Summary of Typhoid Fever

What is it?

  • A serious illness caused by the bacterium Salmonella Typhi (S. Typhi).
  • It infects the small intestines and is also known as enteric fever.
  • It is different from typhus and the more common Salmonella that causes food poisoning.

How does it spread?

  • Primarily through contaminated food and water.
  • Spread occurs when an infected person who doesn’t wash their hands after using the bathroom contaminates surfaces, food, or water.
  • It does not spread through kissing.

Key Symptoms

  • High fever that gets progressively worse over several days.
  • Stomach pain.
  • Headache, muscle aches, cough.
  • Digestive issues: Diarrhea or constipation, nausea, vomiting.
  • Loss of appetite.
  • “Rose spots” rash (faint pink spots on the chest or stomach).

Who is at risk?

  • Travelers to areas where typhoid is common (especially South Asia, parts of Latin America, Africa).
  • People living in rural areas of developing countries without modern sanitation.
  • Children are at higher risk than adults.

Diagnosis & Treatment

  • Diagnosis: A healthcare provider will use travel history, symptoms, and lab tests on blood, stool, or urine.
  • Treatment: Antibiotics are essential. The specific type depends on the strain and its drug resistance.
  • Important: Finish all prescribed antibiotics, even if you feel better.

Complications & Relapse

  • If left untreated, it can cause severe complications like internal bleeding, a hole in the intestines, encephalitis, and can be fatal.
  • Relapse is possible, where symptoms return (usually milder) after recovery.

Prevention

  1. Vaccination: The best way to reduce risk if you are traveling to an affected area.
  2. Safe Food/Water Habits:
    • Drink bottled or treated water.
    • Eat well-cooked, hot foods.
    • Practice good hand hygiene (washing with soap and water).

Crucial Public Health Note: The Carrier State

  • Unlike many illnesses, you can remain contagious even after you feel better.
  • About 5% of people become “long-term carriers,” meaning they can spread the bacteria for a year or more without having symptoms.
  • It is essential to be tested after recovery to ensure you are no longer contagious and cannot spread it to others. The story of “Typhoid Mary” is a famous example of an asymptomatic carrier.

Key Takeaways:

  • For Travelers: Get vaccinated and be vigilant about what you eat and drink.
  • If You Suspect Infection: See a doctor immediately and mention your travel history.
  • After Recovery: Get tested to confirm you are no longer a carrier.