- by Bangalore Baptist Hospital
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- Jul 06 2017
Typhoid-Enteric Fever, Typhoid Fever
Typhoid, also called as enteric fever or typhoid fever, is an infection caused by the bacteria Salmonella typhi.
Through-out the world, millions of people are infected yearly by typhoid, and approximately 200,000 of them die. In North America and the industrialized world, the number of people infected with typhoid every year is very low, but typhoid is typical in developing countries.
Typhoid is usually treatable, but some bacterial strains are becoming progressively unaffected to antibiotics. While travelling to developing areas of the world, most people in North America acquire typhoid.
About ten to sixteen percent of people with typhoid will die, if untreated. This drops to less than One percent when people are treated immediately.
Typhoid usually spreads by food or water, in much the similar way as cholera.
Live bacteria are excreted in urine or feces by people who are infected.
They are usually infectious for a few days before any signs develop, so they don't know they need to take additional preventive measures. The typhoid bacillus can be transferred to water or food and from there to another person, if they don't wash their hands in the right manner. Also, it can be infected directly from person to person through infected fingers.
Whether treated or not, about three percent of infected people, become asymptomatic bearers of Salmonella typhi. That is, that they pursue to discard bacteria in their feces for at least a year and many a times for life but don't have any indications of typhoid. There are a meager number of typhoid carriers in every country. Even the USA and Canada announce quite a few of provincial communicated cases of typhoid every year, though many cases in these countries are among travelers or foreigners who are ill when they arrive.
Symptoms and Complications
Symptoms usually appear one or two weeks after infection but may take as long as three weeks to appear. A high, sustained fever, many a times as high as 40°C or 104°F, and intense fatigue is caused by typhoid.
Other common symptoms are:
Loss of appetite
Rarer symptoms involve:
Bleeding from the rectum
Temporary pink spots on the abdomen and chest
Symptoms start to lessen after five to seven days, with antibiotic treatment, but they keep getting worse for several weeks if not treated, and more than ten percent of untreated people may die.
A lesser number of people who recoup from typhoid may have a lapse of their symptoms just a few weeks later. The second spell inclines to be less serious than the first, and clears up rapidly with further treatment.
Many people are affected from moderate intestinal bleeding, but it is critical in only a small minority of cases. The foremost way typhoid kills is by causing penetration of the small intestines, causing bacteria to stream into the abdominal cavity. This state is called peritonitis, and is often mortal.
Other complications of typhoid happen when a large number of bacteria get into the bloodstream, causing bacteremia. They can move to the lining of the brain (meningitis), lungs, causing pneumonia, the heart valves (endocarditis), to the bones (osteomyelitis), the kidneys (glomerulonephritis) or to the genital or urinary tract, or the muscles. Hepatitis (inflammation of the liver) can also happen.
Your physician will enquire about your symptoms and do a physical examination. If your doctor doubts typhoid fever, it is detected by culturing a stool or blood sample and, in unusual occasions, bone marrow. A blood test that inspects antibodies can be used to make a diagnosis. However, this test is not very specific. Your doctor may do other tests to stipulate other conditions that cause indications similar to typhoid.
Treatment and Prevention
As for most other diarrheal diseases, the primary treatment for typhoid is oral rehydration solution. Typhoid is also treated with antibiotics which generally clear up symptoms in less than a week. People with intense typhoid also may be treated with other medications.
Very few individuals die of typhoid if they are correctly treated. However, they are likely to be infectious for at least a week after symptoms pass. A few people remain infectious, discarding the organisms in the stool, for three months or more. Except for those with gallbladder disease, the long-term carrier state is unlikely to happen.
Vigilant hand-washing after passing stools and prior to handling any food products will help prevent the spread of typhoid. Carriers may be treated with antibiotics for four to six weeks.
Typhoid fever can be got almost anywhere in the world, but it is very scarce in developed countries. If you travel to developing areas such as Asia, Africa, and Latin America, you have a higher risk of getting typhoid fever.
Preventing typhoid is all about avoiding infected water and food. The same healthy implementations will also help safeguard you from diseases such as hepatitis A and cholera, which are transferred in the same way. Follow these guidelines to reduce your risk:
Before drinking boil or disinfect all water – use disinfectant tablets or liquid available in pharmacies or drink commercially bottled (possibly carbonated) beverages.
Peel all vegetable and fruit skins before eating.
Keep flies away from food.
Watch out for ice cream, unpasteurized milk and ice cubes, which can easily be infected.
Cook all food properly and eat it while it's hot.
Be aware of the "danger foods" –, salads, raw fruit and vegetables and shellfish.
Do not drink beverages or eat food from street vendors.
At present, vaccinations against typhoid provide about fifty percent defense for three to seven years – the period of protection depends on the vaccine used. The vaccine is available as an injection or as an oral capsule. Your doctor will decide what form is best for your children or you. Even vaccinated individuals must follow the food safety tips mentioned above. It is best to be immunized at least seven to fourteen days before possible exposure (depending on the vaccine used).
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