3. 其 中 11 名 男 子， 進 食 過 燒 味 、 海 鮮
卷 、 石 斑 、 貴 妃 雞 及 鮮 鮑 蚌 等 食 品
St l lt S l ll t itidi
(2008-06-17 HKT 00:27)
Stool culture: Salmonella enteritidis
MacConkey XLD agar
4. Food borne infectious diseases
Water
(untreated)
Salmonella, shigella, cholera
H titi A/E C li i i /N lk i il litiHepatitis A/E. Caliciviruses/Norwalk virus, poilomyelitis
Giardia, cryptosporidium, cyclospora
Dairy
(unpasteurised)
Brucella, listeria, salmonella, shigella
(unpasteurised)
Raw or Enteric bacteria (salmonella, shigella, C. jejuni, etc)
undercooked
food
( g j j )
Helminths (ascaris, trichinella, taenia, etc)
Protozoa (amoebiasis, toxoplasma)
5. E t i fEnteric fever
Salmonella typhi & S. paratyphiyp p yp
Increasing fever over 1–2 weeks
Headache, abdominal pain
& cough
Rose spots
Fleeting lesions
2 - 3 mm pink-red macules
Rose spots
p
blanch with pressure
11. Antigenic formulae of some representative serotypes of
Salmonella (Kaulffman-White classification)
O-antigen group
A
Serotype name
Paratyphi A
O antigens and Vi
1,2,12
H antigens (I)
a
H antigens (II)
1,2
B Paratyphi B
Typhimurium
Agona
1,4,5,12
1,4,5,12
1,4,12
b
i
f,g,s
1,2
1,2
-
C1
Heidelberg
Choleraesuis
Paratyphi C
1,4,5,12
6,7
6 7 Vi
r
c
c
1,2
1,5
1 5Paratyphi C
Virchow
Infantis
6,7, Vi
6,7
6,7
c
r
r
1,5
1,2
1,5
C2-C3
D1
Newport
Hadar
Typhi
6,8
6,8
9,12, Vi
e,h
z10
d
1,2
e,n,x
-
Enteriditis
Dublin
1,9,12
1,9,12, Vi
g,m
g,p
-
-
20. Clinical features of traveler’s diarrheaC ca ea u es o a e e s d a ea
≥ 3 unformed stools within 24 hours with at least 1 of the following:
N iti bd i l iNausea, vomiting, abdominal pain
Fever, bloody stool
2 – 3 days after arrival
(90% within first 2 weeks)
Onset: Duration:
3 – 5 days
(90%)
> 2 weeks
(10%)
Duration:
0 1 2 >3
Travel
0 1 2 >3
Weeks post-travelHome
21. Approach to Vibrio (curved)Approach to
Cholera-like illness
Vibrio (curved)
TCBS
(thiosulphate citrate bile salts sucrose agar)
Vibrio cholerae Vibrio parahemolyticus
Dept. of Microbiology, QMH
22. Vibrio cholerae ? Serotype
Agglutination test: O1 & O139, Non O1
Dept. of Microbiology, QMH
23. The first imported case of cholera inp
2008
From Philippine
Notification data (DH)
2003: 7003
2004: 5
2005: 5
2006: 1
2007: 3
2008: 1 (till 8 Apr 08)
Oriental daily 8 Apr 2008
24. Cholera stool Treatment ofCholera stool
500 - 1000 ml / hr
Treatment of
watery diarrhea
Rehydration
Rehydration
Rehydration
Rehydration
Rehydration
Rehydration
Lancet. 2004 Jan 17;363(9404):223-33
32. Cefoperazone (32 μg/ml) MacConkey agar:
selective medium for Laribacter hongkongensisselective medium for Laribacter hongkongensis
BA, aerobic
48 h
CMA, aerobic
48 h48 h 48 h
CCDA, aerobic
48 h
CCDA, microaerophilic
48 h
33. Risk factors for gastroenteritis associated with
L ib t h k iLaribacter hongkongensis
Characteristics Patients with L Controls P valueCharacteristics Patients with L.
hongkongensis
GE (n=17)
Controls
without
GE (n=34)
P value
Recent travel histories 10 2 <0 001Recent travel histories 10 2 <0.001
Consumption of fish within 3
days prior to onset of
16 19 <0.01
y p
diarrhoea/interview
Consumption of minced 5 1 <0 05Consumption of minced
freshwater fish meat within 3
days prior to onset of
diarrhoea/interview
5 1 <0.05
Lancet. 2004 Jun 12;363(9425):1941-7.
