How does typhoid fever spread?
You can get typhoid fever by eating or drinking contaminated food or water. Food or water can be contaminated by a food handler with Salmonella typhi, or may be contaminated if sewage accidentally gets into the food or water. Following ingestion, the bacteria spread from the intestine through the blood stream to the lymph nodes of the intestine, the liver and the spleen where they multiply. They may also spread to other parts of the body.
What are the signs and symptoms of typhoid fever?
Those suffering from typhoid fever are usually very ill. The symptoms may be like those of malaria. There is constant fever up to 104 degrees Fahrenheit, headache, generalized body-ache, chill, loss of appetite, stomach pains, constipation followed by diarrhea, dry cough and slow heart beat. There is general discomfort, uneasiness or ill feeling. The stool may be bloody. As the disease progresses, the fever becomes higher and the diarrhea more prominent leading to weakness, profound fatigue (excessive tiredness), and patient becomes confused, agitated, with difficulty in paying attention, hallucinations and disorientation. In Typhoid fever the heart rate becomes very slow as the fever increases. There may be rashes on the lower chest wall and abdomen during the second week of the fever.
Diagnosis
Only your doctor can tell if you have typhoid fever. The diagnosis is made by blood and stool culture to find the Salmonella typhi (the bacteria). There are other blood tests that doctors can do to determine if a patient has the bacteria.
Treatment
Typhoid fever is treated with antibiotics. A person will usually recover in 2-3 days with prompt antibiotic treatment. People who do not get prompt medical treatment may continue to have
Fever for weeks or months, and as many as 20% may die from complications of the infection. If you are being treated for typhoid fever, it is important to do the following:
• Take the prescribed antibiotics for as long as the doctor has asked you to take them.
• Wash your hands carefully with soap and water after using the bathroom
• Do not prepare or serve food to other people.
• Have your doctor collect follow-up stool samples to ensure that no S. typhi bacteria remain in your body.
Prognosis (Expectations)
The illness usually resolves in 2 to 4 weeks with treatment. The outcome is good with early treatment but it becomes poor with complications. Relapse may occur if the treatment has not fully eradicated the infection.
Complication
• If typhoid fever is not treated early and adequately there may be very severe complications. These include bleeding from the intestines which can be fatal if not treated urgently.
• Another complication which is common in our country is intestinal perforation (the intestine burst because of severe infection by the bacteria). This results in the spillage of feces (stool) into the abdominal cavity causing inflammation of the membrane that lines the walls of the abdomen and covers the abdominal organs. This is known as peritonitis which is life threatening and has to be treated urgently. When this occurs the person has severe stomach pains, abdominal distention, fever, vomiting, inability to pass feces or gas, thirst, chills and low urine output. On examination, the abdomen is very tender; it feels hard and “board-like”. The patient usually refuses for the abdomen to be touched and he usually curls up and tries to avoid any movement. The treatment consists of surgery and heavy doses of antibiotics.
• Kidney failure is another complication of typhoid fever that is not treated early and adequately. In this case there is reduced urine production and all the waist products that the kidney disposes off are retained in the body making the patient even sicker
Prevention
Use the following steps to protect yourself from getting infected by Salmonella Typhi:
1. Get vaccinated against typhoid fever. Presently there are no vaccines available in Liberia. The vaccines are not 100% effective so it is necessary to take the additional measures listed below against typhoid fever.
2. Use careful selection of food and drink. This will also help protect you from other illnesses such as cholera, dysentery and hepatitis A.
3. Only use clean boiled water.
4. Take drinks without ice unless the ice is made from boiled water.
5. Only eat foods that have been thoroughly cooked.
6. Avoid raw vegetables and fruits that cannot be peeled.
7. When you eat raw fruits or vegetables that can be peeled, wash your hands with soap, then peel them yourself. Do not eat the peelings.
8. Avoid foods and drinks sold by street vendors.
Remember:
1. Even if your symptoms go away without treatment, you may still be carrying the S. typhi bacteria, and your illness could return and be passed to other people.
2. If you work at a job where you handle food or care for small children, you should not go back to work until a doctor has determined that you no longer carry any S.typhi bacteria.
3. Even if you are vaccinated, you should carefully select your food and drink, especially when visiting areas where typhoid fever is common.
