Typhoid was a very infectious disease in the past. The well known Typhoid Mary caused an epidemic in New York in the early 20th century.
Typhoid is an acute febrile illness caused by the Salmonella typhi bacteria.
It is rare now due to compulsory typhoid vaccination of all food sellers and their assistants.
Typhoid Fever is caused by the bacteria Salmonella typhi which is an extremely hardy bacteria able to live in polluted water, contaminated food and soiled clothes.
Oral ingestion of the bacteria leads to penetration of the small bowel mucosa and rapid spread to lymphatics, lymph nodes and blood stream.
Once it entered the bloodstream, fever occur.
It then enters the spleen, liver and gallbladder and penetrates into the mucosa of the rest of the intestine, causing thinning of the walls of the bowels.
Incubation period is 5-10 days.
The main symptoms of Typhoid Fever are
1. Fever which becomes higher and higher like a step ladder
2. headache
3. abdominal pain
4. green pea soup type of diarrhea
5. enlarged spleen and liver
6. delirium and disorientation
7. lassitude and tiredness
8. rose spots rash in some patients
Symptoms usually appear within 5-10 days after exposure to the germ and last for 3-4 weeks.
Typhoid Fever can be highly contagious.
The germs are commonly transmitted by food handlers.
People can get the germs from contaminated food and drinks.
Doctors generally diagnose Typhoid Fever based on the symptoms and a physical examination.
Confirmation is by blood tests(Widal test), blood and stool cultures.
Typhoid Fever is a disease which can kill especially through its complications:
1.Intestinal hemorrhage
2.Intestinal perforation
3.Cholecystitis
4.Dehydration especially in young children and the very old patients
Because Typhoid is an infectious disease which can spread to other people through soiled clothes and contaminated food, it is advisable to quarantine the patient in hospitals.
Antibiotics is the main treatment against typhoid.
The best antibiotic is chloramphenicol but because of its side effects of aplastic anemia, it should be avoided especially in pregnant women and young children.
Other antibiotics used are septrin(co-timoxazole) and ampicillin.
Antibiotics should be continued for at least 2 weeks.
Symptomatic treatment includes:
1.Paracetamol for relief of fever and headache
Aspirin is to be avoided to prevent intestinal bleeding.
2.antispasmodic drug to stop abdominal cramps
3.medicine to harden the stools such as kaolin
4.slow down the intestinal movement (lomotil or loperamide).
Prompt treatment may be needed to prevent dehydration:
Dehydration can be caused by diarrhea, excessive sweating from the high fever, or by not drinking enough fluids because of loss of appetite.
Mild dehydration can be treated by drinking liquids.
Severe dehydration may require intravenous fluids.
Untreated severe dehydration can be life threatening especially in babies, young children and the elderly.
Gradually reintroduce food, starting with bland, easy-to-digest food, like porridge or soups.
Get plenty of rest.
Complications such as intestinal perforation may require surgical treatment.
Prevention of typhoid is usually by vaccination of all food handlers and staff working in restaurants.
Treatment of chronic typhoid carriers with antibiotics such as ampicillin for 6 months and removal of gallbladder which may harbored the bacteria.
You can avoid infection by:
Avoid eating or drinking foods or liquids that might be contaminated
Good food hygiene
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