Typhoid: Symptoms, treatment, causes, diagnostic tests, and prevention
What is typhoid?
Typhoid is a bacterial infection caused by Salmonella typhi. It is also known as typhoid fever or enteric fever. It is caused by exposure to contaminated food and water. Due to this, typhoid fever is predominantly seen in developing countries.
The typhoid bacteria Salmonella typhi enters from the mouth via contaminated food/ water. This bacteria after reaching the small intestine penetrates it and reaches into blood circulation. After dissemination, the bacteria multiply in the blood, bone marrow, and the intestine causing fever and abdominal pain.
Symptoms of typhoid fever
Symptoms of typhoid fever usually appear after 9-14 days of contact with bacteria.
Fever – High-grade fever of 38- 40 degrees Celsius.
Stomach pain (abdominal pain)
Headache
Severe weakness
Anorexia
Rash- ‘ROSE SPOTS’ is the name given to a typical typhoid fever rash.
Many also present with constipation as the disease progresses. The typical rash in typhoid fever is called ‘rose spots.’ In some persons, typhoid fever can also manifest with diarrhea.
Causes of Typhoid Fever
Typhoid fever is caused by a bacterial infection in the body. The bacteria causing typhoid are:
Salmonella typhi
Salmonella paratyphi serotypes A, B, C
Diagnostic tests
Typhoid bacteria can be cultured in blood, stool, urine. Typhoid antibodies are secreted in the blood by the second week of disease. These antibodies can be detected by two methods-
- WIDAL TEST- This test measures the antibodies against the H and O antigens. The presence of IgG antibody indicates a past infection and IgM antibody indicates recent infection.
- TYPHI DOT TEST- Typhi dot test is a card test and it also detects IgM and IgG antibodies and is more commonly used nowadays.
Apart from these Blood cultures, stool culture, and urine culture are also used for diagnosis in different stages of the disease.
Treatment of Typhoid fever
One should visit a doctor if he develops the symptoms of typhoid fever. It can be treated at home or hospital depending on the symptoms and examination of the doctor. Typhoid fever is treated by the following :
Complete bed rest for 4-5 days.
Antipyretics- Antipyretics like paracetamol is used to lower fever.
Antibiotics- Antibiotics like ceftriaxone, cefixime, ciprofloxacin, azithromycin can be used based on the doctor’s advice.
Adequate nutrition and hydration are of utmost importance.
Pain killers to relieve abdominal pain and headache.
Antiemetics for nausea and vomiting like ondansetron or domperidone.
Multivitamin tablets.
Soft diets like khichri, dal rice, banana, and curd are advised.
Prevention of Typhoid
Typhoid can be prevented through vaccination. There are 2 regimens for children and adults.
Vaccination regimen for children in India :
Adult typhoid vaccination
Ty21a is a live attenuated typhoid vaccine that can be given to anyone > 6 years of age. It has 4 doses which are to be taken on day 1, day 3, day 5, day7. This full course of four doses is repeated every 5th year.
Apart from it frequent hand washing and drinking filtered or boiled water will greatly reduce the disease.