Typhoid fever is an acute illness characterised by fever arising from the Salmonella enterica serotype Typhi bacteria. It can also be due to Salmonella paratyphi, being an associated bacterium that usually causes a less severe illness. The bacteria are accumulated in water or food by a human carrier and are then spread to other people in the area.
The bacterium strives in the intestinal areas and bloodstream of humans. It circulates between individuals by direct contact with the faeces of an infected person. S. Typhi enters via the mouth and stays for about 1 to 3 weeks in the intestine area. After this, it passes along the wall of the intestine and finally into the circulatory system.
From there, it moves into adjoining tissues and organs as well. The immune system of the individual is unable to fight back because S. Typhican live within the host’s cells, safe from the immune system.
Typhoid fever is caused either by drinking or eating the bacteria which is present in contaminated water or food items. People with acute onset of infection can pollute the nearby water supply by means of stool, which has a high concentration of the bacteria. Contamination of the water supply can, in turn, taint the food supply. The bacteria can remain for weeks in water or dried sewage.
Symptoms of typhoid are likely to evolve gradually, often emerging one to three weeks after coming in contact with the disease. These typhoid symptoms are divided into two phases:
Early Typhoid Fever Symptoms
Pyrexia starts low and increases daily, possibly reaching as high as 104.9 F
Lie motionless and exhausted with half-closed eyes
Life-threatening complications often take place during this period. In certain individuals, signs and symptoms may return up to two weeks after the fever has subsided.
Faecal-Oral Route of Transmission
Most people develop typhoid bacteria while they are travelling. Once they get infected, they can pass on this to others via the faecal-oral route. This means that Salmonella typhi spread in the faeces and at times in the urine of infected people.
Most people become infected by the intake of contaminated water or other food products. The bacteria may also pass through contaminated food and through direct contact with someone who is infected with typhoid.
Even after the completion of antibiotic treatment, a small number of people who recover from typhoid fever continue to nurture the bacteria. These are called chronic carriers and don't possess any signs or symptoms of the disease. However, they still drop the bacteria in their faeces and are capable of infecting others.
Medical and Travel history
The doctor is likely to access typhoid fever based on the typhoid symptoms and medical as well as travel history. The diagnosis is verified by the identification of the presence of Salmonella typhi in a culture of blood.
Body Fluid or Tissue Culture
For the culture to be tested, a small sample of blood, stool, urine or bone marrow is taken for examination. The culture is accessed thoroughly under a microscope for the existence of typhoid bacteria. A bone marrow culture is often termed the most sensitive test for Salmonella typhi. Apart from carrying out a culture test which is the most usual diagnostic test, several other testing procedures may be adopted to confirm the presence of a possible typhoid fever infection, like a test done to check the antibodies to typhoid bacteria in the blood.
Typhoid Tests and Exams
The doctor will perform a routine physical check-up and ask about the symptoms, following which he will recommend certain tests. These are:
A complete blood count (CBC) will indicate a significantly higher number of WBC's.
A blood culture taken during the first week of the fever can depict S. Typhi bacteria
Other tests that can assist in diagnosing this condition comprises of:
ELISA test to check for antibodies to the S. Typhibacteria
Fluorescent antibody study to inspect for substances that are specific to S typhibacteria
Platelet count (platelet count may below)
Antibiotic therapy is the only effective treatment of choice for typhoid fever symptoms. Other treatments include:
Drinking fluids: This helps in the prevention of dehydration resulting from a prolonged fever and diarrhoea. If the patient is severely dehydrated, fluids need to be administered through a vein intravenously.
Surgery: If there is a tear in the intestines, the patient will require surgery to repair the issue.
Supportive therapies: like fluid or electrolyte replacement, depending on the severity of the infection.
Risk Factors of Typhoid Fever
Typhoid fever is a significant threat worldwide, and children are at the greatest risk of contracting the disease, although they generally possess a milder form of symptoms than adults do. Risk factors generally include:
People working as clinical microbiologists handling Salmonella typhi bacteria
People in close contact with someone who is already infected or have recently been diagnosed with typhoid fever
Drinking contaminated water by sewage that contains Salmonella typhi
Possible Complications with Typhoid Fever
Possible complications include:
Inflammation of the heart muscle (myocarditis)
Intestinal bleeding or holes
Inflammation of the heart's inner lining and associated valves (Endocarditis)
Infection as well as inflammation of the membranes and fluid surrounding the brain and spinal cord called meningitis
Psychiatric problems include delirium, hallucinations and paranoid psychosis
Prevention From Typhoid Fiver
Consuming safe drinking water, improved sanitation, and adequate medical care can help prevent and control typhoid fever. Unfortunately, in many developing nations, these may be difficult to achieve.
Therefore vaccines are considered to be the best option to control typhoid fever symptoms. Apart from vaccination, certain guidelines need to be followed while travelling to high-risk areas. These include:
Washing of hands regularly
Avoid drinking contaminated water
Avoid consuming raw fruits and vegetables
Avoid having unhygienic food
For the majority of the people who undergo treatment with antibiotics, symptoms of typhoid fever tend to improve within 2 to 4 weeks. However, symptoms may return if patients do not finish their entire treatment as recommended by a doctor.