Typhoid

What is typhoid (typhoid fever)

Typhoid fever or typhoid (in English:Typhoid fever is a contagious systemic
infection caused by the bacteria Salmonella Typhi, through ingestion of
contaminated foods or drinks.

Salmonella typhi-like bacteria can also cause (Salmonella paratyphi) can

cause typhoid fever, and its symptoms are mild compared to typhoid fever
caused by Salmonella typhi.

Causes of typhoid fever (typhoid fever)

The main cause of typhoid fever is infection with Salmonella typhi, which
can infect humans in the following ways:
pollution
The bacteria that cause typhoid fever are transmitted to humans mainly
through contaminated food or water, and sometimes through direct
contact with a person infected with typhoid.
Typhoid fever spreads mainly in developing countries, as a result of poor
sterilization and hygiene, and residents of developed countries often do
not become infected with this disease until they visit one of the
developing countries where it is spreading.
The bacteria that cause typhoid fever are transmitted through the stool of
an infected person, and sometimes they may be transmitted through
urine. Therefore, the infection can be transmitted to another person if he
eats food prepared by a person infected with typhoid fever and does not
clean his hands well after using the bathroom.

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Food sources can be contaminated as a result of the water sources used,
as bacteria can survive for several weeks in the water.
Typhoid fever carriers
After recovery from typhoid fever, a small percentage of patients,
estimated at 3-5%, continue to harbor bacteria in the intestines or
gallbladder without causing any symptoms, and in some cases they may
cause mild illness attacks that go undetected.
The bacteria may remain in carriers of the disease for several years, and
they are called chronic typhoid carriers, as the bacteria continue to be
transmitted through their stool and are able to infect others even though
the carrier does not suffer from any symptoms. These people may cause
an outbreak of the disease for several years.

Risk factors for typhoid fever

Every year, typhoid fever affects approximately 26 million people or more
around the world, especially in developing countries, as it is considered a
widespread disease in the Indian subcontinent, Southeast Asia, Africa, and
South America.
Children are more susceptible to typhoid fever, and often have less severe
symptoms than adults.
The risk of contracting typhoid fever increases for people who do not live
in typhoid fever-endemic areas in the following cases:

Traveling to or working in areas where the disease is widespread.

Working as a microbiologist (in English:microbiologist deals with
salmonella bacteria that cause typhoid.
Having a close relationship with another person who has or has had
typhoid fever not long ago.

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Symptoms of typhoid (typhoid fever)
The incubation period usually lasts one to two weeks, while the disease
period lasts approximately 3-4 weeks. Symptoms include the following:
A continuous rise (no more or less) in body temperature, as the body
temperature may reach 39-40 degrees Celsius.
Fatigue, weakness and general pain.
stomach pain.
Headache.
Constipation or diarrhea.
Cough.
Anorexia.
Chest congestion, which occurs in many patients.
A rash in the form of flat, pink dots may affect some typhoid patients.
In the advanced stages of the disease and in the absence of treatment, the
patient may become delirious, or he may lie tired without moving with half
his eyes closed. This condition is known as typhoid.
Typhoid fever symptoms may return in approximately 10% of patients
after feeling better for two weeks, and this often occurs in patients who
have been treated with antibiotics.

How is typhoid (typhoid fever) diagnosed?

Typhoid fever is diagnosed by taking the patient’s medical history,
including the symptoms and other diseases he suffers from, in addition to
the places he has recently visited. The doctor also performs several tests
to confirm the infection with typhoid fever, which include the following:

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Stool culture, to detect the presence of Salmonella bacteria that cause
typhoid.
Blood or urine culture, which is used in some cases.
Cultivating a sample of bone marrow is considered the most accurate.
The Vidal test is a test that detects the presence of antibodies to the
Salmonella bacteria in the blood of the infected person, or detects the
presence of DNA (DNA) of bacteria in the blood.
Typhoid complications (typhoid fever)
There are many complications of typhoid fever, some of which are serious
and lead to serious problems. The most important complications of
typhoid fever are the following:
Intestinal bleeding or perforation
It is the most serious complication of typhoid fever, as bleeding or
perforation occurs in the intestine in the third week of infection, resulting
in leakage of the contents of the small or large intestine into the intestinal
lumen, causing symptoms that include severe abdominal pain, vomiting,
nausea, and blood inflammation (in English:sepsis); It is a life-threatening
health condition that requires immediate health care.
Less common complications
 Myocarditis.
 Endocarditis.
 Inflammation of the lungs.
 pancreatitis.
 Kidney or liver infections.
 Meningitis.
 Psychological problems, such as delirium, hallucinations, and
psychosis.

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How can typhoid (typhoid fever) be prevented?
Vaccines
The World Health Organization recommends getting one of the following
vaccinations before going to areas where typhoid fever is common:

Typhoid conjugate vaccine (in English:typhoid conjugate vaccine), which is

injectable, which can be used for children from 6 months old to adults up
to 45 years old.
Unconjugated typhoid vaccine (in English:unconjugated), injectable, which
is used from the age of two years and above.
Oral live attenuated typhoid vaccine, which comes in the form of capsules
and is used for ages 6 years and older.
There is currently no vaccine available against typhoid fever, which is
caused by Salmonella typhi-like bacteria.

Vaccines may not provide complete protection against typhoid and require
frequent use, so follow these tips to avoid infection as much as possible:
Drink water after boiling it for at least a minute, or buy bottled water,
preferably carbonated water, as it is safer.
Drink drinks from trusted places without ice, unless you are sure that the
ice is made from bottled or boiled water, and avoid ice cream that may
have been made from contaminated water.
Eat food and drinks from trusted places and avoid street food carts.
Eat only foods that are well cooked and still hot.
Avoid eating raw vegetables and fruits that do not contain peels, especially
lettuce, which can remain contaminated even after washing.
Peel vegetables and fruits yourself after washing your hands well.

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Treatment of typhoid fever (typhoid fever)
Typhoid fever is treated either by using antibiotics or replacing the patient
with fluids, or he may need surgical intervention, and the treatment is as
follows:
Drug treatment
Typhoid fever is treated with antibiotics that kill salmonella bacteria,
including the following:
 Chloramphenicol was considered the antibiotic of choice for treating
typhoid fever for many years, but due to serious side effects,
although rare, it was replaced by other effective antibiotics.
 Ciprofloxacin: This type is often prescribed to non-pregnant patients,
but currently some types of Salmonella, especially those found in
Southeast Asia, have become resistant to this type of antibiotic.
 Azithromycin is used in cases where the patient is unable to take
ciprofloxacin, or in cases where bacteria are resistant to it.
 Ceftriaxone, an injectable antibiotic used in the most complex and
serious cases of typhoid fever, in addition to its use in patients for
whom it is not possible to use ciprofloxacin, such as children.
The appropriate antibiotic is chosen based on the geographical area in
which the patient contracted typhoid fever. If symptoms reappear, the
patient is treated again using antibiotics.

You should continue taking antibiotics for the period recommended by the
doctor, even after the symptoms of the disease disappear. This is to
prevent the return of symptoms or the development of bacteria resistant
to this antibiotic.

3-5% may develop chronic typhoid fever, requiring treatment for long
periods of time with antibiotics.

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Fluid therapy
This is done by drinking plenty of fluids to prevent dehydration, as a result
of high body temperature and prolonged diarrhea. Fluids may be given
intravenously in cases of severe dehydration.

Surgical treatment
Surgery may be performed in the event of a perforation in the intestine to
repair it, and the gallbladder may be removed in people who suffer from
the disease chronically.

Typhoid-related medications
Amoxicillin
Ampicillin
Typhoid vaccine
Typhoid fever vaccine

Refresh
[1] World Health Organization (WHO). Typhoid. Retrieved on the 10th of
January, 2022.
[2] Webmd.com. Typhoid Fever. Retrieved on the 10th of January, 2022.
[3] Mayoclinic. Typhoid Fever. Retrieved on the 10th of January, 2022.
[4] Centers for disease control and prevention (CDC). Typhoid Fever and
Paratyphoid Fever. Retrieved on the 10th of January, 2022.