Typhoid fever is common in south Asia, Africa, and Latin America, accounting for an estimated 22 million cases and 200,000 deaths worldwide each year. Typhoid fever is a systemic disease induced by Salmonellaenterica serovar Typhi (S. Typhi) and spread by contaminated food and water. Symptoms of typhoid include fever, weakness, stomach pains, headache, and loss of appetite. Some patients have constipation, and some have diarrhea. Internal bleeding and death can occur but are rare.

If you suspect Typhoid:

• Go to see your doctor or nurse to get antibiotic treatment for at least 14 days
• Avoid contact with other people while you are sick; avoid kissing, hugging, or sharing eating utensils or cups with other people.
• Do not prepare or serve food for other people.
• Take plenty of water that has been disinfected (boiled, filtered, and treated)
• Wash your hands often.

After the ingestion of contaminated food or water, the Salmonella bacteria invade the small intestine and enter the bloodstream temporarily. The bacteria are carried by white blood cells in the liver, spleen, and bone marrow, where they multiply and re-enter the bloodstream. People develop symptoms, including fever, at this point. Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel. Here, they multiply in high numbers. The bacteria pass into the intestinal tract and can be identified in stool samples. If a test result isn’t clear, blood or urine samples will be taken to make a diagnosis.

How to treat typhoid fever?

Several antibiotics are effective for the treatment of typhoid fever. Chloraphenicol was the original drug of choice for many years. Because of rare serious side effects, chloraphenicol has been replaced by other effective antibiotics. The choice of antibiotics is guided by identifying the geographic region where the infection was contracted. If relapses occur, patients are retreated with antibiotics. For those traveling to high-risk areas, vaccines are now available. Wang Ling (Rola), female, MD, PHD, associate professor in infectious disease department of Xiangya Hospital. She specialized in the diagnosis and treatment of febrile diseases, hepatitis cirrhosis and liver failure.

AT/15/5/19

Thursday May 16, 2019.