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Typhoid fever

Overview of typhoid fever

Typhoid fever, also called typhoid, is life threatening, infectious bacterial disease caused by a bacterium called Salmonella typhi.

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The bacterium spreads easily through contaminated food and water and from person-to-person contact. The bacterium affects the body by penetrating the intestinal wall and multiplying in lymphoid tissue. The disease can be endemic in nature and can cause severe infection in the body.

Symptoms of typhoid fever

According to the World Health Organization (WHO) symptoms usually develop 1–3 weeks after exposure, and may be mild or severe.

Symptoms may include:

  • Sudden and continous fever
  • Severe headache
  • Nausea
  • Weakness
  • Constipation
  • Severe fatigue
  • Red spots on the chest
  • Enlarged spleen and liver

Causes of typhoid fever

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The bacteria that causes the disease spreads through contaminated food and water. Food or water that is in contact with faeces infected with salmonella bacteria can find its way to the human body. This is closely associated with poor hygiene, lack of clean drinking water and inadequate sanitation.

In most cases polluted water is the prime cause of transmission. In addition, shellfish taken from sewage-contaminated beds, vegetables fertilized with night-soil and eaten raw, contaminated milk and milk products have been shown to be a source of infection.

There are cases where even after treatment a person who has suffered from typhoid continues to be the carrier for the bacteria. While they no longer suffer from the disease or show any symptoms of the disease, their faeces may still have the Salmonella typhi bacteria.

Although typhoid fever has practically disappeared from industrialized countries, it remains a serious public health problem in several Asian regions of the former USSR and in parts of South and South-East Asia, Africa and South America, says WHO.

Risk factors for typhoid fever

In the last documented outbreak in the Democratic Republic of Congo, between 27 September 2004 and early January 2005, no less than 42,564 cases of typhoid fever were reported, including 214 deaths and 696 cases of peritonitis and intestinal perforations, says WHO. While the disease is mainly reported in the developing world, infections can happen to anyone and everyone. Risk has also gone up as different strains of S typhi are becoming increasingly common worldwide. Some strains are resistant to chloramphenicol and other recommended antibiotics.

Diagnosis of typhoid fever

A doctor treating a case of typhoid generally starts with a physical examination of the patient to ascertain the symptoms. A doctor would like to know if the patient has traveled to parts of the world or been in contact with someone who are from parts of the world where there are known cases of salmonella infection. Tests available to detect the bacteria include:

Taking samples of blood, stools or urine and examining them under a microscope for Salmonella typhi bacteria. The bacteria are not always detected the first time, so you may need to have a series of tests.

Testing a sample of bone marrow is a more accurate way to diagnose typhoid fever. However, getting the sample is both time consuming and painful, so it is usually only used if other tests are inconclusive. If testing confirms that you have typhoid fever, it is usually recommended that other members of your household are also tested in case you have passed the infection to them.

Treatment of typhoid fever

The treatment of typhoid fever is mainly through antibiotic medicines and the most commonly used medicines are in Ciprofloxacin and Ceftriaxone. Ceftriaxone is an injection and is considered safe for pregnant women and children. These drugs, however, can cause side effects, and long-term use can lead to the development of antibiotic-resistant strains of bacteria.

Strains resistant to chloramphenicol and other recommended antibiotics (ampicillin, cotrimoxazole and even ciprofloxacin) have become prevalent in several areas of the world and have become a major cause of worry.

Typhoid has a tendency to drain a patient and hence it is very important to stay hydrated. A typhoid patient must drink plenty of fluids and prevent dehydration. Eating fruits and vegetable would also be very beneficial.

Prevention of typhoid fever

Te best prevention against typhoid is to prevent the bacteria from entering your body. Sanitation and hygiene are the critical measures that can be taken to prevent typhoid. It is advisable that only safe and pure drinking water is consumed. When traveling it is advisable to drink only bottled water. Do not have ice cream, ice cubes or fruit juice from street vendors and do not eat raw vegetables, peeled fruit, shellfish or salads.

Vaccination for typhoid exists and the choice is mainly between VI vaccine, which is thought to be 75 percent effective against typhoid fever in the first year after vaccination and Ty21a vaccine, which is thought to be 50-60 percent effective against typhoid fever in the first year after vaccination.

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Written by: healthplus24.com team

Date last updated: March 22, 2015

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