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What Is Typhoid Fever? Causes, Symptoms, Risk Factors, Complications, Treatments And Prevention

Typhoid fever, also known as enteric fever (occurring or relating to the intestines) is a type of bacterial infection caused by Salmonella typhi, a Gram-negative bacterium. The infection is commonly spread through contaminated water or food.

With the advancement of public health and hygiene, typhoid fever has disappeared from many developed countries; however, it still is endemic in many developing or low-income countries. According to the CDC, around 21.6 million typhoid cases are reported annually with 100-1000 cases per one lakh population. Typhoid is prevalent in Latin America and Africa, and children under five years of age are at higher risk of the condition.

In this article, we will discuss typhoid fever and its related causes, symptoms, complications, diagnosis, treatments and prevention. Take a look.

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Causes Of Typhoid Fever

The main causative bacteria of typhoid fever are from the genus Salmonella: Salmonella typhi and Salmonella paratyphi. These two typhoidal salmonellae are known to cause serious gastrointestinal complications in humans when ingested, while non-typhoidal salmonella is limited to gastroenteritis and do not cause severe symptoms. [1]

The Salmonella bacterium gets transmitted to the human body by the faecal-oral route through:

  • contaminated foods,
  • contaminated water,
  • uncooked or undercooked foods and
  • infected patients' fomites.

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When a person comes in direct contact with any of the aforementioned mode of transmission, they get infected by the bacteria and themselves becomes a chronic carrier.

Though their symptoms get treated with effective antibiotics, they continue to harbour the bacteria for a long time, remaining asymptomatic, and shed them in their faeces and urine, which again, infect others.

Typhoid is a contagious infection that gets spread from an infected person to healthy adults as humans are the only host to Salmonella bacteria. The major sources of salmonella include eggs, poultry and turtles (rarely).

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The gut microbiota is naturally protective against various infections. However, conditions such as malnutrition and the use of certain antibiotics may disrupt their normal flora and amplify the risk of infections. The illness is common in areas where there are overcrowding, poor sanitation and social chaos.

Symptoms Of Typhoid Fever

Some of the symptoms of typhoid fever include:

  • Fever that starts with low temperature and reaches high.
  • Diarrhoea
  • Abdominal pain [2]
  • Fatigue
  • Loss of appetite
  • Constipation
  • Skin rash
  • Cough
  • Sweating
  • Swollen stomach
  • Dehydration

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Risk Factors Of Typhoid Fever

  • Travelling to areas where typhoid fever is endemic such as Africa and Southeast Asia.
  • Children with a weak immune system.
  • Close contact with an infected person.
  • Drinking sewage or polluted water.
  • Staying in areas with poor sanitation.

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Complications Of Typhoid Fever

  • Swollen lymphatic nodes [3]
  • Necrosis
  • Ulcer in the gastrointestinal system
  • Inflammation of the heart muscles and valves
  • Intestinal inflammation
  • Haemorrhage in the intestines
  • Sepsis
  • Kidney infections
  • Psychic disorders such as hallucinations.
  • Blood in the stools

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Diagnosis Of Typhoid Fever

Typhoid fever is often confused with other similar illnesses such as dengue fever. [4]

  • Stool and urine test: To look for the signs of Salmonella infection.
  • Bone marrow cultures: To look for infection in the bone marrow or know the type of antibodies produces by the white blood cells in response to the type of infection. It also includes blood leucocytes counts to know about fever and toxicity.
  • Liver function test: To lookout for the proper functioning of the liver.

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Treatments Of Typhoid Fever

  • Antibiotics: To kill the pathogens and reduce their count. Drugs such as fluoroquinolones and azithromycin for multidrug-resistant typhoid. [5]
  • Fluid or electrolyte replacement: It is carried out as a supportive therapy if the condition gets severe.
  • Vaccine: It is mainly recommended for children below two years, older adults and people travelling to high-risk areas.

How To Prevent Typhoid Fever

  • Avoid drinking water directly from the tap.
  • Avoid buying bottled water, ice cubes and popsicles if you are not certain about the cleanliness of the area.
  • Avoid drinking unpasteurised milk.
  • Avoid eating street foods.
  • Avoid eating raw or uncooked meat products
  • Avoid eating raw vegetables or fruits until properly washed.
  • Don't eat without washing your hand properly with soap and water.
  • Avoid direct contact with typhoid-infected people and prevent sharing personal belongings with them.
  • Avoid touching face with unwashed hands.
  • Avoid eating fish from polluted water bodies.
  • Maintain proper cleanliness in the area you reside or consult the sanctuary department for improper handling of the waste or sewage system.

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Common FAQs

1. How long does typhoid stay in your body?

According to experts, typhoid fever symptoms can be treated with effective antibiotics, but in some, the bacteria may harbour for a longer period of up to one year, shed through their faeces and infect others.

2. What are the stages of typhoid fever?

There are four stages of typhoid fever. The first stage comes with mild symptoms such as headache, fever and dry cough, second with a loss of appetite and energy and hallucinations, third with severe intestinal perforation and fourth with severe infection and meningitis.

3. Which organ of the human body is mainly affected by typhoid?

Typhoid mainly affects the intestines and related organs such as the stomach, liver, gastrointestinal tract and spleen.