Typhoid fever, also known as enteric fever, is caused by the bacteria Salmonella Typhi (S. Typhi) and affects the small intestines. It is common in places where human waste disposal is not well-managed and water is not effectively sterilised.
Typhoid Symptoms
Consuming food and water contaminated with bacteria causes typhoid fever. Also, being in close proximity with a person carrying Salmonella bacteria can also cause typhoid fever. This may include sharing food items, drinking contaminated water and not washing hands after using the restroom. Symptoms start slowly and become noticeable one to three weeks after exposure to bacteria.
Early typhoid symptoms include:
Headache
Stomach pain
High fever (starts slowly and increases throughout the day, possibly reaching 104 degrees Fahrenheit.)
Chills
Diarrhoea or constipation
Rash
A few weeks after the typhoid symptoms start, problems in the intestine become more common, including:
Typhoid Causes
A strain of bacteria called Salmonella enterica serotype typhi causes typhoid fever. It is found in the intestines (gut) of infected people and spreads through contaminated food and water.
Typhoid Carriers
Even after treatment with antibiotics, some people still have the typhoid-causing bacteria in their bodies. These individuals are called chronic carriers and no longer experience symptoms of the disease. However, they still shed the bacteria in the stool or urine which can spread to other people.
Typhoid Fever Stages
An individual develops symptoms of typhoid fever in four stages. Early typhoid treatment helps keep the illness from progressing to later stages.
Stage 1: A person starts experiencing typhoid symptoms anywhere between five to 14 days after contact with S. Typhi. This first symptom is a fever that increases over a few days.
Stage 2: Around the second week with fever, the bacteria is multiplying in the Peyer’s patches (part of the immune system that recognizes harmful invaders). In this case, a person starts experiencing stomach symptoms like diarrhoea, constipation and abdominal pain.
Stage 3: Without timely treatment, the bacteria can cause severe damage in about the third week after the start of symptoms. Some people may experience serious complications like encephalitis (inflammation in the brain) and internal bleeding.
Stage 4: A majority of people begin to recover in stage four. High fever starts to come down and S. Typhi can live in the gallbladder without causing any symptoms.
Typhoid Complications
One of the most prevalent typhoid fever complications include damage to the intestines. Typhoid fever causes cells in the walls of the small intestine to die. This paves way for the gut content to leak into the body. Damage to the intestines can occur in the later part of typhoid and requires immediate medical attention.
Other complications of typhoid may include:
Myocarditis (inflammation of the heart muscle)
Endocarditis (inflammation of the heart lining and its valves)
Mycotic aneurysm (infection of the major blood vessels)
Pancreatitis (Inflammation of the pancreas)
Infections of the kidney or bladder
Meningitis (inflammation and infection in the membranes and fluid surrounding the brain and spinal cord)
Psychiatric problems, such as paranoid psychosis, hallucinations and delirium.
Typhoid Diagnosis
The following tests can help diagnose typhoid fever:
Blood tests, stool tests and urine tests.
Typhoid Treatment
A majority of people with typhoid fever feel better about a week after the start of typhoid treatment. Without timely treatment, some people may experience typhoid fever complications.
Medications
Typhoid treatment involves antibiotics. Since some newer types of bacteria survive antibiotic treatments, a person may receive treatment with different medications based on the type of typhoid. Antibiotics can also treat paratyphoid fever. These medications include:
Azithromycin
Carbapenems
Ceftriaxone, cefixime or cefotaxime
Ciprofloxacin, ofloxacin or levoflaxin.
Vaccine
Vaccines against typhoid fever can also provide protection. However, it does not offer protection against illnesses caused by other strains of salmonella. Vaccines can also help lower the risk of typhoid fever.
Antibiotic Resistance in Typhoid
Bacteria like Salmonella Typhi can sometimes develop resistance to medications. This means that the antibiotics no longer have an effect on the bacteria.
Some are highly drug resistant (XDR typhoid) and only few antibiotics still work against them. This is why being vaccinated to prevent typhoid is important.
Typhoid Prevention
People who live in areas where typhoid fever is common, getting a vaccination against typhoid fever is important. Since the effectiveness of the vaccine reduces over time, these guidelines can help prevent typhoid fever:
Wash your hands: Frequent hand washing with an adequate amount of soap is the best way to control infection. Scrub the hands thoroughly for 30 seconds especially after eating or using the restroom.
Avoid the use of untreated water: Consuming contaminated or untreated drinking water is a common cause of typhoid fever. Drinking bottled water is always a safe option.
Avoid raw foods: Raw foods like lettuce might be washed with contaminated water, so it's best to avoid them and choose freshly cooked, hot meals instead.
FAQs
Which organ is affected by typhoid?
The typhoid causing Salmonella Typhi bacteria travels to the intestine and then enters the blood. Through the blood, the bacterium travels to the liver, gallbladder, spleen, lymph nodes and other parts of the body.
How long does typhoid fever last?
Typhoid fever typically lasts for up to seven to 10 days if treated soon after the start of the symptoms. If left untreated or if the treatment is delayed, it can last three weeks or more.
Which test confirms typhoid fever?
Typhoid fever diagnosis is confirmed by analysing blood, urine or stool samples. These samples may be examined under a microscope to detect the disease causing Salmonella Typhi bacteria.
Is typhoid serious?
Typhoid is a bacterial infection that spreads throughout the body, affecting many different organs. Without prompt treatment, typhoid can cause life-threatening complications.
