- What is Typhoid Fever?
o It is an acute febrile illness caused by a bacterium called Salmonella Typhi. The disease is more common in the tropical and subtropical regions and less common the developed part of the world. If untreated, it may progress in severity.
- How the disease is caused?
o It is transmitted by the Feco-Oral route ingestion of some contaminated food, water, ice, eggs, and undercooked meat. Also, people who have or carry the bacteria can spread them to others when they handle food without properly washing their hands after using the bathroom. Once the victim is exposed to the pathogen, the first symptom may appear after 7 – 21 days.
- What are the symptoms of Typhoid Fever?
o The doctor makes a diagnosis from a medical history (including travel abroad) and physical examination. The common symptoms of typhoid fever are;
Fever
Headache
Malaise
Abdominal discomfort
Bloating of the abdomen
Constipation
Diarrhea (though less common)
Dry cough
Confusion
Rose spot (transient rash in the thorax or abdomen)
- How the diagnosis is made?
o The diagnosis is made based on the history, clinical examinations and laboratory values. Your physician may require you few tests to be performed like stool detailed report, blood cultures etc. Stool detailed report and blood cultures take 3 – 5 days to turn positive or negative, so the physician may start your treatment before all the laboratory reports are available. Definite diagnosis is made from the positive blood cultures; presumptive diagnosis is made from the positive stool, urine cultures and clinical presentation.
- What to tell to the health care providers?
o The healthcare providers must be aware of ;
Typhoid Vaccination status
Previous recent antibiotic exposure
Visit to endemic areas/tropical or subtropical areas
Closed contact with the typhoid positive patient (may be transmitted by the feco - oral route0
- Are there other disease similar to typhoid fever?
o Yes, the symptoms of typhoid fever are very similar to some of disease, for example;
Malaria
Infectious hepatitis
Atypical pneumonia
Tuberculosis
- What are the Preventions and Modes of Treatment
o The vaccines against the typhoid fever are available and effective. Three typhoid vaccines are currently available for use in the United States: a) an oral live-attenuated vaccine (Vivotif Berna-TM vaccine b) a intramuscular(Typhoid Vaccine, manufactured by Wyeth- Ayerst); and c) a newly licensed capsular polysaccharide vaccine for parenteral use (Typhim Vi, manufactured by Pasteur Merieux). A fourth vaccine, an acetone-inactivated parenteral vaccine, is currently available only to the armed forces. The vaccines are found to be 75% effective in some clinical studies.
o The treatment of typhoid fever is based on the susceptibility of salmonella typhoid in your region. Commonly, the infection is managed in ambulatory care settings, if with no complications. The culture results will help the healthcare professionals to decide the treatment plan for the infection. In certain countries, a class of antibiotics called 3rd generation cephalosporins (cefixime, ceftriaxone etc) is considered to be the drug of choice. In other part of the world, a class of drugs called fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin) can be used to treat typhoid fever. The treatment duration may range from 7 days to 14 days. The initial improvement is not very prompt and fever may be subsided 2 – 5 days of the start of antibiotics.
References:
- Typhoid Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP)
