Typhoid

Typhoid fever is a bacterial infection caused by Salmonella enterica serotype Typhi. It is primarily characterized by symptoms such as high fever, diarrhea, fatigue, rash, headache, and cough. The infection is commonly spread through contaminated food and water. For effective treatment, hospitalization is often required to ensure adequate care, maintaining hydration, and administering antibiotics such as quinolones and tetracyclines. In certain cases, surgery might be necessary if complications occur. Vaccination is available and recommended as a preventive measure against typhoid.

Causes

The main cause of typhoid fever is the bacterium Salmonella enterica serotype Typhi. This bacterium spreads predominantly through food and water contaminated by the feces of an infected individual. Poor sanitation and unsafe drinking water increase the risk of transmission, particularly in certain developing regions such as parts of Africa and South Asia. Infection can occur by consuming contaminated water, raw fruits, vegetables, or inadequately cooked food. Furthermore, improper hand hygiene after using the restroom can unknowingly spread the bacterium. Importantly, individuals who have recovered from typhoid can still carry and transmit the bacteria without exhibiting symptoms. Good sanitation practices, vaccination, and consuming safe food and water are critical for preventing the spread of typhoid fever.

Symptoms

Awareness of typhoid fever symptoms is crucial for timely intervention. Common symptoms include:

• High fever that progressively increases

• Headache and chills

• Abdominal pain

• General fatigue and muscle aches

• Loss of appetite

• A distinctive rash with "rose spots," usually appearing on the chest or abdomen

• Digestive disturbances, such as diarrhea or constipation

• Occasionally, a persistent cough may be present

Without timely treatment, these symptoms may escalate and cause serious complications. Early detection and appropriate medical care are vital in managing symptoms and preventing further health issues.

Diagnosis

Diagnosis of typhoid fever involves assessing symptoms, travel history, and conducting laboratory tests. Healthcare providers will inquire about symptoms and any recent travel to areas where typhoid is prevalent. Confirmatory diagnosis requires blood, stool, or urine samples to detect the Salmonella Typhi bacterium. Blood culture is the most reliable test, where bacteria from the sample are cultivated and identified under a microscope. If blood test results are inconclusive, a bone marrow test, though more invasive, may be used. Accurate and early diagnosis is crucial for effective treatment and controlling the disease spread.

Treatments

The primary management of typhoid fever involves antibiotics, which are crucial in shortening the illness duration and reducing the risk of severe complications. The choice of antibiotics depends on the infection's severity and the bacterial resistance profile. Commonly used antibiotics include fluoroquinolones (e.g., Ciprofloxacin), cephalosporins (e.g., Ceftriaxone), macrolides (e.g., Azithromycin), and carbapenems for severe cases. Increasing antibiotic resistance necessitates selecting appropriate antibiotics based on susceptibility testing. Hospitalization and possibly surgery might be required for complex cases with complications like intestinal damage. Completing the entire course of antibiotics is essential to ensure full recovery and prevent relapse.

Medications

Antibiotics play a pivotal role in treating infections caused by Salmonella Typhi. Common medications used include:

• Fluoroquinolones, such as Ciprofloxacin: Effective by disrupting bacterial DNA replication.

• Cephalosporins, like Ceftriaxone: Used particularly when there is antibiotic resistance.

• Azithromycin: A macrolide suitable for cases resistant to other antibiotics.

• Carbapenems: Considered in more severe cases.

Adherence to the prescribed antibiotic course is critical for recovery, recurrence prevention, and minimizing antibiotic resistance.

Prevention

To prevent typhoid fever, take the following steps:

• Vaccination: Get vaccinated before traveling to high-risk areas, like parts of South Asia and Africa. Choices include an oral vaccine for those over six years old and an injectable vaccine for those over two. Administer vaccines at least two weeks prior to travel, with boosters recommended every two to five years based on the vaccine type.

• Safe Eating and Drinking Habits: Minimize infection risk by eating only well-cooked foods, drinking bottled or boiled water, and avoiding raw foods that cannot be peeled.

• Hand Hygiene: Wash hands thoroughly with soap and water regularly, particularly after using the restroom and before eating or preparing food, to avoid exposure to the bacteria causing typhoid.