Typhoid Fever , how to prevent this killer disease

        Typhoid fever is a life-threatening infection that is caused by Salmonella typhi bacteria. 

A less severe form of typhoid can be caused by the Salmonella paratyphi bacteria. They are collectively referred to as Enteric fevers.

Travellers especially backpackers , volunteers to community projects , solo travellers, YouTubers and all those adventuring off the beaten track to exotic parts of the world in Asia, Africa and South America , need to have a high index of suspicion. 

Usually, a person contracts typhoid by drinking or consuming contaminated food and water. 

However, you can also get the infection by coming into close contact with an infected person. 

Sadly,  typhoid though endemic in the Tropics and sub-tropical regions of the world, is now being overdiagnosed with many cases of fever labelled as ' Malaria and Thyphoid '.

Symptoms of typhoid fever include pain in the abdomen, diarrhoea or constipation, headache, and high-grade fever.

A majority of infected people starts feeling better once they are put on antibiotics. However, some people succumb to the infection due to associated complications.

Signs and Symptoms of Typhoid

Signs of typhoid tend to develop gradually. A person exposed to the disease usually manifests the symptoms one to three weeks after the exposure.

The early symptoms of typhoid include ,

• Fever, which initially starts low and increases every day

• Headache

• Muscle aches

• Weakness

• Fatigue

• Dry cough

• Sweating

• Pain in the abdomen

• Loss of appetite along with weight loss

• Rash

• Significantly swollen abdomen

• Diarrhoea or constipation

As the disease progresses and if proper treatment is not sought, the following symptoms appear,

• Delirium

• The state where the person lies exhausted and motionless with their eyes half closed

It is during the later stages of the disease when if the treatment is not sought, the chances of life-threatening complications such as intestinal perforation are high.

Socrates , Brazillian football legend died in December 2011 at 57yrs from thyphoid fever toxic shock. RIP

If you suspect you or a loved one has typhoid, it is important to consult the doctor right away.

Causes of Typhoid

The infection spreads through contaminated water and food. In developing nations like India, typhoid is an endemic disease, and hence, the chances of contamination are high. 

Also, poor sanitation contributes to the spread of the disease.

An infected person passes out the bacteria in their feces. If this person does not wash their hands properly, the bacteria pass from the hands to the food or water handled by the person. And, when this food or water is consumed, typhoid can be contracted.

Some people become chronic carriers of the bacteria, even after they receive treatment for typhoid. 

Such people may not exhibit signs and symptoms of the disease, but have the ability to infect others.

Typhoid can be treated with antibiotics for a couple of weeks. 

In addition, the person will also be advised to drink ample amounts of water to prevent dehydration caused by prolonged high-grade fever and diarrhoea.

Laboratory diagnosis 

Is mainly by blood or stool cultures at different phases of the disease. 

The common Widal test remains positive for several years after clinical or sub-clinical infection and is therefore not reliable. 

I personally find neutropenia, low neutrocyte count, in the absence of recent viral infection a strong indicator. 

Prevention

Do avoid contaminated food and water in your travels. Water sterilising tablets are available at most pharmacists. 

Boiling for 5 mins kills of the Salmonella bacteria. So avoid uncooked street food and salads.

If it is not hot, bottled or canned it maybe wise to throw it away.

The Good news is, there is a typhoid vaccine which you should take before your travels.

Vaccination for typhoid  is very effective and widely available. 

Vaccines are in the inform of oral tablets and injection. If you are travelling to an endemic region or at high risk, ask your local pharmacist for a vaccine.

Some people  are asymptomatic carriers so typhoid can be spread by food handlers. 

If you must shake hands with strangers and use public toilets, then do wash your hands or use a hand sanitiser regularly.

Remember typhoid is transmitted via the faceo-oral route. 

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