Typhoid fever is a bacterial infection caused by Salmonella
enterica. It is also termed as enteric fever. It is a highly contagious
disease. Typhoid can
be fatal if it is not attended too quickly. It is transmitted by the
ingestion of food or water contaminated with bacterium Salmonella. Typhoid is
also transmitted through the feces of an infected person. Common symptoms
include high or slow fever, profuse sweating and gastroenteritis. Typhoid fever
is a common worldwide illness. It can affect any person irrespective of health,
background and race. There are 1000 different types of typhoid bacteria. Various drugs used to treat
typhoid are unsuccessful against resistant strains of typhoid bacteria. In
developing country such as India, it is a great threat and a major cause of
death. Typhoid disease mainly hit on children who are in school-going age. It
is not very common in adults and older people.
Bacteria of typhoid are survived in
unhygienic conditions. These bacteria are spread by typhoid patients and
carriers in large quantities through stools and vomit. The bacteria then travel
to food, drinks and water through house-flies and other insects. Such foods are
contaminated. When these contaminated food or drinks, are taken by healthy
person, bacteria enter in to the body of person and causes typhoid fever.
Person may get typhoid fever by consuming food or drink that has been carried
by someone having the bacteria, or if sewage contaminated with S.typhi gets
into water used for drinking or washing food. There are 107 different strains
of this bacterium.
Paratyphoid is caused by Salmonella
enteritidis paratyphi A, B or C. It is generally a less infection than typhoid.
A very low percent of typhoid patients remain chronic carriers regardless of
treatment. Most common complications are intestinal bleeding and perforation.
The source of fever is polluted water. In India, due to population explosion,
water is polluted and this disease is matter of worry especially in disaster
areas, where water supply and sewage disposal are disrupted. Raw vegetables
grown on sewage fields also spread infection. The bacteria can survive in soil
and water for several months. They grow rapidly in milk and milk-products.
Typhoid
cases are more common in developing countries due to unhygienic conditions.
Early and most common symptoms include fever, malaise, abdominal pain and
severe diarrhea which could worse conditions more. Other symptoms include
abdominal tenderness, bloody stools, chills, confusion, nose bleeding,
lethargic feeling and weakness.
Salmonella
causes three clinical syndromes in human being they are enteric fever, gastroenteritis
and septicemia. Bacteria usually enters the body through mouth by the contaminated food or water. Once bacteria
resist host defense mechanism and manage to penetrate intestinal wall and
multiplies in great number. Within 24 hours to 72 hours bacteria tries to enter
into bloodstream causing septicemia and systemic infection.
Salmonella
multiplies in gall bladder abundantly and is discharged continuously into the
intestine where it involves Peyers’s Patches and Lymphoid follicles. These
become inflamed and undergo necrosis and slough off, leaving behind the
characteristic typhoid ulcers. Ulceration of bowels leads to complication known
as intestinal perforation and hemorrhage. Onset is usually gradual with
headache, abdominal discomfort, lethargic etc. The typical feature is step
ladder pyrexia.
Apart
from intestinal perforation and hemorrhage other complications involved is
circulatory collapse. Some degree of bronchitis or bronchopneumonia is always
found. Some develop psychoses, deafness or meningitis. Cholecystitis,
abscesses, arthritis, periosteistis, nephritis, hemolytic anemia, venous
thromboses and peripheral neuritis are other complications found. The number of
such symptoms involved is quiet less but fatality rate is very high.
Treatment
As it is said for all
diseases, prevention is the best remedy. For typhoid, proper antibiotics have
to be used. There is a growing frequency of resistant strains of the bacteria.
Other treatment is to reduce symptoms through drinking more fluids. This prevents
the dehydration that results from a prolonged fever and diarrhea. If a patient
is severely dehydrated, he may need to receive fluids intravenously. Patient
must take a healthy diet. Typhoid fever in most cases is not fatal. Antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, amoxicillin and ciprofloxacin,
have been commonly used to treat typhoid fever in microbiology. Even after
treatment with antibiotics, some people who recover from typhoid fever continue
to carry the bacteria in their intestinal tract or gallbladder for years. Such
people called chronic carriers. They carry the bacteria in their feces and are
capable of infecting others, although they no longer have signs or symptoms of
the disease themselves.
