In the last 5 years of practice as a Community Pharmacist, I've seen people coming for consultation with several misconception about Typhoid Fever. Many want to treat Typhoid with Malaria even when the widal test shows negative. As a result, I will like to enlighten our audience about Typhoid Fever.
Typhoid is a bacterial infection that can lead to a high fever, diarrhea, and vomiting. It can be fatal. It is caused by the bacteria Salmonella typhi.
The infection is often passed on through contaminated food and drinking water, and it is more prevalent in places where handwashing is less frequent. It can also be passed on by carriers who do not know they carry the bacteria.
What is typhoid?
Typhoid is an infection caused by Salmonella typhimurium bacteria that is spread from human to human.
Typhoid is an infection caused by the bacterium Salmonella typhimurium (S. typhi).
The bacterium lives in the intestines and bloodstream of humans. It spreads between individuals by direct contact with the feces of an infected person.
No animals carry this disease, so transmission is always human to human.
If untreated, around 1 in 5 cases of typhoid can be fatal. With treatment, fewer than 4 in 100 cases are fatal.
S. typhi enters through the mouth and spends 1 to 3 weeks in the intestine. After this, it makes its way through the intestinal wall and into the bloodstream. From the bloodstream, it spreads into other tissues and organs. The immune system of the host can do little to fight back because S. typhi can live within the host's cells, safe from the immune system.
Typhoid is diagnosed by detecting the presence of S. typhi via blood, stool, urine, or bone marrow sample.
How many people get typhoid fever and paratyphoid fever each year?
Worldwide, typhoid fever affects an estimated 11 to 21 million people and paratyphoid fever affects an estimated 5 million people each year.
In the United States each year, about 350 people are diagnosed with typhoid fever and 90 people are diagnosed with paratyphoid fever each year. These cases do not include people who do not seek medical care, who are not tested for either disease, or whose disease is not reported to CDC. CDC estimates typhoid fever affects 5,700 people in the United States each year. CDC has not made estimates for Salmonella Paratyphi.
Most people diagnosed in the United States have traveled to places where the diseases are most common.
If typhoid is caught early, it can be successfully treated with antibiotics; if it is not treated, typhoid can be fatal.
How are typhoid fever and paratyphoid fever spread?
These diseases are spread through sewage contamination of food or water and through person-to-person contact. People who are currently ill and people who have recovered but are still passing the bacteria in their poop (stools) can spread Salmonella Typhi or Salmonella Paratyphi.
You can get typhoid fever or paratyphoid fever if
√ You eat food or drink a beverage that has been touched by a person who is shedding (getting rid of) Salmonella Typhi or Salmonella Paratyphi in their poop and who has not washed their hands thoroughly after going to the bathroom.
√ Sewage contaminated with Salmonella Typhi or Salmonella Paratyphi gets into water you drink.
√ Sewage contaminated with Salmonella Typhi or Salmonella Paratyphi gets into water used to rinse food you eat raw.
What happens if you eat or drink something contaminated with Salmonella Typhi or Salmonella Paratyphi?
If you consume a food or drink contaminated with Salmonella Typhi or Salmonella Paratyphi, the bacteria can multiply and spread into the bloodstream, causing typhoid fever or paratyphoid fever.
How can I protect myself from typhoid fever?
Countries with less access to clean water and washing facilities typically have a higher number of typhoid cases.
If traveling to an area where typhoid is prevalent, vaccination is recommended. Before traveling to a high-risk area, getting vaccinated against typhoid fever is recommended.
Vacination: This can be achieved by oral medication or a one-off injection:
√ Oral: a live, attenuated vaccine. Consists of 4 tablets, one to be taken every second day, the last of which is taken 1 week before travel.
√ Shot, an inactivated vaccine, administered 2 weeks before travel.
Vaccines are not 100 percent effective and caution should still be exercised when eating and drinking.
Vaccination should not be started if the individual is currently ill or if they are under 6 years of age. Anyone with HIV should not take the live, oral dose.
The vaccine may have adverse effects. One in 100 people will experience a fever. After the oral vaccine, there may be gastrointestinal problems, nausea, and headache. However, severe side effects are rare with either vaccine.
There are two types of typhoid vaccine available, but a more powerful vaccine is still needed. The live, oral version of the vaccine is the strongest of the two. After 3 years, it still protects individuals from infection 73 percent of the time. However, this vaccine has more side effects.
The current vaccines are not always effective, and because typhoid is so prevalent in poorer countries, more research needs to be done to find better ways of preventing its spread.
How Can I Avoid Typhoid Fever?
Typhoid is spread by contact and ingestion of infected human feces. This can happen through an infected water source or when handling food.
The following are some general rules to follow when traveling to help minimize the chance of typhoid infection:
√ Drink bottled water, preferably carbonated.
If bottled water cannot be sourced, ensure water is heated on a rolling boil for at least one minute before consuming. Be wary of eating anything that has been handled by someone else.
√ Avoid eating at street food stands, and only eat food that is still hot. Do not have ice in drinks.
√ Avoid raw fruit and vegetables, peel fruit yourself, and do not eat the peel.
Watch out for our next write up on The Symptoms and Treatment of Typhoid Fever.
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