TYPHOID

          

            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.