Typhoid
Typhoid fever is highly communicable bacterial disease. Bacteria are present in
water or food contaminated with stool by human carrier and spread to other
people in developing countries like India, Pakistan, Nepal, Bangladesh and Egypt.
Worldwide, typhoid fever affects more than 21 million people annually, with
about 200,000 people dying from the disease.
Causative Agent: It is caused by Salmonella typhi bacteria. It is also caused by
Salmonella paratyphi, a related bacterium that usually causes less severe illness.
Mode of Transmission: Typhoid fever is transmitted by consuming contaminated
food/water. About 3%-5% of people become carriers of the bacteria after the
acute illness. These people may become long-term carriers of the bacteria - even
though they have no symptoms and can be cause of new outbreaks.
Incubation Period: It ranges from 1-3 weeks after exposure to the bacteria.
Symptoms: People develop following symptoms:
Early illness
Fever starts low and increases daytime, reaching as high as 104.9 F (40.50 C).
Headache
Weakness and fatigue
Muscle aches
Sweating
Dry cough
Loss of appetite and weight loss
Abdominal pain
Diarrhea or constipation
Rash
Extremely swollen abdomen
Later illness:
If not treated, patient becomes motionless, exhausted with eyes half-closed in what's known
as typhoid state. In addition, life-threatening complications often develop at this time.
Complications
• Intestinal bleeding or holes - may develop in third week of illness like severe
abdominal pain, nausea, vomiting and bloodstream infection (sepsis). This
life-threatening complication requires immediate medical care.
Risk factors: If one lives in a country where typhoid fever is rare, at increased
risk if:
Work in or travel to areas where typhoid fever is established (endemic)
Work as a clinical microbiologist handling Salmonella typhi bacteria
Have close contact with infected or has recently been infected with typhoid fever
Drink water contaminated by sewage that contains Salmonella typhi
Diagnosis (The test is called ‘Widal Test’):
- blood culture
- stool test
Treatment: Use of antibiotic medicines like
- Chloromycetin
- Amoxyllin
- Chloramphenicol
- Ciprofloxacin (Cipro)
- Azithromycin (Zithromax)
- Ceftriaxone
Other treatments include:
• Drinking fluids: This helps prevent dehydration that results from a prolonged
fever and diarrhea.
• Intra-venous - receive fluids through a vein.
• Surgery: If intestines become perforated, need surgery to repair hole.
Vaccines
Two vaccines are available.
• One is injected in a single dose at least one week before travel (TAB).
• One is given orally in four capsules - one capsule taken every other day
(Typhoral).
No vaccine is 100 percent effective, and both require repeat immunizations, as vaccine
effectiveness diminishes over time.
Prevention
• Good sanitation
• Avoid drinking untreated water
• Avoid raw fruits and vegetables
• Choose hot foods
• Take antibiotics properly
• Vaccination
