Enteric fever commonly known as Typhoid Fever is an acute bacterial infection caused by bacteria Salmonella Typhi (S.Typhi). Typhoid Fever is prevalent in areas with poor sanitation.
Causes
Typhoid Fever is contracted by consuming water or food contaminated by bacteria S.Typhi. People with acute illness can contaminate the surrounding water supply through feces, which contains a high concentration of the bacteria. Contamination of the water supply can, in turn, contaminate the food supply. Less frequently Typhoid also spreads through the urine of infected person.
S.Typhi enters through the mouth and stays in the intestine for 1-3 weeks. The bacterium lives in the bloodstream of humans and spreads into other tissues and organs. No animals carry this disease, so transmission is always human to human.
The other ways of the spread of Typhoid Fever includes:
- Using a toilet that is contaminated with Salmonella bacteria and not washing hands properly before eating.
- Consuming seafood contaminated with the bacteria.
- Eating raw or inadequately cooked vegetables grown using human waste as fertilizer.
- Through oral or anal sex with a carrier of Salmonella Typhi bacteria.
Risk Factors
- Age – Typhoid infection predominantly occurs in school kids and young adults.
- It is common in people who consume outside food.
- Usually, it is a disease caused due to contaminated water and poor sanitation practices.
- Peak incidence of this infection occurs through July to September
- People who have strains of Salmonella are at increased risk of acquiring the infection. Cooks being the carriers of infection, have a propensity for causing Typhoid infections
Carriers
Around 2-5% of those who suffer from Typhoid, continue to carry the bacteria in their gallbladder (in the liver), even after the symptoms have resolved. The bacteria residing in the gallbladder can cause cholecystitis. Though they do not show any symptoms, they continue to spread bacteria through their feces or urine.
Symptoms
- Fever
- Diarrhea
- Loss of appetite
- Headache
- Weakness and tiredness
- Muscle aches
- Sweating
- Dry cough
- Pain in abdomen
- Abdominal swelling
- Skin Rashes
These conditions if left untreated can lead to serious complications such as a state of confusion, exhaustion or even death.
Diagnosis
- Complete blood count (CBC) may show an increased number of white blood cells.
- A blood culture during the initial week of the fever may show growth of Salmonella Typhi bacteria.
- Widal test is used to detect H and O antigens of Salmonella Typhi.
- Stool Examination – As S. Typhi is present in the acute stage of the disease; stool examination is done for its detection.
Treatment
- Proper hydration should be maintained either orally or intravenously if required.
- Appropriate nutrition is a must for a healthy recovery
- Antipyretics should be used for the management of fever
- Typhoid Fever can be treated effectively with the recommended course of antibiotics usually prescribed for 7 to 14 days. Avoid self-medication.
- Almost 90% of the patients can be managed at home. Hospital admission may be advised if you have serious symptoms like severe vomiting, diarrhea or abdomen swelling.
Complications
The most severe complication of typhoid fever is the development of perforation in the intestine, which can lead to the contents of the intestine leak into the abdominal cavity. It may also result in internal bleeding. Other less common complications include:
- Inflammation of the heart muscle-Myocarditis
- Inflammation of the heart and valves-Endocarditis
- Inflammation of the pancreas- Pancreatitis
- Lung infection such as Pneumonia, Kidney or Bladder infections
- Infection and inflammation of the protective membranes covering the brain and spinal cord-Meningitis
- Psychiatric symptoms such as delirium, hallucinations, and psychosis.
Prevention
- Vaccinations are done in two forms. One is an injectable vaccine given as single dose at least a week before travel. The other is four capsules taken orally every other day.
Do not ignore early signs of Typhoid.
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