Typhoid fever

Summary about Disease


Typhoid fever is a systemic infection caused by the bacterium Salmonella enterica serovar Typhi. It's characterized by fever, abdominal pain, headache, and rose-colored spots on the chest. Without treatment, it can lead to serious complications and death. It is typically contracted through contaminated food or water.

Symptoms


Common symptoms include:

High fever (gradually increasing)

Headache

Weakness and fatigue

Muscle aches

Stomach pain

Constipation or diarrhea

Rose-colored spots on the chest or abdomen

Loss of appetite

Causes


Typhoid fever is caused by Salmonella enterica serovar Typhi bacteria. The bacteria are usually spread through:

Contaminated food or water

Close contact with someone who is infected or is a carrier of the bacteria

Poor hygiene and sanitation

Medicine Used


Antibiotics are the primary treatment for typhoid fever. Commonly used antibiotics include:

Ciprofloxacin (although resistance is increasing)

Azithromycin

Ceftriaxone

Other antibiotics may be used depending on antibiotic sensitivity testing.

Is Communicable


Yes, typhoid fever is highly communicable. The bacteria are shed in the stool and, less commonly, in the urine of infected individuals.

Precautions


Vaccination: Get vaccinated against typhoid fever, especially if traveling to endemic areas.

Safe Water: Drink bottled or boiled water. Avoid ice cubes.

Safe Food: Eat thoroughly cooked food served hot. Avoid raw fruits and vegetables that you haven't peeled yourself.

Hand Hygiene: Wash your hands frequently with soap and water, especially before eating and after using the toilet.

Sanitation: Ensure proper sanitation and sewage disposal.

Avoid Contaminated Sources: Be cautious of street food and food from unreliable sources.

Carrier Status: People who are carriers of typhoid should follow strict hygiene practices to prevent spreading the disease.

How long does an outbreak last?


The duration of a typhoid fever outbreak can vary depending on several factors, including:

Identification and Isolation: How quickly the source of the outbreak is identified and infected individuals are isolated.

Public Health Interventions: The effectiveness of public health measures implemented to control the spread, such as water treatment, sanitation improvements, and hygiene education.

Antibiotic Resistance: The presence of antibiotic-resistant strains can prolong an outbreak.

Outbreaks can last from a few weeks to several months.

How is it diagnosed?


Typhoid fever is diagnosed through:

Blood Culture: A blood sample is taken to test for the presence of Salmonella Typhi bacteria. This is the gold standard.

Stool Culture: A stool sample can also be cultured to detect the bacteria.

Urine Culture: A urine sample can be cultured, but this is less common than blood or stool cultures.

Bone Marrow Culture: In some cases, a bone marrow culture may be performed.

TyphiDot test: An Immunochromatographic assay detecting anti-OmpC antibodies to S. typhi.

Widal test: An older serological test that is less reliable than cultures.

Complete Blood Count (CBC): Can show changes in white blood cell count.

Timeline of Symptoms


The timeline of symptoms can vary, but typically follows this pattern:

Incubation Period: 6-30 days (average 7-14 days)

Week 1: Slowly rising fever, headache, malaise, abdominal pain, cough.

Week 2: High fever (103-104°F or 39-40°C), weakness, rose spots (sometimes), abdominal distention.

Week 3: Complications such as intestinal bleeding, perforation, or encephalopathy may occur.

Week 4: If untreated, symptoms can worsen, leading to exhaustion, delirium, and potentially death. With treatment, symptoms gradually improve.

Important Considerations


Antibiotic Resistance: Antibiotic resistance is a growing concern in the treatment of typhoid fever. It's important to determine the antibiotic susceptibility of the infecting strain.

Carriers: Some individuals can become chronic carriers of Salmonella Typhi, even after successful treatment. They can shed the bacteria in their stool for months or years and pose a risk of transmission to others.

Travel: Typhoid fever is more common in developing countries with poor sanitation and hygiene. Travelers to these areas should take precautions, including vaccination and safe food and water practices.

Complications: Untreated typhoid fever can lead to serious complications, including intestinal perforation, bleeding, and encephalitis. Prompt diagnosis and treatment are essential.

Vaccination: Two types of vaccines are available: injectable inactivated vaccine and oral live-attenuated vaccine. Vaccination is recommended for travelers to endemic areas and individuals at high risk.