Paratyphoid

Question 1

Is paratyphoid nationally notifiable?

Answer 1

Yes - urgent - labs, docs

Question 2

Which organism causes paratyphoid?

Answer 2

S. enterica serovar paratyphi A, B, C

Question 3

How is paraythoid transmitted?

Answer 3

Faecal oral - contaminated food / water
Direct person-person rare

Question 4

What is the reservoir?

Answer 4

Humans and some domestic animals

Question 5

What are the clinical features?

Answer 5

Similar to typhoid but more benign

Question 6

What are the complications?

Answer 6

Meningitis, endocarditis, OM

Question 7

Who are high-risk groups?

Answer 7

Immunosuppressed
Gastric achlorydia

Question 8

How is it diagnosed?

Answer 8

Culture - blood, stool, urine, bone marrow > MDU for typing

Question 9

What are the case definitions?

Answer 9

Confirmed only (isolation / detection)

Question 10

What is the incubation period?

Answer 10

1 - 10 days

Question 11

What is the infectious period?

Answer 11

While present in stool - up to 5-6 weeks usually, may be longer

Question 12

What is the outbreak definition?

Answer 12

> = 2 cases linked by time, place, epi (not including HH transmission)

Question 13

What is the key feature of most cases?

Answer 13

Returned traveller esp. Southern Asia

Question 14

How common are local outbreaks / clusters?

Answer 14

Rare

Question 15

How is it prevented?

Answer 15

Hygiene – hand, food prep, handwashing for food handlers and those caring for children

Food / water – safe food and water consumption when travelling
- Boiled water / bottled water, no ice
- Thoroughly cooked food
- Avoid raw fruit / veg
- Undercooked shellfish, seafood, salads, cold meats, street vendors

No vaccination - only for typhoid

Question 16

How are cases managed?

Answer 16

Interview – DRSVECTA – demo, RFs, sx, vax, travel hx, if no travel – detailed exposure hx e.g. cases, untreated water, food premises, high-risk – CC, hospital, food handler, RACF, ECEC

Question 17

For how long should cases be excluded?

Answer 17

• Work, school, CC, pools – 48hrs post Sx
• High-risk – 2 x negative stool specimens 48 hours apart (at least 48hrs post Abx)

Question 18

What education should be given?

Answer 18

• Transmission
• Not prepare food until 48hrs post Sx resolve

Question 19

What precautions should be taken?

Answer 19

Contact, standard

Question 20

What should be done with collected specimens?

Answer 20

Sent for culture, typing, sensitivity

Question 21

Who are considered contacts?

Answer 21

Co-travellers, HH, HH-like, shared bathroom, eaten food prepared by case

Question 22

What information should contacts be given?

Answer 22

Transmission, hygiene, monitor for sx

Question 23

Which contacts should be excluded?

Answer 23

High-risk e.g. food handler, HCW, CCW – until 2 x negative stools 24hrs apart
No exclusion / restriction for other contacts

Question 24

What resources are available?

Answer 24

SoNG, DH protocol

Question 25

What should be considered if a food handler worked when infectious?

Answer 25

Environmental risk assessment / evaluation – VASH Consider F/U patrons (e.g. via booking lists / media) if had diarrhoea / poor hygiene practices, no hazard control system in place, handled food not subsequently cooked before serving e.g. salads

Question 26

What should be considered if a HCW/CCW worked while infectious?

Answer 26

Risk assessment – shared bathrooms, hygiene practices Info and IPC advice to facility Notify clients / patients / families

Question 27

Who should be noted of outbreak / cluster?

Answer 27

OzFoodNet, Food Safety Unit (EH) EH - Intensive search for related causes, source ID (food / water / chronic carrier) - Test suspected carriers - Analytical study - Trace back of food sources

Question 28

What should be done for chronic carriers?

Answer 28

Refer to ID for Tx Hygiene education esp. if high-risk occupation or attend high risk setting