Typhoid Fever Symptoms, Causes, Prevention and Treatment

Typhoid Fever Overview

Typhoid fever or enteric fever is caused by serious bacterial infection by the bacterium Salmonella enterica serotype Typhi. Typhoid fever is transmitted in humans through contaminated food or water, when a person drinks or eats any contaminated food which is having bacteria, they are infected by typhoid fever.

Areas that have poor sanitation and poor hygiene practices have high chance to develop the Salmonella enterica serotype Typhi bacteria. People infected with typhoid fever can easily spread bacteria around them and can affect other humans. This typically happens when an infected person uses public places such as bathrooms, restaurants, railway stations, etc.

The typhoid bacteria are carried and deposited by humans in public places and then it spreads to other people in the same area.

Cases of typhoid fever in the United States and other developed countries have decreased in the last few decades, last year less than 500 cases were reported annually in USA. The main reason for reduced typhoid fever cases in United States is due to environmental sanitation.

However, Typhoid fever is more common in developing countries like India, Pakistan, Africa, and Egypt. These areas possess a high risk of developing typhoid.

Globally Typhoid fever affects around 24 million people annually out of which 2 million deaths are reported due to typhoid fever worldwide.

How do people get infected with Typhoid Fever?

Typhoid fever is transmitted through contaminated food or water. People who are diagnosed with Typhoid fever can contaminate the surrounding water bodies through stool. These water bodies contain high concentrations of bacteria which in turn contaminate the food supply. Thus allowing bacteria to survive for months in water bodies or dried sewage.

Any person coming into contact with these contaminated water bodies or food supplies gets infected with typhoid fever. Also, he becomes the carrier of typhoid bacteria after acute illness. Some people may not suffer from any symptoms or illness, but they also become carriers of the bacteria. Whenever these person use any public places and other healthy person uses the same, the transfer of bacteria takes place from person to person.

To reduce the chance of getting infected with typhoid fever, good sanitation, and hygiene practices need to be followed such as drinking clean water, washing hands before and after a meal, use of sanitizers to sanitize the hands and surface, and consuming properly clean food.

If you suspect you or anyone near you have been infected with typhoid fever, or you have been exposed to someone who has typhoid fever, it’s very important to take immediate medical help to diagnose the symptoms of fever and typhoid treatment.

What are the symptoms of typhoid fever?

The symptoms of typhoid fever in individuals can vary from person to person depending upon their age, medical history, and severity of illness. The most common symptoms of typhoid fever are :-

High Fever- People infected with typhoid may experience very high fever often reaching 103 to 104 Degree F. The fever can last up to several weeks.
Headache– Episodic or severe headache episodes are experienced by people during the course of typhoid fever.
Abdominal Pain and Discomfort
Rashes over abdomen and chest
Weakness and fatigue
Gastrointestinal symptoms –
Stomach pain
Constipation or diarrhea – Diarrhea or constipation, nausea, vomiting, and loss of appetite may occur in typhoid fever. The stool may be loose and can have a characteristic foul odour.
Muscle aches
Joint pain
Cough
Irregular heartbeat

Typhoid Fever Diagnosis

Typhoid fever can be diagnosed by your health expert through a combination of clinical evaluation, patient medical history, and laboratory tests.

Your healthcare expert will ask you some questions related to your travel history, he will examine your symptoms like rashes, fever, and sleep disorder. However, laboratory tests are still required to confirm and rule out the other possibility of any other disease. The most common methods used for diagnosing typhoid fever are: –

Blood Tests- Blood tests are the most common and reliable method for diagnosing typhoid fever. A sample of blood is collected from the infected person. Further, this blood culture is sent to a laboratory to check the presence of Salmonella Typhi bacteria. If the bacteria is present it is declared positive.
Stool Culture- Stool culture tests are recommended when clinical suspicion of patient for typhoid fever remains high but blood tests (blood culture) are negative. A stool sample is used to identify the presence of “Salmonella Typhi bacteria”.
Urine Tests or Urine Culture- Urine tests can also be used to identify the presence of bacteria in the urine. Although this test is very uncommon and less commonly used as compared to Stool culture and blood tests.
Serology Tests- Serology tests are useful in the later stage of typhoid or in complicated typhoid fever. Serology tests involve measuring the antibodies against Salmonella Typhi in blood samples.

Treatment for Typhoid Fever:

If you are diagnosed with Typhoid fever, it is essential to take medical attention for proper treatment. Treatment of typhoid fever includes antibiotics, which are used to kill the bacteria Salmonella typhi. Earlier when the antibiotics were not used or were used limited, the fatality rate was around 25%.

People who were diagnosed with typhoid earlier were also diagnosed with other diseases like pneumonia, infection, bleeding in the intestine, and perforation of the intestine. All these illness factors increase the chances of patient death if not treated on time or without antibiotics.

With the use of antibiotics to treat typhoid fever in the last few decades the mortality rate has come down significantly i.e., only up to 2%. With immediate support, care, and an antibiotics course patients’ health starts improving in one to two days and recovery starts usually within a week.

The treatment of typhoid fever is a combination of antibiotics courses, supportive care, and prevention measures. Below are the common approaches to typhoid fever treatment: –

Antibiotics- Antibiotics are used as the primary treatment factor for typhoid fever. The most common antibiotics used for treating typhoid fever are fluoroquinolones ( such as ciprofloxacin or levofloxacin) or cephalosporins(such as ceftriaxone).

Earlier Chloramphenicol was the first drug used to treat typhoid fever but due to some serious side effects of this drug, it was replaced by other drugs. Healthcare experts choose antibiotics for treating on several factors such as geographical condition, patient age, medical history, and severity of infection.

Supportive Care- Typhoid fever dehydrated the patient’s body very fast and adds other complications as well, such as high fever, nausea, vomiting, rashes etc. So, supportive care is necessary for the patients. To keep the body hydrated, several fluids like ORS (Oral Rehydration Solution), Juices, fluid rich fruit are given to patients at regular intervals of time.
Nutritional Support- For speedy and fast recovery from typhoid fever, a healthy diet containing nutrients, and protein is necessary for the patient. Eating a healthy diet is necessary to boost the immune system and for after recovery process.
Preventive Measures- Preventive measures are very necessary before, during, and after typhoid fever. Preventive measure helps to avoid typhoid, diagnosis helps in fast recovery and block the chain of typhoid fever, and preventive measure helps to protect ourselves from typhoid fever.

Some of the common preventive measures are – practicing good hygiene, washing hands frequently with soap at regular intervals of time, sanitizing the hands when in a public place, avoiding intake of contaminated food, and drinking fresh and clean water. Taking necessary vaccines when traveling to areas which are affected by typhoid fever.

How to prevent Typhoid fever when traveling?

If you planning to travel the areas where typhoid fever is common, the best course of action is to get yourself vaccinated before travel, eat your food and drinks carefully, and use sanitizers to sanitize your hands to kill the germs.

While traveling to typhoid-prone areas, talk to your healthcare expert if the vaccine is recommended before travel or after travel. If you are living in United States, book your appointment with doctor at least one month before. Discuss your travel plans with your medical advisor. Based upon your travel destination, you would be recommended “Pill Vaccine” or “ Shot Vaccine”.

* Pill Vaccine- People in the age group of 6 years or old can do the pill vaccine course. A person needs to take 4 pills (one pill per day) and at least 1 week before their departure.

Shot Vaccine- People who are above 2 years are eligible for shot vaccine. You can get a booster shot or shot vaccine at least 2 weeks before your departure date.

Typhoid vaccines are not 100% effective. You need to take care of your food habits to lower the risk of getting infected by typhoid. Following are the best practices to prevent typhoid –

Food and Drinks

Only consume food that is hot and cooked well.
Avoid consuming food that is on the buffet for very long.
Consume raw fruits & vegetables once they are washed and cleaned in clean water.
Drink Beverages/Energy drinks/flavoured milk from the factory-sealed containers. Do not consume if the seal is broken.
Always use ice which is prepared from clean water. Avoid taking ice outside because it may have been prepared from unsafe water.
Only consume pasteurized milk when outside, at home always boil the milk before consumption.Hygiene Practices – Washing your Hand

As we know typhoid is a bacterial disease, it is important to clean your hands at regular intervals and maintain body hygiene and surrounding hygiene.
Always wash your hands with Soap and water for at least 20 seconds, especially after you use the restroom and before consuming anything.
Use an alcohol-based sanitizer if soap and water are not available.
Try to keep your hands away from your mouth and face when not required.

Note:- If you feel sick after your travel or during your travel it is important to take medical assistance immediately to treat typhoid fever efficiently.

Frequently Asked Questions

Q1. Till how many days typhoid fever lasts?

Ans. Typhoid fever typically lasts for about 2 to 4 weeks, although the duration can vary depending on various factors, including the individual’s overall health, the severity of the infection, and the effectiveness of treatment.

Q2. Is typhoid a serious fever?

Ans. Yes, typhoid fever is considered a serious illness. It is caused by the bacterium Salmonella typhi, which can spread through contaminated food, water, or contact with infected individuals.

If not taken care on time or left untreated typhoid fever can be life threatening.

Q3. What is the best cure for typhoid?

Ans. The best cure for typhoid fever is antibiotic treatment. Antibiotics are medications that specifically target and kill the bacteria responsible for the infection. ciprofloxacin or levofloxacin, are commonly used as the first-line treatment for uncomplicated cases of typhoid fever

Q4. How typhoid fever is transmitted?

Ans. Typhoid fever is primarily transmitted through ingestion of the bacterium Salmonella typhi, which causes the infection. The bacterium is typically found in contaminated food or water, or on surfaces that have been contaminated with fecal matter from an infected person.

Q5. Is typhoid fever contagious?

Ans. Yes, typhoid fever is contagious. It can spread from person to person through various modes of transmission, including contaminated food and water, person-to-person contact, and carriers who harbor the bacteria even after their symptoms have resolved.

Q6. What are the stages of typhoid fever?

Ans. There are 4 stages of typhoid fever-

Incubation Period
Prodromal Stage
Acute Stage
Convalescent stage

Q7. What vaccine is used to treat typhoid fever?

Ans. Commonly there are two types of vaccine that are used to prevent typhoid fever-

Typhoid Vi polysaccharide vaccine- This vaccine provides protection against bacteria Salmonella typhi and Salmonella Paratyphi B.
Typhoid live attenuated oral vaccine- It provides protection against the bacteria Salmonella typhi. This is recommended for age group of 6 years and older

Q8. What are the causes of typhoid fever?

Ans.

Common causes of typhoid fever are-

Ingestion of contaminated food or water
Poor sanitation and hygiene practices
Coming to close contact with typhoid-infected person.
Touching contaminated surfaces and objects that have been contaminated by typhoid bacteria and then touching the mouth or face can lead to typhoid fever.
Travelling to places that have high incidences of typhoid fever.