How are tests for typhoid fever performed? What are they? Typhoid fever classified as acute intestinal infections, but it stands apart. Usually with intestinal infections students begin to study a course in infectious diseases, and the first of them is usually typhoid fever and paratyphoid fevers A and B, the causative agents of which form the typhoparatyphoid group.
Why does the study of this complex course begin with typhoid fever? Yes, because this disease develops in clearly defined stages, proceeds predictably, tests for typhoid fever and diagnostic principles are standard and uncomplicated, and using the example of typhoid fever, you can fully get acquainted with the typical course of an acute intestinal infection.
About typhoid fever
Where does typhoid fever come from? This is a disease of “dirty hands” and contaminated water. The causative agent of typhoid fever is a large microorganism called Salmonella from the genus Enterobacteriaceae, and the causative agent of typhus is extremely small rickettsia.
Usually, when people talk about typhus, the harsh years come to mind civil war. But then there were epidemics, mainly of typhus. And today, every year more than 20 million people, or the population of two cities like Moscow, become infected with typhus. Almost 900 thousand of them die every year. Such outbreaks occur in hot African countries, India, Colombia and Malaysia, Indonesia and Afghanistan. That's why great danger lies in wait for those travelers who underestimate the likelihood of infection.
It is very easy to become infected with typhoid fever, and the severity of this disease lies, first of all, in the fact that it begins as a mild ailment with normal food poisoning. Such features of this infection have led to the fact that all so-called decreed persons working in the food industry educational institutions And medical organizations, must be tested annually for typhoid fever and checked for carriage of typhoid bacilli. Persons working in the food trade should undergo the same examination.
Features of the course of infection
Typhoid fever occurs with gradually increasing high temperature, the appearance of abdominal pain, general symptoms of intoxication, characteristic of all infections. A feature of typhoid fever is the proliferation of pathogens that have penetrated through the intestinal wall into the organs immune defense intestines - into lymphatic follicles, into the liver, into immune defense cells. In these follicles, pathogens multiply, and then they penetrate into the blood through the thoracic lymphatic duct and this coincides with the beginning acute period diseases. A characteristic danger of typhoid fever is intestinal bleeding, intestinal perforation or necrosis of lymphatic follicles.
At the same time, typhoid fever is a unique disease that requires the presence of an abdominal operating room in infectious diseases hospital. The fact is that a patient diagnosed with typhoid fever and with intestinal bleeding, under no circumstances should you be hospitalized in the general surgery department because it is highly contagious. Therefore, in an infectious diseases hospital, a special operating room is equipped for such a case, and, if necessary, surgeons are called in to perform an emergency operation.
Typhus is transmitted only by humans; you cannot get typhus from animals. You can get sick, I communicate not only with the sick person, but also with a healthy carrier. One of the most famous figures in history is the so-called “Typhoid Mary.” While clinically healthy, she worked as a cook in the early 20th century in the United States and, as a result of her food-related work, a total of about 47 people died, whom she personally infected. Typhoid pathogens multiplied in her gallbladder and went out to environment along with feces. The situation was aggravated by the fact that she refused to be examined and denied the preventive value of hand washing.
But great amount victims who regularly appear to this day in countries with hot climates and low level life is associated with the consumption of food and, above all, with infected water and milk, which are contaminated with feces and sewage in the absence of a centralized sewerage system.
The outcome of typhoid fever can be either recovery or transformation of the patient into a chronic carrier. No more than 5% of all those who have recovered become chronic carriers, and this causes a certain epidemiological danger.
Types of tests for typhoid fever
The most important thing to remember is that a 100% positive result is only the isolation of typhoid bacilli from the patient’s blood at the height of the disease, when Salmonella overcomes the protective barriers of the intestinal lymphatic follicles and a state of bacteremia occurs. Starting from the second week of illness, it becomes possible definition typhoid bacilli in feces. Of course, the likelihood of detecting microorganisms depends on the antibiotic treatment and on the initial concentration of microbes in the biological material.
By the end of the first week after the disease, typhoid fever can be determined by examining the patient’s blood for antibodies that have developed to the Salmonella antigens of the causative agent of typhoid fever. These are the ones that are carried out during blood serum tests. The specificity of these tests is lower because the pathogen is not directly detected. There may also be false positive tests for typhoid fever if the patient has previously had this disease.
It should be taken into account that there are many salmonella pathogenic for humans. After suffering from salmonellosis, there may be a cross-reaction, as well as with some shigellosis or bacterial dysentery. Therefore, in the serological diagnosis of typhoid fever, as in the case of almost all bacterial infections, it is very important to repeat the blood test for typhoid fever after about a week in order to detect an increase in titer, that is sharp increase amount of antibodies. This is what will characterize the acute infectious process and then the diagnosis will be confirmed.
Looking ahead, it must be said that it is never used to confirm the diagnosis of typhoid fever. He can show general symptoms acute infectious process: the presence of increased leukocytosis, an increase in the erythrocyte sedimentation rate, and in severe cases and the development of infectious-toxic shock, leukopenia and other signs of toxic inhibition of red bone marrow function may occur. But a general blood test is clearly not enough to make a diagnosis. Let's list the main methods laboratory research, with the help of which typhus is diagnosed in patients and in clinically healthy carriers:
- Method for isolating blood culture (bacteriological blood test).
Hemoculture allows you to obtain positive results already in the first days of the disease. This is a long but inexpensive method. The causative agents of typhoid fever ripen well on media that contain bile broth. If you combine a bacteriological study with the immunofluorescence method (RIF), then the culture of the typhus pathogen grown within 12 hours can already be preliminarily identified, but then you must wait for confirmation in the classical way. Typically, blood should be taken in an amount of no more than 20 ml.
Despite the emergence of new diagnostic methods, such as, the method of isolating blood cultures has not lost its practical significance. It is not enough for the doctor to know that the patient’s blood contains the causative agent of typhoid fever. He needs to know which antibiotics can be used to quickly get rid of an aggressive microorganism. Typhoid bacilli, just like any other microbes, are constantly being “improved” and acquiring drug resistance to various antibiotics. The isolated pure culture makes it possible to determine the sensitivity of the pathogen to antibacterial drugs. This allows, after receiving a preliminary analysis, to begin targeted treatment, change empirical therapy to a rational one, which, of course, will speed up the patient’s recovery.
- Bacteriological examination of duodenal contents, feces and urine.
These tests are extremely important, as they make it possible to identify healthy carriers from among previously ill individuals. Therefore, before being discharged from the hospital, the patient must submit stool and urine for bacteriological examination, and if the bacterial cultures are negative, then the patient is discharged. How is bile taken? Similarly, on average, 7 days before planned discharge from the hospital, the patient undergoes diagnostic duodenal intubation. A search for pathogens is carried out in portions of gallbladder bile, for which the bile is also inoculated on nutrient media. The so-called typhoid Mary retained typhoid fever pathogens in her gall bladder for life, which multiplied and posed a threat to others.
3 months after discharge from infectious diseases hospital A bacteriological examination of feces, urine and bile is again carried out, since all those who have recovered from the disease are being monitored by an infectious disease specialist. If at least one test for typhoid fever after discharge shows the presence of a pathogen, then the patient is hospitalized according to sanitary and epidemiological indications and treated as a carrier. And only if all culture results are negative, the patient is removed from the register. In the same case, if the patient works in the food industry, in educational or medical institutions, then he is under special supervision throughout labor activity, regularly testing feces for dysgroup and typhus;
Since serological research methods associated with the detection of antibodies can show their presence in people who have been ill for a long time, they must be repeated after a few days when acute illness. Shown enzyme immunoassay with severe gastroenteritis with an unclear course, in the presence of fever, which is combined with diarrhea and bradycardia. Slow heartbeat (bradycardia) is very characteristic symptom typhoid fever caused by the action of antigens and toxins of this pathogen. ELISA is also used to monitor the dynamics of the acute process in patients during clinical observation, after an illness, as well as for the initial identification of carriers of the infection;
- Vidal's reaction.
For many years, the classic serological reaction, which has been included in all textbooks, is the Vidal reaction. How to take this test? Simply by donating venous blood, which is then centrifuged to obtain serum. The Widal reaction is a study of the patient's blood serum, which contains antibodies, with a special typhoid diagnosticum. Its role is performed by standardized sheep erythrocytes, on which antigens of typhoid pathogens are artificially applied, or, in scientific terms, sensitization of these erythrocytes is carried out.
After mixing the components, the mixture is incubated for 2 hours at body temperature, and when diagnostic erythrocytes are bound by antibodies, a precipitate appears in the form of whitish flakes, then the reaction is considered positive. The disadvantages of this reaction are obvious: it uses biological material, careful adherence to temperature conditions, as well as certain quantities, is necessary to eliminate false positive values. Currently, the Widal reaction is being replaced by enzyme immunoassay methods for which it is not necessary to use sheep red blood cells.
Interpretation of results
The most common blood test for typhoid fever is healthy people who get jobs in various food production or receive a health certificate to work as a food seller. If the result is negative, then most likely the person is healthy and has never been sick.
But if the patient is taken to the hospital with diarrhea, intoxication and an unclear picture, then in the first four or five days of typhoid fever he may also have negative results, since the antibodies simply have not yet developed.
If typhoid antibodies are detected in the patient’s blood, the titer must be indicated as a result of the analysis. When positive analysis There are only four possible scenarios:
- acute illness;
- a long-term infection, when circulating antibodies remain for life;
- chronic carriage;
- Occasionally, false-positive cross-reactions occur, after suffering from salmonellosis, for example.
Therefore, patients have positive results serological diagnostics be sure to examine classical ways. How much research is being done in this case? This is a bacteriological method for examining urine and feces and the contents of the gallbladder. Blood culture, like a test for typhoid fever, is taken almost exclusively when there are signs of the disease.
Typhoid fever is an acute infectious disease characterized by prolonged fever, toxicosis, enlarged spleen and liver, enteritis, skin rash. A blood test for typhoid fever is carried out to distinguish the disease from tuberculosis, brucellosis, typhus, and other diseases characterized by intoxication and fever.
Indications
The causative agent of typhoid fever is transmitted through household contact, most often through contaminated water. Without treatment, the disease is life-threatening due to the development of complications such as intestinal perforation.
Of the laboratory tests for diagnosing the abdominal type, the most valuable is the isolation of the pathogen from the patient’s blood. Additionally carry out hematological studies and determine the number of leukocytes and the ratio of their formed elements.
Preparation and delivery of analysis
To achieve the right results, you must stop taking medications three days before the procedure. Two days before the typhus test, you should not drink alcohol. On the day of donating blood for typhoid fever analysis, you must avoid foods such as eggs, dairy products, smoked foods, spicy seasonings and fried foods. Do not smoke an hour before donating blood.
For diagnostic purposes, a blood test for typhoid fever is performed according to the following indicators:
- Hemogram, or. Carried out when there is suspicion of infectious diseases. The detection of typhoid fever can be indicated indirectly by leukopenia, absence of eosinophils and;
- Bacterial culture. It may take up to five days for microflora growth to appear and to be identified;
- is able to detect the presence of proteins indicating the acute course of the disease;
- for typhus, which makes it possible to detect antibodies on the fourth day of illness;
- for typhus;
- RNHA is a reaction of mediated (indirect) hemagglutination.
Positive results confirm the presence of antibodies to the pathogen. This indicates either the presence of the disease in the acute phase, or a past infection.
If the test result for typhoid is negative, this indicates either that the disease has just begun, or that it has been suffered for a long time, or that the person is healthy and has never had typhoid fever.
Sometimes tests give false positive result. The cause may be other Salmonella infections, hemolysis of the blood sample, or antibiotic use.
Differential diagnosis of typhoid fever can be complicated. The independent laboratory Invitro came to the aid of public medical institutions. The Invitro laboratory network uses the latest test systems from the leaders of the global pharmaceutical industry in Ukraine, Belarus, Kazakhstan and Russia.
Invitro successfully diagnoses a variety of diseases, including typhoid fever. The basis for confirming the diagnosis is the isolation of Salmonella typhi from the patient's blood.
The pathogen is detected in the blood by bacteriological (blood culture on nutrient media) and serological methods (RPHA rapid test for antibodies). Rapid tests are inferior to bacteriological methods in specificity, since they detect antibodies to other microbes of the genus Salmonella. In addition, the test also reacts positively to antibodies indicating a previous illness. Therefore, a repeat test is indicated after five days. If the antibody titer increases, then the disease is in the acute phase.
No special preparation is required for taking blood for analysis in Invitro. Blood must be taken on an empty stomach, or four hours after breakfast or lunch.
Typhoid fever is information for the doctor, who makes the final diagnosis.
Treatment and prevention
Patient care is of great importance in the treatment of typhoid fever. Patients are hospitalized, and during the critical stage of typhoid fever they are prescribed bed rest, which is extended after the temperature drops for another week. Then, the recovering person will be allowed to sit down, and after another week get up.
During hospitalization, the patient should drink as much as possible, preferably sweet tea. Food should be semi-liquid and high in calories
Treatment of typhoid fever is carried out in two directions:
- combating the pathogen and measures against intoxication and dehydration. The fight against the causative agent of typhus comes down to the use antimicrobial agents. Measures against dehydration and intoxication are carried out using parenteral administration of appropriate drugs.
Depending on the situation, symptomatic drugs are used, cardiac, restorative and others. Patients with typhus are discharged from the hospital no earlier than three weeks after the temperature drops, subject to negative results of bacteriological tests.
Treatment and prevention of typhoid fever involves vaccination to prevent the person recovering from becoming a carrier of the bacilli. Prevention of typhus, excluding vaccination, consists of observing sanitary hygiene standards, monitoring the sanitary condition of food industry enterprises, catering and trade.
Personal prevention is washing hands, vegetables and fruits before eating and heat treatment of raw animal products.
Typhoid fever is dangerous disease infectious nature, the causative agent of which is Salmonella S.typhi. You can catch typhoid fever through foods, contaminated water, or if you do not follow simple rules hygiene (through unwashed hands), as well as from the carrier of infection.
The initial signs of typhoid fever are in many ways very similar to various other infectious diseases, therefore, if there is a suspicion of the presence of this infection in the body, it is necessary to do a test for typhoid fever mandatory for accurate diagnosis. Only in this way can the fact of infection be confirmed and effective treatment be prescribed in a timely manner.
Indications for prescribing a blood test for typhoid fever
A test for typhoid fever is required if the following symptoms occur:
- Attacks of nausea, vomiting, abdominal pain.
- Signs of body intoxication: insomnia, loss of appetite.
- Unstable stool: constipation or vice versa diarrhea.
- Feeling of general malaise and weakness.
- Symptoms of dehydration: dry skin, thirst, coated tongue.
- A gradual increase in body temperature turning into fever.
The presence of typhoid fever is determined based on indications laboratory tests, anamnesis data (patient interview), which may indicate characteristic features diseases and contact with a carrier of infection. To prevent the occurrence of typhoid fever and comply with standard sanitary standards blood test for typhus is given to workers medical institutions, preschool institutions, as well as workers in the food industry, enterprises selling various food products, etc. at intervals of once a year.
What tests are prescribed to diagnose typhoid fever?
If there are signs of illness, a blood test for typhus should be taken before taking antibiotics. This condition is explained by the fact that after 2-4 days from the start of treatment, a blood test may give a negative result. In general, a number of the following tests are usually prescribed for such a study:
- Serological blood test(Vidal reaction). With its help, you can detect antibodies to the causative agent of typhoid fever on the 4-5th day of illness.
- General blood analysis. Such an examination is usually prescribed in the first days of the disease, but it only indirectly indicates the presence of typhoid fever.
- Biochemical analysis blood- detects acute phase proteins.
- Bacterial culture- the results of such a blood test can be obtained only after 4–5 days.
To detect antibodies to typhoid, radioimmunoassay and enzyme immunoassay blood tests are used. The most common method of analysis, which is used to detect carriers of infection among employees in the food industry and to assess the effectiveness of vaccination against typhoid fever, is the research method using RNGA (reaction indirect hemagglutination). The material for this analysis is venous blood. To obtain the most accurate data, smoking is prohibited 30 minutes before taking the RNGA analysis.
If the blood test for typhus is positive, we can talk about acute course illness, or about a previous infection. In addition, a positive result may indicate that the person is a carrier of the causative agent of typhoid fever. If the test results are negative, the doctor can conclude that a long time has passed after recovery, an early form of the disease (in the presence of appropriate clinical manifestations) or even about the absence of infection in the body. A false positive test for typhus is possible if there is cross reactions with other pathogens of infectious diseases from the genus Salmonella.
How to properly prepare for testing for typhoid fever?
The main factors that influence the result of a blood test for typhus include:
- Eating. On the day of testing for typhoid fever, it is not recommended to eat fried, spicy, smoked and fatty foods, as well as butter, dairy products and eggs. With such an unhealthy diet, it is possible to have both a direct effect on the composition of the blood due to the absorption of food components, and an indirect effect - the effect of sample turbidity, shifts in hormone levels.
- Alcohol. Two days before donating blood for analysis, it is prohibited to drink alcohol, since it has acute and chronic action on many metabolic processes.
- Smoking. An hour before your visit to the blood donation point for analysis, you must refrain from smoking. The point is that this bad habit alters secretion biologically active substances, which negatively affects the results of the study.
- Emotional and physical overload- cause biochemical and hormonal changes.
- Instrumental examinations, physiotherapy - may cause temporary changes in laboratory parameters.
In addition, when taking blood, it is very great importance has a time of day: each person has certain daily rhythms of activity and, in accordance with this, daily fluctuations in many biochemical and hormonal parameters, expressed to a lesser or greater extent for different indicators. If possible, it is advisable to donate blood for analysis on an empty stomach (at least 8 hours and no more than 14 hours of fasting, you can drink water as usual), avoid food overload the day before. The most optimal time to take blood tests for typhoid fever is in the morning, between 8 and 11 am.
4.50 out of 5 (5 Votes)A diagnostic serological test for detecting antibodies to Vi-antigens of the typhoid pathogen in blood serum is intended to confirm or deny the fact of carriage.
| Deadlines | 7-8 days |
| Synonyms (rus) | Serological analysis for Vi-antibodies of the causative agent of typhoid fever in blood serum |
| Synonyms (eng) | Indirect hemagglutination assay for Salmonella typhi Vi antibodies |
| Method of analysis |
Indirect hemagglutination reaction (IRHA) |
| Preparing for the study | The analysis is carried out in the morning, on an empty stomach. At least 8 hours must pass since the last meal. |
| Avoid drinking alcohol at least 24 hours before taking biomaterial. | |
| It is not recommended to donate blood for serology after fluorography, x-rays, or physiotherapeutic procedures. |
|
| Biomaterial and methods of taking it | Deoxygenated blood |
General information about typhoid fever and its detection
Typhoid fever refers to acute infectious intestinal diseases. It is characterized by a cyclic flow with systemic damage intestinal organs, central nervous system, liver, lymphatic system; general intoxication of the body, persistent bacteremia, in which the presence of bacteria is detected in the blood. The source of infection is sick, recovered bacteria carriers.
The causative agent of typhoid fever - salmonella Salmonella typhi, refers to intestinal bacteria.
The antigenic system of the pathogen is represented by antigens O, H, Vi.
Vi antigen is a virulence antigen, forming the resistance of the typhoid Salmonella pathogen to the body’s protective reactions. The presence of antibodies to Vi-antigens of Salmonella typhi during serological testing of blood samples serves as a marker of bacterial carriage.
Blood test method with Vi-antigen
Antibodies to erythrocyte Vi antigens are detected using serological reaction of indirect hemagglutination, RNHA , using special diagnostics.
RNGA method:
- based on the ability of interaction between blood serum antibodies and antigens that are fixed on red blood cells (erythrocyte diagnosticum); the result of the reaction is aggregation of erythrocytes followed by sedimentation, agglutination;
- by the nature of the erythrocyte sediment, one judges the presence of antibodies (a characteristic “umbrella”) or their absence (a sediment in the form of a “dot”);
- is semi-quantitative; to carry out the reaction, dilutions of blood serum are used to determine the diagnostic titer;
- the minimum diagnostic titer during the reaction is 1:40;
- an increase in the diagnostic value of the reaction is observed when using reanalysis(paired serum method);
- the reaction is highly sensitive and specific and can be used on the fifth to seventh days of the disease.
The main purpose of the study is to identify the carriage of typhoid Salmonella bacteria.
Analysis results and their interpretation
Test results may be positive or negative.
A positive response:
- detection of antibodies to Vi-antigens of the typhoid pathogen in the blood (minimum diagnostic titer value 1:40) is considered as an indication of the fact of bacterial carriage and the need for repeated testing;
- the response records the titer value;
- may indicate a leak acute infection, about a previous illness, about vaccination;
- in rare cases it may be false positive due to cross-reaction.
Carrying out this study is of particular importance for preventing the spread of typhoid fever by bacteria carriers.
It is taken based on the places of maximum concentration of bacteria. Previously, rods appear in the blood. For the sanitation they take feces and urine. This is how the stick comes out of the carriers. The contents of the duodenum are analyzed at medical institutions. Salmonella infects bile.
In taking analyzes there are no features. A bacteriological study is being carried out. There is no need for strict sealing measures, as when identifying dysbacteriosis. The rod survives in an oxygen environment. the main role belongs to bacteriological research. On late stages diseases, antigens appear in the blood, detected by biochemical means. An example is the Vidal reaction to typhoid fever.
Bacteriological research is carried out constantly. This is how human carriage is detected, even if there are no symptoms. The following bacteria detection media are subject to examination:
- blood;
- urine;
- bile.
Serological analysis
In the first stage, microbes enter the blood. Occurs during the incubation period - a blood culture is obtained when the patient first approaches with complaints. It is impossible to quickly identify the pathogen using a bacteriological method. The chance is based on biochemical characteristics, but the technique is not applied. Treatment begins immediately while the results of the first studies are clarified.
After donation, 5-10 ml of blood (from a syringe) is inoculated into the bile broth (in the presence of bile, the rod shows growth). The microbe is undemanding; meat peptone broth and Rapoport's medium are suitable. Antibodies appear in the serum. This allows blood to be used to detect disease using biochemical methods. Material and medium are taken in a ratio of 1 to 10.
Serological testing is used for surveillance. It is easier to donate blood for typhoid fever in large numbers. This affects the income of clinics. Blood sampling is carried out at an even, fast pace. Serological testing for typhoid fever is a popular type of research. The price does not exceed 500 rubles.
In addition to the Widal reaction, RPHA with cysteine is used. Antibodies should appear in the blood. As immunity develops, the titer increases. Based on the increase in the number of antibodies, a diagnosis is made. Immunoglobulins remain in the blood for a long time (even after recovery). The density does not change much.
Antibodies in the blood may be a consequence of immunization with the vaccine. Biochemical analysis shows the presence of these formations. The first results are obtained a day after the second sampling.
An enzyme immunoassay for the presence of immunoglobulins M and G is aimed at identifying the outer membrane protein OMP (which provokes the production of Salmonella antibodies). The result is given in 2-3 days and allows you to track both types of immunoglobulins separately. The level of IgM depends on the infection, IgG lasts longer. Doctors can judge the timing of the development of the disease.
Identification on early stage in blood blood cultures of typhus, serology considers sufficient evidence of the presence of typhus and paratyphoid in a person. Therefore, the analysis is performed at the onset of the disease and during prevention.
Bacteriological research
Blood is not the only method of collecting bacteria. At some stage, the rods disappear from the serum, replaced by the immune system fighting for the health of the body. Doctors examine feces, urine, and bile. This stage occurs at 2 weeks. Media used are Ploskirev, Muller, Levin. Shoots appear after 2 days, after appearance is put preliminary diagnosis. While the patient is waiting for therapy to be prescribed, he is under the influence of general medications.
By the fourth day, the size of the colonies clears up the picture. To speed up the process, an immunofluorescence reaction is used. This applies to blood culture detection. Serums are focused on O and Vi antigens. Express analysis gives first results within 1 hour. Within a day, the doctor understands how to treat. This shows the preferred family of antibiotics.
Doctors are waiting for the end bacteriological research to find out the sensitivity of the strain to drugs. Typhoid fever is difficult to treat. With dysentery, doctors admit powerlessness - they say that the disease goes away naturally.
Bone marrow examination
Bone marrow studies are being carried out. Bacteria penetrate into Bone marrow, disrupting hematopoiesis. They take a puncture and examine it. This is more complicated than collecting stool, but the Widal test gives an accurate result - there are no other pathogens in this area. Until the results are received, doctors can only pump patients with antibiotics. wide range actions, follow sanitary rules.
Disadvantage of the procedure: the Widal test gives increased percentage false positive diagnoses. At the same time, they donate feces, blood, and urine. Additional information gives an examination, during which the doctor clinical symptoms makes a diagnosis.
General tests
Doctors tell me to take it general tests blood and urine. This allows us to judge the processes taking place.
- In the first days of the disease, moderate leukocytosis is recorded. Deficiency of white bodies causes leukopenia.
- Along the way, aneosinphilia and lymphocytosis are observed, and the rate of erythrocyte sedimentation increases.
- A urine test reveals the presence of protein, small amounts of blood, and cylindruria.
Prevention
SanPiN has a special attitude towards food industry workers. There is a need to pass the RNGA. It's worse for the infected. They are closely monitored. They are deregistered after 2 years if the test results are negative. Those in contact with patients are checked - typhoid fever is considered contagious.
In 5-10% of cases, bacterial carriage develops. This is unnecessary pain for local doctors. They do this rarely in the Russian Federation.
