According to the latest estimates of the World Health Organization (WHO), globally, there are 28 000 to 161 000 typhoid-related deaths a year. According to this world body, there are about 11 to 21 million cases of this bacterial disease worldwide annually. Typhoid is mostly prevalent in India and other South East Asian countries, Africa, Central and South America, and Western Pacific countries. These areas have poor water quality and sewage sanitation.
What is Typhoid?
Typhoid, a gastrointestinal infection caused by bacteria known as Salmonella typhi (S.typhi), is characterised by high fever, diarrhoea, and vomiting. One can get this bacterial infection through contaminated water or food. S. typhi sneaks into your intestine through the mouth and stays there for about 1-3 weeks before making way to your bloodstream via the intestinal wall. From the blood, the typhoid bacteria spread to other tissues and organs and hide inside cells, that cannot be traced by your immune cells. Typhoid is curable with proper treatment. However, left untreated, it can be fatal. Possible complications of typhoid include kidney failure, severe GI bleeding, intestinal perforation, etc.
According to some estimates, about 3-5 per cent of people affected by typhoid become carriers of this bacterium. Asymptomatic people may also become carriers of the typhoid bacteria.
Typhoid patients experience symptoms about 1-3 weeks after exposure to the bacteria. The duration of the disease is 3 to 4 weeks depending upon the severity. The normal incubation time is 7 to 14 days. Here are some of the prominent symptoms:
- Constipation or diarrhoea
- High fever (103 degree Farenheit)
- Poor appetite
- Enlarged spleen & liver
- Rose-colored spots on the chest
- Chest congestion
- Abdominal pain
- Generalized pain and weakness
What Causes Typhoid?
One contracts typhoid fever by eating foods and drinking water contaminated with faecal matter containing a high volume of S.typhi bacteria. The whole water supply around a typhoid patient can be contaminated by his stool. This, in turn, can lead to the contamination of the entire food supply chain around him.
Diagnosis of Typhoid
Your doctor is likely to recommend a few tests if your symptoms hint at typhoid. The confirmatory diagnosis tests include culture of your blood, stool, urine or bone marrow to detect the presence of Salmonella typhi. Bone marrow culture is considered to be the most sensitive test for the typhoid bacteria. Your physician may also suggest other blood tests to check typhoid DNA and antibodies.
Treatment of Typhoid
Antibiotics such as ciproflaxin and ceftriaxone are generally prescribed to treat typhoid. Azithromycin is another option. These are, however, not prescribed for expecting moms. In severe cases, where the bowel has become perforated, surgery may be required.
People suffering from typhoid fever complain of digestive or gastrointestinal issues too. Loss of appetite and nausea are the associated symptoms of this bacterial infection. A well-planned diet will go a long way in managing typhoid. Nutritionists and doctors recommend small, frequent meals for people living with this condition. They also advise typhoid patients to go for easy-to-digest foods as the digestive tract fails to function at its best during this bacterial infection. Ideally, you need to maintain a balance of carbs, fats and proteins when dealing with typhoid. Follow these food rules to ease the symptoms and make the healing process smooth.
- Go for a high-calorie diet. The typhoid bacteria may make you shed kilos unnecessarily. A diet loaded with calories will help you maintain a healthy body weight. Bread, bananas, boiled potatoes can be good options.
- Have plenty of fluids. Typhoid comes with high fever and diarrhoea, both of which may lead to dehydration. Depleted levels of fluid can lead to the complication of typhoid treatment. Make sure that you drink enough water and fresh fruit juices.
- Rely on semi-solid foods like boiled rice, baked potato, so on and so forth. They are easy to digest.
- Include protein-rich foods like legumes, cheese and yogurt in your meals. However, avoid meat because you may find it difficult to digest.
- Avoid high-fibre, spicy and deep-fried foods. Ghee, butter and dairy products should also be kept at bay.
Prevention of Typhoid
WHO recommends two vaccines to prevent typhoid. One of them is an inactivated vaccine shot while the other is a live, weakened one administered orally.
Vaccine shot: The injection is recommended for anyone above 2 years of age. Repeat doses are advised for people in the high-risk category.
Oral vaccine: This can be given to people above 6 years of age. It comes in a pack of 4 tablets, three of which have to be taken on alternate days. Your doctor may recommend you to take the last one just a week before going to a place with high typhoid incidence. Each capsule needs to be taken an hour before a meal. Ideally, you should have it with cold or lukewarm water. It is important to store these capsules in a refrigerator. Doctors recommend a booster dose of this vaccine every 5 years for people in high risk zone.
Apart from vaccines there are other steps that you can take to keep typhoid at bay:
- Maintain proper hand hygiene. Wash your hands frequently, especially before having food and after using the washroom.
- Avoid street foods. They can be the breeding grounds for the typhoid bacteria.
- Make sure that you wash your utensils with clean, uncontaminated water.
- Eat hot and fresh foods as high temperature hinders the growth of bacteria.
- Avoid eating raw veggies and fruits and drinking untreated or contaminated water.
- Keep all your household items (especially in the kitchen) well-cleaned and sanitized.
- In case you are travelling to any part of the world that can put you at high risk of getting infected with typhoid, then vaccination is the best option available.