Paraphysical B characteristics, symptoms, treatment, prevention

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Basil Manning
Paraphysical B characteristics, symptoms, treatment, prevention

The paralytic B o Salmonella Schottmuellen is a serotype of Salmonella responsible for producing paratyphoid fever B, a gastrointestinal infectious disease similar to typhoid fever but milder, although it can also produce severe episodes of gastroenteritis, septicemia and meningitis in young children.

Most infections caused by Salmonella paratific B are the product of contamination of food or water with feces from infected patients.

Salmonella (Source: Roinujs [CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0)] via Wikimedia Commons)

Reptiles, including turtles, have been recognized and well studied as a reservoir for the Salmonella, so they are a source of infection for man. Some children who have pet turtles have been infected with salmonella paratype B, developing severe infections.

Many salmonellosis present with mild gastroenteritis and even remit without treatment. However, they can present with severe complications such as septicemia and meningitis, particularly in young children, the elderly and immunosuppressed patients, and can have fatal outcomes..

Characteristics

In developed countries, most cases of enteric fevers caused by Salmonella tific or paratphic are produced by people who have traveled or come from endemic areas or areas where these infections are very common.

Studies carried out in England between 2007 and 2010 on epidemiological surveillance of cases of typhoid and paratyphoid fever, show that most of the cases were of people who traveled to endemic areas or who were in contact with people from endemic areas.

These studies showed that they were most commonly infected with serotypes of typhus and paratype A and the lowest incidence (4%) was with serotype B-paratype. In the case of B-paratype patients, the average onset of symptoms was during travel. or within 21 days after return from endemic areas.

In France in the 1990s, two outbreaks occurred caused by goat cheese made from unpasteurized goat's milk contaminated with Salmonella paratific B. The cases presented as gastroenteritis and septicemia and the source of contamination of the goat's milk was not identified.

Fountain

The most important source of contamination with Salmonella paratific B is the consumption of contaminated water, ice or food, especially raw food and those that were washed with contaminated water. Contamination generally comes from human feces from sick patients or healthy carriers.

However, the origin of an infection can come from contamination with feces of reptiles carrying the Salmonella paratific B. Contamination with flies that can land on contaminated food has also been described.

Turtles, for example, may have the Salmonella in their intestinal tract without being sick, being able to distribute it through the feces by the water or any surface in contact with it.

Turtle photography (Image by Capri23auto on Pixabay.com)

Many serotypes of Salmonella associated with salmonellosis have been found in reptiles. These include: Salmonella Paratyphi B (S. Paratyphi B), S. Poona, S. Pomona, S. Marina, S. Stanley, S. Litchfield, S. Newport and the most common serotypes S. Typhimurium and S. Enteritidis.

Among reptiles, turtles represent a special interest because they are a risk to the health of young children as they are frequently kept as pets..

Paratyphoid serotype B transmitted by tortoises can cause gastroenteritis or enteric fever and cause serious complications in young children or immunosuppressed patients, including septicemia and meningitis..

Symptoms and diagnosis

There are a series of clinical, laboratory and epidemiological criteria that allow defining cases of typhoid or paratyphoid fever..

Clinical criteria

Person with prolonged fever and at least two of the following four manifestations:

- Headache.

- Relative bradycardia.

- Dry cough.

- Diarrhea or constipation, malaise, or abdominal pain.

Paratyphoid fever B, when it presents as enteric fever, has the same symptoms as typhoid, but milder. However, it can present as gastroenteritis with frank diarrhea or with some complications such as meningitis and septicemia, as already explained above..

Laboratory criteria

Isolation of Salmonella paratyphic B in a blood or stool sample.

Epidemiological criteria

At least one of the following three epidemiological relationships:

- Exposure to a common source: exposure to the same source or vehicle of infection as a confirmed case.

- Person-to-person transmission: person who has had close contact with a laboratory-confirmed case.

- Exposure to contaminated food or water: person who has consumed laboratory confirmed contaminated food or products from a laboratory confirmed infected or colonized animal.

Treatment

Many cases infected with paratyphoid B that present as mild gastroenteritis resolve even without treatment, simply with rest and oral rehydration..

In the case of more severe gastroenteritis, parenteral rehydration and antibiotics may be required..

There is an extensive list of antibiotics that can be used for these cases, among these we can name the following:

- Amoxicillin / Clavulanic Acid

- Tetracycline

- Streptomycin

- Kanamycin

- Gentamicin

- Nalidixic acid

- Ciprofloxacin

- Chloramphenicol

- Trimethoprim / sulfamethoxazole

- Sulfonamide-derived compounds such as sulfadiazine, sulfathiazole, and sulfamerazine sodium.

Treatment will depend on the resistance of the strains involved and the severity and type of infection. In some cases, such as meningitis complicated by brain abscesses, treatments must be prolonged for at least 4 weeks to avoid relapses..

Prevention

The prevention and control of salmonellosis in general and specifically those that cause typhoid and paratyphoid fever, are in charge of the health authorities, which are the entities in charge of epidemiological surveillance, detection, diagnosis, treatment and follow-up of cases and possible contacts.

The health authorities are also in charge of tracing the origin or source of contamination in order to take the pertinent health measures..

In these cases, sick people who are not hospitalized will not be able to attend schools, jobs or nurseries until the health authorities indicate it..

Infected people will not be able to handle food, care for children, the sick or residential care until the health authorities indicate it..

People who travel to endemic areas should avoid street food and drinks, should not eat raw food as much as possible, should not consume ice and should preferably drink bottled or treated water.

Fruits and vegetables should be washed with boiled or bottled water and it is advisable to wash your hands before eating, drinking or smoking or handling any food or drink..

References

  1. Balasegaram, S., Potter, A. L., Grynszpan, D., Barlow, S., Behrens, R. H., Lighton, L.,… & Lawrence, J. (2012). Guidelines for the public health management of typhoid and paratyphoid in England: practice guidelines from the National Typhoid and Paratyphoid Reference Group. Journal of Infection, 65(3), 197-213.
  2. Denny, J., Threlfall, J., Takkinen, J., Lofdahl, S., Westrell, T., Varela, C.,… & Straetemans, M. (2007). Multinational Salmonella Paratyphi B variant Java (Salmonella Java) outbreak, August-December 2007. Euro Surveill, 12(12), E071220.
  3. Desenclos, J. C., Bouvet, P., Benz-Lemoine, E., Grimont, F., Desqueyroux, H., Rebiere, I., & Grimont, P. A. (1996). Large outbreak of Salmonella enterica serotype paratyphi B infection caused by a goats' milk cheese, France, 1993: a case finding and epidemiological study. BMJ, 312(7023), 91-94.
  4. Hernández, E., Rodriguez, J. L., Herrera-León, S., García, I., De Castro, V., & Muniozguren, N. (2012). Salmonella Paratyphi B var Java infections associated with exposure to turtles in Bizkaia, Spain, September 2010 to October 2011. Eurosurveillance, 17(25), 20201.
  5. Levine, M. M., Ferreccio, C., Black, R. E., Lagos, R., Martin, O. S., & Blackwelder, W. C. (2007). Ty21a live oral typhoid vaccine and prevention of paratyphoid fever caused by Salmonella enterica Serovar Paratyphi B. Clinical Infectious Diseases, Four. Five(Supplement_1), S24-S28.
  6. Nagano, N., Oana, S., Nagano, Y., & Arakawa, Y. (2006). A severe Salmonella enterica serotype Paratyphi B infection in a child related to a pet turtle, Trachemys scripta elegans. Japanese journal of infectious diseases, 59(2), 132.
  7. Wahid, R., Simon, R., Zafar, S. J., Levine, M. M., & Sztein, M. B. (2012). Live oral typhoid vaccine Ty21a induces cross-reactive humoral immune responses against Salmonella enterica serovar Paratyphi A and S. Paratyphi B in humans. Clin. Vaccine Immunol., 19(6), 825-834.

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