Biological Hazards Module 3
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NORTHERN ILLINOIS UNIVERSITY – COPYRIGHT 2007
- Objectives y Describe salmonellosis and typhoid
fever (salmonella)
y Recognize symptoms of exposure
y Describe treatments available
y Develop a response plan
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- Salmonellosis Definition y Severe lower GI disease
 Over 40,000 cases
 600 deaths
y Salmonella typhimurium most virulent
y Drug-resistant strains emerged in 1990
 Due to antibiotics fed to animals
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NORTHERN ILLINOIS UNIVERSITY – COPYRIGHT 2007
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Biological Hazards Module 3
- Salmonellosis Transmission y Salmonella in the intestinal tract
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Animals
Reptiles
Birds
y Contracted by eating
 Raw or undercooked eggs, poultry or meat
 Milk
 Uncooked vegetables and fruits
y Cross-contamination can occur
 Transfer by food handlers
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- Symptoms of Salmonellosis y Incubation 12-72 hours
y 4 -7 days
 Abdominal cramps
 Diarrhea
 Fever
y Self-limiting
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- Treatment For Salmonellosis y Antibiotics not recommended
 Person can become carrier
y Hydration required
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Biological Hazards Module 3
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NORTHERN ILLINOIS UNIVERSITY – COPYRIGHT 2007
- Typhoid Fever -
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- Typhoid Fever Definition y Systemic disease
y Salmonella serogroup typhi
y Isolated from:



Blood
Bone marrow
Stool or urine
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Biological Hazards Module 3
- Typhoid Fever Occurrence y United States annually
 400 cases
y Worldwide annually
 21 million cases
 200,000 deaths
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- People at Risk y Low risk in the U.S.
y 812 cases per 1 million in India
y Highest in the developing world
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
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Central Asia
India
Asia
Pacific Islands
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- Typhoid Fever Transmission y Contaminated drinking water or food
 Fecal contamination of water supplies
 Street-vended foods
y Carriers excrete organism
 5% of infected persons
 Longer than 1 year
y Person-to-person transmission
 Sexual activity
y Flies depositing fecal matter
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Biological Hazards Module 3
- Symptoms of Typhoid Fever y Incubation: 3 days - 3 months
y Initial flu-like symptoms
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
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
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Fever
Headache
Constipation
Malaise
Chills
y Unlike salmonellosis
 Diarrhea uncommon
 Vomiting not severe
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- Symptoms of Typhoid Fever (continued)
y Severe cases
 Confusion and delirium
 Intestinal perforation
 Death
y Untreated
 Illness may last for 3 to 4 weeks
 Death rates 12% to 30%
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- Treatment For Typhoid Fever y Antimicrobial treatment


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Fluoroquinolones
Ciprofloxacin
Cephalosporins
Azithromycin
y Increasing resistant strains
y Vaccines available but not
always effective
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Biological Hazards Module 3
- Response to an Outbreak y Safe water
 Bottled
 Boiled
y Drinks without ice
y Avoid popsicles
y Eat thoroughly cooked foods
y Avoid raw vegetables and fruits that
cannot be peeled
y Avoid street vendors
y Upgrade water supplies
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- Terrorist Attack y Chemical / conventional weapons
 When the event is over the attack is over
y Communicable diseases
 The attack continues as long as the disease spreads
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Biological Hazards Module 3
- Typhoid Mary y Mary Mallon was a carrier of
typhoid bacteria
y 5% of those infected do not
exhibit symptoms or believe
they are ill
y Typhoid bacteria
 Found in the gall bladder and
intestines
 Excreted in stool
 Contaminates food when people
have poor hygiene habits
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- Typhoid Mary (continued)
y Typhoid Mary first
identified carrier
y Early 1900s
 3,000 to 4,500 new cases per
year in NYC
 3% became carriers
 90 to 135 new carriers per
year
y Tony Labella
 122 illnesses
 5 deaths
 Isolated 2 weeks and released
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- Typhoid Fever Characteristics y Communicable disease
y Can be spread by carriers with no symptoms
y Long incubation prior to illness
 People may spread disease before they become ill
y Net effect may be significantly more than
initial release
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Biological Hazards Module 3
- Questions y How could a terrorist use
typhoid’s characteristics to
make an attack more
effective?
y What would be an ideal
target for the initial
release?
y How does the incubation
period affect the
response?
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- Review y Describe salmonellosis and typhoid fever
(salmonella)
y Recognize symptoms of exposure
y Describe treatments available
y Develop a response plan
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