Typhoid fever

Introduction

Typhoid fever is an infection which can cause fever, diarrhea and can even be fatal. Typhoid ranges from being a mild illness to causing death. It is endemic in developing countries especially in Asia and Africa.

Causative Agents

It is caused by a bacterium (germ) called Salmonella typhi. This bacterium may contaminate food or drink in areas of poor sanitation.

Pathogenesis - Action in the Body

The bacteria enter the body by consumption of contaminated food or water. The interval between contracting infection and development of the disease is 1 – 3 weeks. It mainly infects the digestive tract and the blood stream. People with typhoid fever pass out the bacteria with their faeces (motions). If the stools are not properly disposed it can contaminate water sources and food by handling.

Symptoms and Signs - The symptoms range from mild to severe.

·         High fever

·         Dry cough

·         Malaise (body aches) and abdominal pain

·         Anorexia (loss of appetite, nausea)

·         Headache

·         Constipation or diarrhea

·         Rash – rose colored spots on the chest

Illness can get usually severe in infants and elderly.

Complications

Patient can get toxic due to severe illness. Sometimes intestines can perforate and there can be bleeding. Spleen of the patient can enlarge.

Myocarditis - inflammation of the heart muscle

When typhoid infection is severe death can occur.

Some people who are infected continue to carry the bacteria. They are called carriers and they can infect others unless treated. 1 in 10 of infected people can become carriers.

Management

·         Supportive management - Adequate rest, rehydration with water, fluids, jeewani and correction of electrolyte disturbances    with jeewani (oral rehydration solution) , intravenous fluids

·         Manage fever - with paracetamol (correct dose, 6 hourly)

·         If symptoms which are suggestive of typhoid fever occur it is necessary to consult a qualified medical practitioner. Antibiotics should be started Ex. Chloramphenicol, ampicillin, ciprofloxacin etc.

Prevention and promotion

Wash hands with soap and water especially before preparing food, eating and after using the toilet.

Drink boiled and cooled water.

Eat foods which are thoroughly cooked.

Protect cooked food from flies and cockroaches.

Wash raw fruits, vegetables and leaves before consumption.

Use of latrines and proper disposal of stools of young children.

Immunization - typhoid vaccination before traveling to endemic areas.

The treating doctor would have notified about the illness and the area public health inspector (PHI) would visit your house. He will take measures to prevent further spread in the neighborhood.