Typhoid

 

Typhoid

 Typhoid fever is an infection that causes diarrhea and a rash. It is most commonly caused by bacteria called Salmonella typhoid (S typhi).

Typhoid fever is an illness you get from S. Typhoid bacterium. It causes a high fever, flu-like symptoms and diarrhea. You can be contagious with ty
phoid even if you don’t feel sick. Typhoid can be life-threatening and should be treated promptly with antibiotics. If you live in or travel to an area where typhoid is common, you should get vaccinated.

What is typhoid fever?

Typhoid fever is an illness caused by the bacterium Salmonella Typhi (S.Typhi). It infects your small intestines (gut) and causes high fever, stomach pain and other symptoms. Typhoid fever is also called enteric fever.

You’ll commonly hear paratyphoid fever mentioned along with typhoid. Paratyphoid fever is similar to typhoid with more mild symptoms. It’s caused by Salmonella Paratyphi (S. Paratyphi).

S. Typhi and S. Paratyphi are different than the Salmonella bacteria that cause salmonellosis, a common type of food poisoning.

Causes

S typhi is spread through contaminated food, drink, or water. If you eat or drink something that is contaminated with the bacteria, the bacteria enter your body. They travel into your intestines, and then into your blood. In the blood, they travel to your lymph nodes, gallbladder, liver, spleen, and other parts of the body.

Some people become carriers of S typhi and continue to release the bacteria in their stools for years, spreading the disease.

Typhoid fever is common in developing countries. Most cases in the United States are brought in from other countries where typhoid fever is common.

Symptoms

What are the symptoms of typhoid fever?

Typhoid fever gets its name from a high fever that can last for weeks if left untreated. It often gets progressively worse over a few days.

Other symptoms of typhoid fever include:

 

Early symptoms include fever, general ill-feeling, and abdominal pain. High fever (103°F, or 39.5°C) or higher and severe diarrhea occur as the disease gets worse.

Some people develop a rash called "rose spots," which are small red spots on the abdomen and chest.

Other symptoms that occur include:

•        Bloody stools

•        Chills

•        Agitation, confusion, delirium, seeing or hearing things that are not there (hallucinations)

•        Difficulty paying attention (attention deficit)

•        Nosebleeds

•        Severe fatigue

•        Slow, sluggish, weak feeling

•        Headache.

•        Chills.

•        Loss of appetite.

•        Stomach (abdominal) pain.

•        “Rose spots” rash, or faint pink spots, usually on your chest or stomach.

•        Cough.

•        Muscle aches.

•        Nausea, vomiting.

•        Diarrhea or constipation.

 

What is the treatment for typhoid fever?

Typhoid is treated with antibiotics. Some newer types of the bacteria are able to survive antibiotic treatments, so you’ll be treated with different antibiotics depending on what type of typhoid you have and where you got sick. Paratyphoid fever is also treated with antibiotics.

If you’re severely ill or have complications, you might need additional treatments. You’ll probably need to be admitted to the hospital for these treatments.

 

What medications are used to treat typhoid fever?

Your healthcare provider will treat typhoid fever with antibiotic, which may include:

•        Ciprofloxacin, levoflaxin or ofloxacin.

•        Ceftriaxone, cefotaxime or cefixime.

•        Azithromycin.

•        Carbapenems.

If your case is severe, you may be treated with steroids, like dexamethasone.

Antibiotic resistance in typhoid

Bacteria like S. Typhi can sometimes develop resistance to medications. This means that antibiotics don’t work to destroy them anymore

Many cases of typhoid can’t be destroyed by antibiotics we once used, but some drugs still work on them. Some are extremely drug resistant (XDR typhoid) and only a few antibiotics still work on them. This is one of the reasons that getting vaccinated to prevent typhoid is so important.

Health officials are concerned that we may no longer be able to treat typhoid if available medicines stop working. You’ll be treated with an antibiotic that works on the kind of typhoid you have based on the results of strain testing.

 

 

Fluids and electrolytes may be given by IV (into a vein) or you may be asked to drink water with electrolyte packets.

Antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your provider will check current recommendations before choosing an antibiotic.

Typhoid fever and paratyphoid fever are common in many parts of the world.

Typhoid fever and paratyphoid fever are most common in parts of the world where water and food may be unsafe and sanitation is poor. These places include parts of East and Southeast Asia, Africa, the Caribbean, and Central and South America. If you’re traveling to places where typhoid and paratyphoid fever are common, you can take steps to protect yourself from infection.

Two basic actions can protect you:

1.       Get vaccinated against typhoid fever. Visit your doctor or a travel clinic at least 2 weeks before traveling to discuss your options.

2.       Practice safe eating and drinking habits. Carefully selecting what you eat and drink when you travel is important because typhoid fever vaccines do not work 100% of the time and there isn’t a paratyphoid fever vaccine. Safe eating and drinking will also help protect you from other illnesses, including travelers’ diarrhea, cholera, dysentery, and hepatitis A.

Preventing infecting yourself

• Wash hands frequently in hot, soapy water before eating or preparing food, as well as after using the toilet. Alcohol-based sanitizer can be used in the absence of hot water.
• Avoid drinking contaminated water by ensuring water is bottled or boiled. Carbonated bottled water is safer to drink than UN carbonated.
• Wash teeth using bottled water and avoid swallowing shower water.
• Avoid ordering drinks with ice, unless you know the ice is made form boiled or bottled water. Also avoid flavored ices that could have been made with water that is contaminated.
• Only eat foods that have been thoroughly cooked and served steaming hot and avoid foods that have been stored or served at room temperature.
• Only eat raw vegetables if they can be peeled. Items such as lettuce are particularly at risk of contamination and are very difficult to clean properly.
• Avoid food and drink being sold by street vendors as it is difficult to keep food clean in the street.

Preventing infecting others

If a person is recovering from infection with typhoid fever, they can take the following measures to prevent infecting others:

• Follow the doctor’s instructions for taking antibiotics and be sure to complete the whole course.
• Avoid preparing food for others until it is confirmed that you are no longer contagious. It will not be possible to return to a job in the food service industry until tests have confirmed there is no risk of you passing typhoid bacteria.
• Frequently wash hands using hot, soapy water before preparing or eating food, as well as after using the toilet. Hands should be scrubbed thoroughly for at least 30 seconds.