TYPHOID FEVER
Typhoid fever, also called typhoid or enteric fever, acute infectious disease caused by the bacterium Salmonella enterica serovar Typhi. The bacterium usually enters the body through the mouth by the ingestion of contaminated food or water, penetrates the intestinal wall, and multiplies in lymphoid tissue; it then enters the bloodstream and causes bacteremia.
CAUSES
Typhoid fever is caused by virulent bacteria called Salmonella typhi (S. typhi). Although they’re related, S. typhi and the bacteria responsible for salmonellosis, another serious intestinal infection, aren’t the same.
Fecal-oral transmission route
The bacteria that cause typhoid fever spread through contaminated food or water and occasionally through direct contact with someone who is infected. In developing nations, where typhoid fever is endemic, most cases result from contaminated drinking water and poor sanitation. The majority of people in industrialized countries pick up typhoid bacteria while traveling and spread it to others through the fecal-oral route.
This means that S. typhi is passed in the feces and sometimes in the urine of infected people. You can contract the infection if you eat food handled by someone with typhoid fever who hasn’t washed carefully after using the toilet. You can also become infected by drinking water contaminated with the bacteria.
Signs and Symptoms
The incubation period is usually one to two weeks, and the duration of the illness is about four to six weeks. The patient experiences
- poor appetite;
- abdominal pain and peritonitis;
- headaches;
- generalized aches and pains;
- high fever, often up to 104 F;
- lethargy (usually only if untreated);
- intestinal bleeding or perforation (after two to three weeks of the disease);
- Diarrhea or constipation.
Vaccination
If traveling to an area where typhoid is prevalent, vaccination is recommended.
Before traveling to a high-risk area, getting vaccinated against typhoid fever is recommended.
This can be achieved by oral medication or a one-off injection:
- Oral: a live, attenuated vaccine. Consists of 4 tablets, one to be taken every second day, the last of which is taken 1 week before travel.
- Shot, an inactivated vaccine, administered 2 weeks before travel.
Vaccines are not 100 percent effective and caution should still be exercised when eating and drinking.
Diagnosis
A diagnosis of typhoid fever can usually be confirmed by analysing samples of blood, stools or urine. These will be examined under a microscope for the Salmonella typhi bacteria that cause the condition.
The bacteria aren’t 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 of diagnosing typhoid fever. However, getting the sample is both time-consuming and painful, so it’s usually only used if other tests are inconclusive.
Treatment
The only effective treatment for typhoid is antibiotics.
Other than antibiotics, it is important to rehydrate by drinking adequate water.
In more severe cases, where the bowel has become perforated, surgery may be required.