Typhoid fever is a life-threatening bacterial infection which is contacted by eating or drinking contaminated food or drink; and it causes health problems and complications if untreated. It is a common ancient bacterial disease transmitted by the ingestion of food or water contaminated with feces containing the bacterium – salmonella typhi.
Typhoid fever is rare in many industrialized countries. However, it remains a serious health threat in the developing world, especially among children. The World Health Organization identifies typhoid fever as a serious public health problem. There are estimated 33 million cases of typhoid fever annually resulting in about 216,000 deaths in endemic areas with highest incidences in children and young adults between 5 and 19 years old. Early identification and partnering in typhoid fever control and management interrupt its transmission.
WHAT IS TYPHOID FEVER
Typhoid fever (nervous fever) is a bacteria disease which is contacted by eating or drinking contaminated food or drinks, and it can last for 5-6 weeks if untreated. It is caused by Salmonella typhi bacteria spread through oral contact with contaminated feces or urine of infected people. A few people can become carriers of Salmonella typhi, spreading the disease for years as long as they continue to release the bacteria in their stools.
MODE OF TRANSMISSION OF TYPHOID FEVER
The salmonella typhi bacterium that causes typhoid fever may be spread through poor hygiene habits and public sanitation conditions; and sometimes by flying insects feeding on feces. The fever does not affect animals; therefore, transmission is only from human to human because salmonella typhi solely lives in humans. Typhoid fever can only spread in environments where contaminated human feces or urine comes into contact with food or drinking water. Persons with typhoid fever carry the bacteria in their bloodstream and gastrointestinal tract. In addition, a small number of persons, called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed Salmonella typhi in their feces.
Typhoid fever can also be contacted through eating food or drinking beverages that have been handled by a person who is shedding Salmonella typhi or if sewage contaminated with Salmonella typhi bacteria gets into the water for drinking or washing food. Therefore, typhoid fever is more common in areas of the world where washing of hands is less frequent and water is contaminated with sewage. Once Salmonella typhi bacteria are eaten or drunk, they multiply and spread inside the bloodstream. Good sanitation and hygiene habits are the critical measures that can be taken to prevent typhoid fever.
COMPLICATIONS OF TYPHOID FEVER
If foods or drinks contaminated with the typhoid fever bacteria are ingested orally, they travel into the intestines, bloodstream, lymph nodes, gallbladder, liver, spleen and other vital organs of the body, causing health problems and complications. Typhoid fever cases are not fatal sometimes. However when it is not identified and properly treated, it persists for three weeks to a month and may cause death. Symptoms usually improve in 2 to 4 weeks with early treatment, although a small percentage of people may die of complications. If treatment is poor, typhoid fever symptoms may return with complications such as severe intestinal hemorrhage, intestinal perforation, kidney failure, encephalitis and peritonitis.
SIGNS AND SYMPTOMS OF TYPHOID FEVER
Although children with typhoid fever sometimes become sick suddenly, signs and symptoms do develop gradually over 1–3 weeks of infection and may be mild or severe. Signs and symptoms usually experienced include fever that starts low and increases daily to as high as 39.40 or 400 C, usually in the afternoon during the first and second week. Headaches, weakness, severe fatigue, dry cough, loss of appetite, and severe diarrhea (six to eight greenish, pea soup-like and foul smelling stools in a day) or constipation are common observations.
There are rashes called “rose spots,” which are small red spots on the abdomen and chest, considerable weight loss, delirium (“muttering delirium” or “coma vigil”), exhaustion and motion difficulty with eyes half-closed, agitation and bloody stools. Typhoid fever also presents signs and symptoms of chills, confusion, difficulty paying attention (attention deficit), fluctuating mood, hallucinations and nose bleeding. Other signs and symptoms of typhoid fever include slow, sluggish and lethargic feeling; enlarged and tender spleen and liver, decreased blood cells, extremely distended and painful abdomen in the right lower quadrant and dehydration.
TREATMENT AND PREVENTION OF TYPHOID FEVER
Typhoid fever can usually be treated with antibiotics and prevented with vaccine. When properly treated with appropriate antibiotics, most people with typhoid fever ideally feel better within few days. Vaccines against typhoid fever are available, but they are only partially effective. Vaccines are usually reserved for those who may be exposed to the disease or are traveling to areas where typhoid fever is endemic.
AVOIDABLE RISK FACTORS OF TYPHOID FEVER
Traveling to typhoid fever endemic regions without medical advice or relevant precautions should be avoided. Avoid risky foods and drinks that can expose you to typhoid fever and other illnesses such as travelers’ diarrhea, cholera, dysentery and hepatitis A. Preparing food carelessly and with unwashed hands should be avoided. Discontinue the eating of raw vegetables and fruits that are easily prone to contamination with Salmonella typhi. Foods and beverages from street vendors should be avoided. It is difficult for food to be kept clean on the street and many travelers get sick from typhoid fever due to food bought from street vendors.
GOOD HABITS THAT KEEP AWAY TYPHOID FEVER
Consult expert healthcare providers immediately, if you develop signs and symptoms of typhoid fever. If you want to travel to a foreign country, find out in advance about medical care in the area you want to visit. Get appropriate vaccination against typhoid fever.
If you want to eat raw fruits or vegetables that can be peeled, peel them yourself after washing your hands with soap and water and drink water that is bottled and carbonated or boiled. Eat foods that are thoroughly cooked, hot and steaming.
Ensure good water treatment and waste disposal to protect food and drink from contamination. Take the prescribed antibiotics according to prescription and counseling to avoid medication complications in the treatment of typhoid fever. Wash your hands carefully with soap and water after using the bathroom and toilet; and before preparing and serving food.