Know all that you must know about typhoid, its prevention, diagnosis and treatment.
Of the several water-borne diseases, typhoid fever is one of the most contagious and acute. This affliction is caused by the salmonella typhi bacteria. Typhoid can also be caused by salmonella paratyphi, which is a related bacterium that usually causes a less severe illness. It’s more prevalent in regions where water is untreated and hygiene conditions are poor.
What Causes Typhoid Fever?
This fever is contracted by consuming the bacteria present in contaminated food or water. This bacteria is so highly contagious that people with acute typhoid can contaminate the surrounding water supply through their stool, as it contains high concentration of the bacteria. This contaminated water supply can, in turn, infect the food supply. The bacteria can thrive in water or dried sewage for several weeks.
While many suffer a very mild infection that often goes unrecognized, about 3%-5% people become potent carriers of the bacteria after the acute illness. “As a possibility, many of these people who may not even carry any detectable symptoms may become long-term carriers of the bacteria. These carriers can become the source of new outbreaks of typhoid fever for several successive years,” says Dr RK Lalwani, senior physician, Fortis Healthcare.
How Is Typhoid Fever Diagnosed?
“After the consumption of infected food or water, the salmonella bacteria attack the small intestine and enter the bloodstream temporarily. Later, the white blood cells carry the bacteria in the liver, spleen, and bone marrow. This is where they multiply and enter the bloodstream yet again. At this point, people develop symptoms, like fever. Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel. Here, they multiply in high numbers, and other symptoms start showing,” says Dr Lalwani.
1. The main symptom of typhoid infection is persistent, high fever that ranges between 103° to 104° F (39° to 40° C). Watch out for these symptoms too: stomach pain, rose-colored spots, headache, loss of appetite, enlargement of the spleen, malaise, a rash of flat, and an abnormally retarded heartbeat (less than 60 beats a minute). There could also be other mild and non-typical infections in some cases.
2. It’s important to understand that the only way to be certain if the illness is typhoid fever is by clinical analysis of stool or blood. The bacteria pass into the intestinal tract and can be identified in stool samples. If a test result isn't clear, blood samples will be taken to make a diagnosis.
3. See a physician immediately for treatment if you think you have contracted this disease.
How is Typhoid Fever Treated?
Antibiotic therapy aides in killing the salmonella bacteria that causes typhoid. However, preceding the use of antibiotics, the fatality rate was alarmingly low! Death occurred from intestinal bleeding, pneumonia, overwhelming infection, or intestinal perforation. With antibiotics and proper health care, mortality has been successfully reduced to 1%-2%. Antibiotics can usually show signs of marked improvement within one to two days. Complete recovery can happen within seven to 10 days. However, it’s important for required tests to ascertain that.
Several antibiotics are effective in the treatment of typhoid fever. Because of its infrequent but serious side effects, other effective antibiotics have substituted chloramphenicol. “The array of antibiotics is largely driven by identifying the geographic region where the infection was contracted. If relapses occur, patients are retreated with antibiotics. It is best to seek your local physician’s advice for the same,” says Dr AK Mishra, senior general physician in New Delhi.
In chronic cases, (about 3%-5% patients), treatment can be sought by prolonged antibiotics. Often, gallbladder removal also provides a cure, as it is the site of chronic infection.
Prevention is better than Cure
Typhoid fever is an infection which can cause fever, diarrhoea and can even be fatal, claiming the patient’s life too if the right treatment doesn’t reach him timely. Hence, it is necessary to get travel injections and typhoid immunisation. Here’s how you can prevent this water-borne ailment.
1. Eat only well-prepared fresh foods while travelling to areas where typhoid fever occurs or a place that has sanitation issues. Take these precautions to ensure you are not ingesting foods that may be infected:
- Eat only well-cooked and fresh food.
- Strictly avoid raw vegetables and fruits that cannot be peeled. Wash and peel well before consuming raw fruits and vegetables. Vegetables like lettuce and cabbage get easily contaminated, and are difficult to wash well should be avoided.
- Avoid street food and beverages, as much as possible.
2. Drink water only from clean and untainted sources. Buy bottled water or bring the regular bottle to a rolling boil for over a minute before drinking it. Bottled, carbonated or boiled water is safer than uncarbonated water. Did you know that even ice could be contaminated? Either do without ice, or make sure the water used to make the ice was pure and safe.
3. You must get vaccinated for typhoid fever, especially when traveling to or through any part of the world where exposure to this bacteria or disease is possible.
4. The vaccine is not 100 per cent effective. Utilise both preventive measures of vaccination as well as make sure you consume only safe food and water to prevent the infection.
5. Two kinds of vaccines are available worldwide today. Both are equally effective at preventing typhoid fever, but the duration of effectiveness differs significantly. The longest-lasting vaccine is taken orally in capsular form - one capsule every other day for eight days and a total of four capsules. This form of vaccination provides protection for five years. Ideally, this treatment regimen must be completed one week prior to any travel. The alternative, and shorter-duration vaccine, is given intramuscularly (or in one shot) and provides protection for two years. This treatment regimen must be administered at least two weeks prior to travel.
Should typhoid patients be isolated or excluded from work or school? “Typhoid patients should be strictly confined to bed and excluded from every kind of work (also high-risk occupations food handling, day care providers, or health care) until at least three consecutive negative stool cultures taken at least 24 hours apart and at least 48 hours after antibiotic therapy has stopped and not earlier than one month after the onset of illness. Even household and close contacts of the patient should be excluded from high-risk occupations until at least two negative stools samples taken 24 hours apart are obtained,” says Dr Mishra.
Things to keep in mind:
· Vaccination is only 50 to 80 per cent effective at preventing typhoid fever. Please make ample preventive measures and maintain good personal and regional hygiene. Don’t solely rely on vaccination.
· Children under six years of age are not advised vaccination.
· Pregnant women should not be vaccinated.
Friends, let’s not wait until the last minute to get vaccinated. It can take up to two weeks for the vaccine to be effective. And it may get very late by then. Find out, as soon as possible, if the area you are located at or plan to travel to puts you at risk to typhoid fever. Take timely precautions and stay healthy.
Of the several water-borne diseases, typhoid fever is one of the most contagious and acute. This affliction is caused by the salmonella typhi bacteria. Typhoid can also be caused by salmonella paratyphi, which is a related bacterium that usually causes a less severe illness. It’s more prevalent in regions where water is untreated and hygiene conditions are poor.
What Causes Typhoid Fever?
This fever is contracted by consuming the bacteria present in contaminated food or water. This bacteria is so highly contagious that people with acute typhoid can contaminate the surrounding water supply through their stool, as it contains high concentration of the bacteria. This contaminated water supply can, in turn, infect the food supply. The bacteria can thrive in water or dried sewage for several weeks.
While many suffer a very mild infection that often goes unrecognized, about 3%-5% people become potent carriers of the bacteria after the acute illness. “As a possibility, many of these people who may not even carry any detectable symptoms may become long-term carriers of the bacteria. These carriers can become the source of new outbreaks of typhoid fever for several successive years,” says Dr RK Lalwani, senior physician, Fortis Healthcare.
How Is Typhoid Fever Diagnosed?
“After the consumption of infected food or water, the salmonella bacteria attack the small intestine and enter the bloodstream temporarily. Later, the white blood cells carry the bacteria in the liver, spleen, and bone marrow. This is where they multiply and enter the bloodstream yet again. At this point, people develop symptoms, like fever. Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel. Here, they multiply in high numbers, and other symptoms start showing,” says Dr Lalwani.
1. The main symptom of typhoid infection is persistent, high fever that ranges between 103° to 104° F (39° to 40° C). Watch out for these symptoms too: stomach pain, rose-colored spots, headache, loss of appetite, enlargement of the spleen, malaise, a rash of flat, and an abnormally retarded heartbeat (less than 60 beats a minute). There could also be other mild and non-typical infections in some cases.
2. It’s important to understand that the only way to be certain if the illness is typhoid fever is by clinical analysis of stool or blood. The bacteria pass into the intestinal tract and can be identified in stool samples. If a test result isn't clear, blood samples will be taken to make a diagnosis.
3. See a physician immediately for treatment if you think you have contracted this disease.
How is Typhoid Fever Treated?
Antibiotic therapy aides in killing the salmonella bacteria that causes typhoid. However, preceding the use of antibiotics, the fatality rate was alarmingly low! Death occurred from intestinal bleeding, pneumonia, overwhelming infection, or intestinal perforation. With antibiotics and proper health care, mortality has been successfully reduced to 1%-2%. Antibiotics can usually show signs of marked improvement within one to two days. Complete recovery can happen within seven to 10 days. However, it’s important for required tests to ascertain that.
Several antibiotics are effective in the treatment of typhoid fever. Because of its infrequent but serious side effects, other effective antibiotics have substituted chloramphenicol. “The array of antibiotics is largely driven by identifying the geographic region where the infection was contracted. If relapses occur, patients are retreated with antibiotics. It is best to seek your local physician’s advice for the same,” says Dr AK Mishra, senior general physician in New Delhi.
In chronic cases, (about 3%-5% patients), treatment can be sought by prolonged antibiotics. Often, gallbladder removal also provides a cure, as it is the site of chronic infection.
Prevention is better than Cure
Typhoid fever is an infection which can cause fever, diarrhoea and can even be fatal, claiming the patient’s life too if the right treatment doesn’t reach him timely. Hence, it is necessary to get travel injections and typhoid immunisation. Here’s how you can prevent this water-borne ailment.
1. Eat only well-prepared fresh foods while travelling to areas where typhoid fever occurs or a place that has sanitation issues. Take these precautions to ensure you are not ingesting foods that may be infected:
- Eat only well-cooked and fresh food.
- Strictly avoid raw vegetables and fruits that cannot be peeled. Wash and peel well before consuming raw fruits and vegetables. Vegetables like lettuce and cabbage get easily contaminated, and are difficult to wash well should be avoided.
- Avoid street food and beverages, as much as possible.
2. Drink water only from clean and untainted sources. Buy bottled water or bring the regular bottle to a rolling boil for over a minute before drinking it. Bottled, carbonated or boiled water is safer than uncarbonated water. Did you know that even ice could be contaminated? Either do without ice, or make sure the water used to make the ice was pure and safe.
3. You must get vaccinated for typhoid fever, especially when traveling to or through any part of the world where exposure to this bacteria or disease is possible.
4. The vaccine is not 100 per cent effective. Utilise both preventive measures of vaccination as well as make sure you consume only safe food and water to prevent the infection.
5. Two kinds of vaccines are available worldwide today. Both are equally effective at preventing typhoid fever, but the duration of effectiveness differs significantly. The longest-lasting vaccine is taken orally in capsular form - one capsule every other day for eight days and a total of four capsules. This form of vaccination provides protection for five years. Ideally, this treatment regimen must be completed one week prior to any travel. The alternative, and shorter-duration vaccine, is given intramuscularly (or in one shot) and provides protection for two years. This treatment regimen must be administered at least two weeks prior to travel.
Should typhoid patients be isolated or excluded from work or school? “Typhoid patients should be strictly confined to bed and excluded from every kind of work (also high-risk occupations food handling, day care providers, or health care) until at least three consecutive negative stool cultures taken at least 24 hours apart and at least 48 hours after antibiotic therapy has stopped and not earlier than one month after the onset of illness. Even household and close contacts of the patient should be excluded from high-risk occupations until at least two negative stools samples taken 24 hours apart are obtained,” says Dr Mishra.
Things to keep in mind:
· Vaccination is only 50 to 80 per cent effective at preventing typhoid fever. Please make ample preventive measures and maintain good personal and regional hygiene. Don’t solely rely on vaccination.
· Children under six years of age are not advised vaccination.
· Pregnant women should not be vaccinated.
Friends, let’s not wait until the last minute to get vaccinated. It can take up to two weeks for the vaccine to be effective. And it may get very late by then. Find out, as soon as possible, if the area you are located at or plan to travel to puts you at risk to typhoid fever. Take timely precautions and stay healthy.
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