Typhoid Fever

What Is Typhoid Fever? What Is Typhoid?

Typhoid fever is an infectious disease caused by the bacteria Salmonella typhi. It is also known as enteric fever, or commonly just typhoid. Typhoid fever and paratyphoid fever are clinically indistinguishable diseases, collectively called enteric fever. It easily spreads through contaminated food and water supplies and close contact with others who are infected. The illness is characterized by very high fever, sweating, gastroenteritis, and diarrhea. Although typhoid is very rare in the developed world, it is still a serious health threat in the developing world. Typhoid is treatable with antibiotics.

Typhoid used to be endemic in many currently developed nations some centuries ago. In fact, scientists have for several years debated the cause of the Plague of Athens. Analysis carried out by Manolis Papagrigorakis and colleagues using DNA collected from teeth from an ancient Greek burial pit points to typhoid fever as the disease responsible for this devastating epidemic.

Who gets typhoid fever?

The World Health Organization (WHO) has deemed typhoid fever a serious problem in endemic areas (India, Southeast Asia, Africa, Central and South America) where there are between 16 and 33 million cases each year that result in over half a million deaths.
However, some industrial nationals are experiencing worrying rises in typhoid fevers; mainly among people who visited parts of the world where it is endemic. In 2006 there were almost 500 cases (497) of enteric fever reported in England , Wales , and Northern Ireland - the highest level for 10 years; the Health Protection Agency, UK, says UK travellers visiting friends and relatives on the Indian sub-continent are carrying an unnecessary burden of typhoid and paratyphoid. Paratyphoid fever is increasing across Asia, a study revealed.

Though children are more likely than adults to get typhoid, adults tend to have worse symptoms. Risk factors for typhoid include working in or traveling to areas where the illness is endemic, having close contact with another person infected with typhoid, having a weakened immune system due to medication or disease, and drinking water that has been contaminated with the bacteria that cause typhoid.

What causes typhoid fever?

Typhoid fever ultimately is caused by the Salmonella typhi bacteria, and it is most commonly transmitted through the fecal-oral route. That is, patients with typhoid can contaminate the water supply with their stool, where the bacteria flourish. The food supply can become contaminated by infected stool, poor sanitation, or someone who fails to wash his hands after using the bathroom. When another person consumes tainted food or water, he can pick up the typhoid bacteria and become infected.
Some people, known as chronic carriers, still harbor typhoid bacteria (and can still contaminate food and water supplies) even after receiving antibiotic treatment and proving to be free of symptoms.

What are the symptoms of typhoid fever?

Typhoid sufferers often have fevers that run as high as 103 or 104 degrees (39 to 40 Celsius). Additional initial signs of the condition include:

• Headaches
• Poor appetite
• Generalized aches and pains
• Lethargy, weakness, and fatigue
• Diarrhea
• Rash (rose-colored sports on the lower chest and upper abdomen)

If untreated, a second stage of typhoid may result with a continuation of a high fever, severe constipation or diarrhea that resembles pea soup, extreme weight loss, and an uncomfortable, distended abdomen.

The final stage of symptoms, known as the typhoid state, leaves a person delirious and lying motionless with her eyes half-closed. During the fourth week of illness, improvement slowly begins to come and the fever is likely to decrease gradually over ten days.

How is typhoid fever diagnosed?

If a physician suspects typhoid based on the physical symptoms mentioned above, she will order a stool culture and/or blood culture to specifically identify the Salmonella typhi bacteria. A doctor will also conduct a detailed medical and travel history to assess your exposure to the bacteria. Additional tests used to diagnose typhoid fever include enzyme-linked immunosorbent assay (ELISA) and fluorescent antibody test.

How is typhoid fever treated?

The Salmonella bacteria that causes typhoid can be killed by antibiotics such as ciprofloxacin or ceftriaxone. However, some strains become resistant to antibiotics after long-term use, and antibiotics have known side-effects.

Additional treatments for typhoid include drinking fluid to prevent dehydration and eating a healthy diet to ensure the absorption of nutrients.

How can typhoid fever be prevented?

Typhoid fever can be prevented through proper sanitation and hygiene. Since the disease spreads in places where human feces come into to contact with food and drinking water, prevention relies on careful food preparation and persistent hand washing. To prevent typhoid, people in endemic areas should avoid drinking untreated water, avoid raw fruits and vegetables, choose to consume hot foods where bacteria cannot survive, adequately clean household items, and avoid handling food if there is a risk of spreading the disease.

There are two vaccines that are recommended by the World Health Organization. They are usually only given to those who are traveling to typhoid endemic areas and they are from 50 to 80% effective in preventing typhoid.