Typhoid is a contagious bacterial infection that can cause fever, headache, abdominal pains, and loss of appetite. Typhoid spreads throughout the body and can affect multiple organs. Most people recover quickly with prompt treatment. However, untreated typhoid can be fatal or cause life-threatening complications.
Associated Anatomy
Multiple organs
Typhoid Causes
- The bacteria Salmonella typhi (or S. typhi) causes typhoid. While S. typhi is not the bacterium that causes other food poisoning or foodborne illnesses like salmonella, they are related.
- typhi is transmitted through the oral-faecal route, which spreads through contaminated food or water. Furthermore, the transmission also happens due to direct contact with a patient (or person) who already has a typhoid infection.
Signs or Symptoms of Typhoid
Once a person gets infected with typhoid-causing bacteria, the signs of infection will develop only after a week or two. A few prominent signs or symptoms of typhoid are:
- Persistent high fever or temperature
- Headache
- Fatigue (or extreme tiredness)
- Weakness
- Confusion
- Cough
- Bloating
- Weight-loss
- Stomach pain
- Headache
- Constipation
- Poor appetite
- Rashes
- Dry cough
- Diarrhoea
Typhoid Treatment
Antibiotic treatment is effective in the treatment of typhoid. A few common antibiotics that can be prescribed for typhoid include:
Ciprofloxacin
Commonly used to treat typhoid, doctors often prescribe Ciprofloxacin for adults who are not pregnant. Similar to Ciprofloxacin, Ofloxacin drugs can be prescribed.
Azithromycin (Zithromax)
If Ciprofloxacin doesn’t work due to bacteria resistance, Azithromycin (Zithromax) can be used.
Ceftriaxone
Ceftriaxone is used to deal with complicated infections. This injectable antibiotic is for those who cannot consume Ciprofloxacin, such as children.
Other typhoid treatments include
Drinking fluids
Fluids prevent dehydration due to diarrhoea or prolonged fever. Furthermore, if people get severely dehydrated, they may receive fluids intravenously (through a vein).
Surgery
If your intestines get torn, you need a surgical process to repair them.
Risk Factors of Typhoid
You are at increased risk of typhoid disease if:
- You travel or work in typhoid-prone areas or countries, such as India, South America, Southeast Asia, and Africa.
- Your work requires handling S. typhi bacteria, or you are a clinical microbiologist working around the same bacteria.
- You come in contact with an infected person.
- You consume water or food that is affected by Salmonella typhi.
Typhoid Stages
Typhoid fever has four distinct stages:
Stage 1
In the first stage, the patient will have preliminary symptoms of infection, such as headache, dry cough, and mild fever (only in a few cases).
Stage 2
This stage is marked by weight loss and a rise in fever. The stomach also becomes bloated. The patient will feel lethargic and have fever dreams or hallucinations.
Stage 3
In this stage, holes form in the intestine, leading to an abdominal haemorrhage. This severe stage can also cause encephalitis (inflammation in the brain). Due to acute dehydration, a person may experience a higher intensity of delirium. Furthermore, the person becomes so weak that they cannot stand or walk.
Stage 4
This stage involves extremely high fever with several health complications like severe infections, pneumonia, kidney failure, and inflammation of the pancreas.
Typical Tests for Typhoid
To test for typhoid, you must get your stool, urine, and blood samples cultured. A bone marrow culture, which is a sensitive and complex test for Salmonella typhi, can also be done to diagnose typhoid fever.
Other tests can also be carried out to confirm typhoid infection, such as an antibodies test or a test to determine the presence of typhoid DNA in your blood. If your typhoid is confirmed, your family members will also need to take the test to check if they have been infected.
Primary Prevention
Before travelling to typhoid-prone regions, consider getting vaccinated. The options include:
- Oral:You can take a live attenuated vaccine for typhoid that consists of four tablets. You may consume one tablet every second day. The medication must be planned accordingly so that the last pill is taken a week before travel.
- Injection: A vaccine shot for typhoid can be administered 14-15 days (two weeks) before travel.
Secondary Prevention for Typhoid
Several secondary precautionary measures must be exercised to avoid typhoid:
Watch what you drink
- Avoid drinking tap water or directly from a well.
- Do not use popsicles or ice cubes if they aren’t made from bottled water.
- Buy carbonated bottled drinks whenever possible.
- If you are using non-bottled water, ensure that it is boiled.
- While consuming milk, tea, or coffee, ensure the milk is pasteurised.
Watch what you eat
- Refrain from eating raw produce (fruits, vegetables). Even if you consume it, ensure you wash your hands and peel them yourself.
- Avoid street food.
- Don’t eat undercooked fish or meat.
- Consume only pasteurised dairy products.
- Avoid fresh salads and condiments.
Practice good hygiene
- Keep your hands clean. Wash them often or use hand sanitisers, especially before touching food items and after using the washroom.
- Refrain from touching your face regularly with unwashed hands.
- Avoid meeting with people who are infected or sick.
Alternate Name
Typhoid Fever, Enteric Fever
Epidemiology of Typhoid
- Typhoid is prevalent in India, South America, Southeast Asia, and Africa.
- It affects about 2.7 crore people each year.
- While children remain at higher risk of getting typhoid, they tend to have milder symptoms than adults.
Expected Prognosis of Typhoid
In several cases, patients experience a relapse of typhoid fever when the symptoms return. This generally happens about a week after the antibiotic treatment has concluded. However, the relapse phase sees milder symptoms, and the illness lasts for a shorter duration than the original illness. An antibiotic treatment works best at this stage.
Natural Progression of Typhoid
If typhoid is not treated on time and allowed to progress naturally, it can cause life-threatening complications and turn fatal.
Pathophysiology of Typhoid
The pathogenesis of typhoid is influenced by factors like the patient’s immunity, infectious dose, and infectious dose. Depending on the patient’s immune system, the incubation phase lasts from 3 days to 3 weeks. During the incubation interval, a patient may have minor complaints of abdominal pain or fever. Some might not show any sign. Once the bacterium reaches a critical mass, a patient is infected with active typhoid.
Possible Complications of Typhoid
If a patient is not treated timely and with the appropriate antibiotics, they may experience complications in the third week of typhoid infection. One common complication is internal bleeding, which occurs in the digestive system. The other is the perforation (splitting) of a few parts of the bowel or digestive system, further infecting nearby tissues.
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