the most destructive—was [[Mary Mallon]], also known as Typhoid Mary. In [[1907]], she became the first [[United States|American]] carrier to be identified and traced. She was a cook in [[New York]]; some believe she was the source of infection for several hundred people. She is closely associated with forty-seven cases and three deaths.<ref name=Nova>{{cite web | title=Nova: The Most Dangerous Woman in America | url=http://www.pbs.org/wgbh/nova/typhoid/letter.html}}</ref> Public health authorities told Mary to give up working as a cook or have her [[gall bladder]] removed. Mary quit her job but returned later under a [[Pseudonym|false name]]. She was detained and [[quarantine]]d after another typhoid outbreak. She died of pneumonia after 26 years in quarantine.
In 1897, [[Almroth Edward Wright]] developed an effective vaccine.
Most developed countries saw declining rates of typhoid fever throughout first half of 20th century due to vaccinations and advances in public sanitation and hygiene. Antibiotics were introduced in clinical practice in 1942, greatly reducing mortality. At the present time, incidence of typhoid fever in developed countries is around 5 cases per 1,000,000 people per year.
An outbreak in the [[Democratic Republic of Congo]] in 2004-05 recorded more than 42,000 cases and 214 deaths.<ref name="who"/>
=== Famous typhoid victims ===
<!-- 25 September 2006. add Reports of Osama bin Laden's death due to "Typhoid" are conjectural at this point. [[WP:NOT|Wikipedia is not a news sources, nor a crystal ball]]. Please refrain from adding him to the List of typhoid victims until solid confirmation has occurred -->
<!-- Please do not add individuals for whom no Wikipedia article exists, or where typhoid is not listed as the definitive cause of death --><!--
Famous people who have succumbed to the disease include:
* [[Wilbur Wright]] Brother of [[Orville Wright]]
* [[Abigail Adams]], U.S. President [[John Adams]]'s wife
* [[Albert of Saxe-Coburg-Gotha]], British [[prince consort]], [[Queen Victoria]]'s husband
* [[John Buford]]
* [[Stephen A. Douglas]]
* [[Alexander Alexandrovich Friedman]]
* [[Mark Hanna]]
* [[K. Hedgewar]], founder of Rashtriya Swayamsewak Sangh
* [[Archduke Karl Ludwig of Austria]]
* [[Mary Henrietta Kingsley]]
* [[Joseph Lucas]]
* [[Leland Stanford, Jr.]]
* [[Henry Frederick Stuart]], [[Prince of Wales]], original heir to the throne of [[James I of England]]
* [[Evangelista Torricelli]]
* [[Godfrey Weitzel]], [[major general]] in the [[Union army]] during the [[American Civil War]]
* [[Ignacio Zaragoza]]
* [[Belle Boyd]] the female confederate spy
* [[Frank McCourt]], author
* [[Joseph Smith Jr.]], first Prophet of The Church of Jesus Christ of Latter Day Saints, aka [[Mormons]] -->
== Daveoù ==
=== Levrlennadur ===
* ''Gale's Encyclopedia of Medicine'', embannet gant Thomas Gale e 1999, ISBN
== Liammoù diavaez ==
{{commons|Typhoid fever}}
*{{en}} {{cite web|url=http://www.netdoctor.co.uk/travel/diseases/typhoid.htm|title=Pennad diwar an derzhienn-domm evit ar veajerien|accessdate22 Mezheven 2019}}
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*{{en}} {{cite web|url=http://www.medicalnewstoday.com/medicalnews.php?newsid=36578|title=Pennad diwar an derzhienn-domm ha faezhidigezh Aten|accessdate=22 Mezheven 2019}}
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[[Rummad:Kleñvedoù degaset gant bakteri]]
[[la:Typhus (morbus)]]
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