Typhoid Fever

Typhoid fever is a serious health threat in the developing countries especially for children.

It is a bacterial infection characterized by severe gastro-intestinal disorders. It spreads via contaminated food and water or by close contact with infected people.

It generally resolves with proper antibacterial treatment without any serious complications. Although vaccines are available to prevent it, a small number of deaths have been reported.

Signs and symptoms of typhoid fever often develop within one to three weeks after exposure to salmonella bacteria.

Early signs and symptoms include:

• fever that increases every day possibly reaching as high as 104.9F,
• headache,
• weakness,
• fatigue,
• muscle aches,
• sweating,
• dry cough,
• loss of appetite,
• weight loss,
• abdominal pain,
• diarrhea or constipation,
• rashes,
• extremely swollen abdomen.

Later, without treatment, typhoid fever may become delirious or lead to typhoid state (lie motionless and exhausted with eyes half closed). Life-threatening complications may also develop and some signs and symptoms may occur again after the fever has subsided.

The causative factor of typhoid fever is Salmonella typhi bacteria. It gets transmitted by fecal-oral route i.e. a healthy person may get the infection from contaminated food and water and sometimes by close contact with infected person.

In developing nations, where typhoid fever is endemic, most cases result from contaminated drinking water. Some people still continue to harbor the bacteria after treatment in their intestines and gallbladders. Such people are called chronic carriers.

The doctor will base the diagnosis of typhoid fever on medical and travel history, physical examination and some additional test to confirm the disease.

Those additional tests include body fluid or tissue culture in which include taking a small sample of blood, stool, urine or bone marrow and placing it on a special medium that encourages growth of bacteria and the culture is checked for presence of typhoid bacteria.

Special antibodies against typhoid bacteria is found in the blood.

The best treatment option for typhoid fever is to start with antibiotic therapy. Antibiotics like Ciprofloxacin or Ceftriaxone (for children). Recently, the existence of antibiotic-resistant bacteria has become a worldwide problem.

Other treatments include drinking to prevent dehydration and surgery, if the intestines become perforated.

To prevent typhoid fever, certain public health goals have been set up like safe drinking water, improved sanitation and adequate medical care.

Vaccinations are also available which include one injection in a single dose at least a week before travelling and the other one is given orally in four capsules. They may not be 100% effective.

Some steps must be followed like washing hands regularly, avoid drinking untreated water, avoid eating raw fruits and vegetables and eat hot or cold food.

If a person is infected with typhoid fever, taking antibiotics as prescribed, washing hands often and avoid handling food to avoid infecting others.

There are several risks and complications associated with typhoid fever.

Typhoid fever is endemic in many developing countries like Southeast Asia, Africa, South America and India.

Children are also at high risk of getting this disease due to weakened immune system worldwide. Also, people are at high risk of developing the disease if a person travels to area where typhoid fever is endemic, works as microbiologist, have close contact with someone with typhoid fever or drink contaminated water.

Some of the common complications that can occur as a result of this disease are intestinal bleeding or perforations that may eventually lead to sepsis which requires immediate medical care.

Additional less complications are:

• myocarditis,
• endocarditis,
• pneumonia,
• pancreatitis,
• kidney or bladder infections,
• meningitis or psychiatric problems.

Without proper treatment, some people may die.