Typhoid fever -- know the symptoms, causes and treatment

Typhoid, also known as typhoid fever is a life threatening disease that is caused due to an infection by the bacterium Salmonella typhi. According to the CDC (Center for Disease Control) almost 21.5 million people in developing countries contract typhoid each year. Here are a few common questions about the disease answered.

How is typhoid caused?

Typhoid is caused by the bacteriumSalmonella typhi, which is present only in human beings and is transmitted through contaminated food or water. People with this infection carry the bacterium in their intestines and bloodstream. Also, people who have recovered from the disease could still have the bacterium in their system; they are known as carriers of the disease. The common modes of transmission of this bacteria are:

• The infection usually spreads when food or water is handled by a person who is shedding the bacterium (after or during their recovery from the disease).
• Both ill people and carriers shed Salmonella typhi in their stool. If sewage water leaks into drinking water or food which is then consumed, the risk of contracting the disease is high.
• This disease is common in areas where proper hand washing techniques are not followed.

What are the common symptoms of typhoid?

Once the bacterium is ingested it quickly multiplies within the stomach, liver or gallbladder and finally enters the blood stream causing symptoms. The common signs and symptoms of typhoid are:

• Fever (usually between 103⁰F- 104⁰F) also known as step ladder fever.
• Rashes (flat, rose-coloured spots)
• Vomiting
• Loss of appetite
• Headaches
• General fatigue

In severe cases, one may suffer from:

• Intestinal perforations or internal bleeding
• Diarrhoea orconstipation

What is step ladder fever?

One of the characteristic symptoms of typhoid is a step ladder fever . This means that the fever fluctuates between very high and low temperatures for a short period of time, till it peaks at 103⁰F 104⁰F. In patients without any complications the condition subsides in about three to four weeks after its onset. In about 10% of people, the condition relapses after about one week of convalescence.

How is it diagnosed?

The disease is usually diagnosed using a stool sample or blood sample. The presence of the bacterium is most easily visible either at the beginning or at the end of the disease. Other diagnostic tests that are currently used to diagnose typhoid are:

• ELISA
• Fluorescent antibody study
• Platelet Count
• Blood culture

Here is some additional information on diagnosis of typhoid.

Is there a cure?

Usually, depending on the severity of the condition, a patient might be administered drugs either orally or intravenously.

Antibiotics: Once diagnosed, the first line of treatment involves the use of antibiotics such as ciprofloxacin and ampicillin. Although chloramphenicol was used previously, due to severe side effects in some patients, the use of this drug has been discontinued.

Additional treatment options: These include staying hydrated by consuming uncontaminated drinks or water and eating a diet rich in nutrients.

Recently there have been advances in the treatment and prevention of typhoid, one of the most interesting finds is the development of a new vaccine to prevent typhoid.

What care should one take duringconvalescence?

Ideally, a person suffering from typhoid should not discontinue their medication as soon as they feel better. This is because, typhoid has a high rate of relapse and hence the patient should continue his/her medication until their doctor asks them to stop. They must also ensure that they wash their hands well with an antibacterial soap after going to the toilet and before touching any food or water.

What can one do to avoid contracting the condition?

Here are few tips for people to prevent typhoid and stay protected:

Vaccination: Today, there are vaccines that can protect you from contracting typhoid. The Ty21a vaccine is administered intramuscularly (injected into a muscle) and requires the patient to take a booster shot after five years. That being said, even if a person has taken the vaccine, they should not expose themselves to possible infectious agents, because the vaccine is still not very effective.

Apart from the vaccine, there are some basic things that one can take care of in order to avoid the condition:

• Do not eat roadside food: It is best to avoid food cooked on the road side asit is very difficult to judge the water source they use and the cleanliness of the food handler.
• Do not have ice or popsicles prepared locally: Since the water source and cleanliness of the manufacturing facility is unknown, it is best to avoid them and stay healthy.
• Do not eat pre-cut fruits and raw vegetables: This is because, the chances of bacteria infesting the pre-cut fruits or vegetables that are often left uncovered is very high. This might lower your immunity and enhance your chance of getting infected.
• Wash your hands properly: One must make sure that they wash their hands properly before cooking a meal or eating food.
• Drink boiled or bottled water: Always drink either bottled water or boiled water. It is essential that the water is brought to a rolling boil. This means that the water reaches a boiling point and is allowed to boil for about two to three minutes.

Typhoid is a completely avoidable condition, just keep these simple tips in mind to keep the disease at bay.