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Typhoid

User profile imageDr. Daisy Dharmaraj

Typhoid

Typhoid fever is an infection that spreads through contaminated food and water. Eating out is so common these days. While this is fun, one has to be able to fathom what is safe to eat, and what is not. Food can be contaminated by harmful organisms like bacteria, fungi, viruses, in many ways. Flies, fingers, faeces, water, soil   are the routes by which the organisms are transported to food, and cause diseases to those who consume infected food.  Some of such diseases are hepatitis, typhoid, worms, diarrhoea, dysentery, and could make a person very ill.

Typhoid is a disease in which the intestines are primarily infected. It usually presents as a sudden fever (acute), but could become a prolonged disease (chronic) going on for months or years together. The patient has fever which could be mild to very high and intermittent. The fever manifests from a week to about 2 months from the time that the bacteria entered the body.  Weakness, pain, constipation, and headaches also commonly occur. Diarrhea is uncommon and vomiting is not usually severe. Some people develop a skin rash with rose spots. In severe cases there may be some metal symptoms like disorientation. In severe cases, the bacteria could even cause brain fever (encephalitis).

Typhoid usually lasts for 3 weeks and the complications occur mostly in the second week.  The intestines   have ulcers which could even perforate if not treated. Other complications could be - septicemia ; respiratory diseases such as pneumonia and acute bronchitis; neuropsychiatric symptoms, and metastatic abscesses, infection of gall bladder, heart or bone. Thus, typhoid is a disease that could be dangerous if the patient is not treated.

One of the complexities of typhoid is that in chronic disease, the patient does not show symptoms but can continue to excrete faeces which have numerous bacteria. These bacteria could spread to others through finger, food, water or through other agents, and many contact persons get infected.

Bacteria called Salmonella typhi cause this disease. There are different types of the bacteria, and blood tests help us to identify these. Rapid diagnostic tests using a specific kit, Blood count, Widal serological test, blood culture are some of the tests used for diagnosis. Very often typhoid fever is mis-diagnosed and hence general public have to be wary of the diagnosis unless it is done by a reliable source.

Typhoid fever has to be treated by specific antibiotics, bland diet, and bed rest. Fever has to be controlled. The patient has to be closely monitored so that if complications arise, these could be diagnosed on time and treated.

There are vaccines against typhoid fever. Vi vaccine – given as a single injection. Ty21a vaccine – given as three capsules to take on alternate days. Typhoid vaccines are also given in combination with some other vaccines. Newborns also are immunized against typhoid as per specific schedules. The vaccines work by stimulating your body to create antibodies (infection-fighting proteins) that prevent you getting ill if you become infected with the typhoid bacteria.

It's important to remember that none of the typhoid vaccines are 100% effective, and you should always take precautions not to eat food and drink water which are not safe. Water has to be boiled for about 20 minutes to be considered safe. Cover all food and water, protecting them from flies. Hand washing with soap and water before food is important. One should avoid consuming food exposed to flies, and food not properly preserved. Ice creams, and juices are potent vehicles of infection.

Domestic and international travelers are often advised to protect themselves against typhoid by the following.

  • only drink bottled water from a bottle that was properly sealed, or water that's been recently boiled for 20 minutes
  • avoid ice cream and don't have ice in your drinks
  • avoid uncooked fruits and vegetables, unless you've washed them in safe water or peeled them yourself
  • avoid shellfish, seafood or salads.
  • Get vaccinated against typhoid before going to places endemic for typhoid.
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