Typhoid fever is a common infectious disease.  Typhoid occurs in both developed and developing countries. Typhoid fever is caused by Salmonella enterica serotype Typhi (S typhi), a Gram-negative bacterium. A similar but often less severe disease is caused by S paratyphi A and less commonly by S. paratyphi B and S. paratyphi C.

Due to recent advances in public health and hygiene, there is a gradual disappearance of infection in developed countries but Typhoid remains endemic in developing countries. Travellers are affected easily when visiting endemic areas.

Mode of Spread:

The commonest mode of infection is through ingestion of contaminated food and water. This occurs because of poor Hygiene and contamination of water with sewage.

Symptoms:

In general high-grade fever and other associated symptoms like myalgia, abdominal pain, and anorexia are seen. Liver and spleen enlargements may be present. In fewer cases, skin lesions (Rose spots)  are seen on chest and abdomen.

Investigations:

The best way of diagnosing Typhoid fever is with blood culture. Sometimes “Widal test” is used and needs to be interpreted with caution.

There may be an increase in the Leukocyte count up to 25,000/Cu.mm and decrease in thrombocytes. Liver profile can also deranged, especially in late and complicated cases.

Although there are many other diagnostics tests emerging, diagnosis of Typhoid is more often done by taking clinical symptoms as a criteria.

Treatment:

 Treatment is with antibiotics and supportive care.

  • Proper rest and adequate hydration play a role in the treatment of Typhoid fever.
  • Adequate nutrition: easily digestible food can be given unless the patient has serious gastrointestinal problems
  • Close attention to hand washing and limitation of close contacts with susceptible individuals during the acute phase of infection prevents the spread
  • Antipyretics (paracetamol taken orally every 4-6 hours)  reduces the temperature
  • Antibiotics prescribed by the doctor up to 5-7 days
  • Treatment of complications
  • Regular follow-ups of affected persons with the doctor to detect relapse of infection

Vaccination:

  1. Oral Typhoid vaccine— Capsules on every alternative day for a total of 4 doses. It is contraindicated in pregnant women and children below 6 years. The booster can be taken for every 5 years
  1.     b) Vi polysaccharide vaccine- This vaccination is an injection taken intramuscularly. A booster dose can be taken for every 2 years

Tips for travellers

  •  Use bottled water or boiled water whenever required
  • “Wash it, peel it, cook it or forget it”. Follow this during preparation of food
  • Wash your hands clean all the time before eating food. Carry personal hand sanitizer
  • Plan to take vaccination before travelling to endemic areas

    

Dr.Bhavani Sagar Surampally

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