Typhoid Fever
Typhoid fever is caused by Salmonella typhi, the typhoid bacillus. At present, there are 107 different strains of the bacteria. Typhoid fever is still common in the developing world, where it affects about 17 million persons each year with approximately 600,000 deaths. Salmonella Typhi lives only in humans. People with typhoid fever carry the bacteria in their bloodstream and intestinal tract. In addition, a small number of persons called carriers, recover from typhoid fever but continue to carry the bacteria. Both ill persons and carriers shed S. Typhi in their faeces (stool). Severe forms have been described with mental dullness and meningitis. Case-fatality rates of 10% can be reduced to less than 1% with appropriate antibiotic therapy.
Transmission: Typhoid fever is transmitted by food and water contaminated by the faeces and urine of patients and carriers. Polluted water is the most common source of typhoid. In addition, shellfish taken from sewage contaminated beds, vegetables fertilized by nightsoil and eaten raw, contaminated milk and milk products have been shown as a source of infection.
Manifestations: Persons with typhoid fever usually have a sustained:
- Fever as high as 39° to 40°C (103° to 104°F)
- Malaise
- Abdominal pains
- Headache
- Loss of appetite
- Rash of flat, rose-colored spots.
Diagnosis and treatment: The only way to know for sure if an illness is typhoid fever is to have samples of stool or blood tested for the presence of S. Typhi. Treatment with antibiotics is available.
Vaccination: Immunisation for typhoid fever is recommended for international travellers to endemic areas, especially if travel will involve exposure to unsafe food and water or close contact in rural areas and with indigenous populations.
Prevent typhoid fever by:
- Drink canned water
- Carbonated water is safer than un-carbonated water
- Ask for drinks without ice
- Avoid popsicles and flavoured ices that may have been made with contaminated water
- Eat foods that have been thoroughly cooked and that are still hot and steaming
- Avoid raw vegetables and fruits that cannot be peeled
- Vegetables like lettuce are easily contaminated and are very hard to wash well
- Eat raw fruit or vegetables that can be peeled, peel them yourself. (Wash your hands with soap first.) Do not eat the peelings
- Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street, and many traveller’s get sick from food bought from street vendors.
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