What is Typhoid Fever? Symptoms, transmission and treatment

What is typhoid fever?

Typhoid fever is a disease caused by the bacterium Salmonella enterica typhi , transmitted to man through contaminated water and food, in addition to direct contact with fluids from infected people. It can lead to death.

Also called enteric fever, the disease corresponds to code A01.0 in the International Classification of Diseases (ICD-10). The problem directly affects the intestine, causing symptoms such as diarrhea , vomiting and abdominal swelling.

Currently uncommon in fully industrialized regions, typhoid fever is currently endemic in some locations around the world, as it is directly related to poor basic sanitation conditions. Despite this, the risk of contracting the disease does not necessarily increase in times of flood.

The problem is treated exclusively with antibiotics and rehydration of the patient, who loses a lot of fluid due to vomiting and diarrhea.

Among the possible complications of the problem, when untreated, are bleeding and perforation of the intestine, septicemia, neuropsychological disorders and death.

Prevention can be done through the application of the vaccine against typhoid fever and simple hygiene measures.

Typhoid fever is a notifiable disease. This means that any case of the problem must be notified to the health department of your city or state as soon as possible, since the infection can be a sign that something is wrong with the basic sanitation in the region.

Are typhoid and typhus the same thing?

Although they share similar names, typhoid and typhus are quite different diseases caused by different agents.

Typhus is a term used as a comprehensive umbrella for a series of diseases caused by bacteria in the same family, called Rickettsia, transmitted to humans through insect bites.

Typhoid fever, on the other hand, is a problem caused by a totally different bacterium, called Salmonella enterica typhi , which, in turn, is transmitted through the ingestion of contaminated water and food.

Causes

Typhoid fever is a disease caused by a bacterium called Salmonella enterica typhi , popularly known as salmonella , which belongs to the Enterobacteriaceae family.

This type of bacteria is known for its ability to infect certain types of food and water sources, causing problems for humans.

This infection can happen through the contact of the soil with feces and urine of a carrier that is contaminated, or when a patient with typhoid fever handles the food during preparation without hand hygiene.

It is also possible for food contamination to occur when the water used for irrigation of a given plantation is infected.

In general, Salmonella enterica typhi can survive for days, weeks and even months in certain environments, according to the table below:

Atmosphere Survival
Sewer On average 40 days.
Fresh water At most one month, according to variables such as oxygen, temperature and pollution levels.
Salty water From 3 to 4 weeks, depending on the salinity levels of the water, although contamination of marine waters by salmonella is rare.
Oysters, shellfish and mollusks in general At most one month.
Dairy products Up to two months.

The Salmonella enterica typhi can also contaminate beef meat, poultry and fish, and eggs. However, contamination of humans through this type of food is more rare, since cooking kills the bacteria.

Streaming

The transmission of typhoid fever can happen in two different ways. Are they:

Direct transmission

Direct transmission of typhoid fever through the hands of infected people who do not sanitize them properly after going to the bathroom.

It can occur through the contact of the patient’s hands with the mouth of another person or when the carrier handles food that becomes contaminated.

Contagion can also happen through contact with certain bodily fluids of the carrier, such as vomiting, phlegm, pus, feces and urine. There are very rare reports, too, of contamination through sexual intercourse without condoms.

Indirect transmission

Indirect transmission is the most common form of infection by typhoid fever and occurs through the ingestion of food or liquids contaminated by the bacterium Salmonella enterica typhi .

These foods, in turn, can be contaminated in three ways:

  1. Through the contact of the soil or the springs of rivers and lakes with feces and urine of people contaminated by the causative bacteria;
  2. Through the handling of food by contaminated people who do not sanitize their hands properly after using the bathroom;
  3. When the water used to irrigate crops is contaminated.

Is typhoid contagious?

There is a possibility that typhoid fever can be transmitted through direct contact with the hands and / or body fluids of infected patients.

However, the most common mode of transmission is through eating infected food and fluids.

Risk factors

The biggest risk factor for typhoid fever is regional. Cases in locations such as Canada, the United States, Australia, Japan and Western European countries are rare.

Contamination is more frequent in places like Africa, Asia, the Caribbean, Central and South America. Therefore, the most significant risk factor is living in countries in these regions or traveling there.

According to data from the World Health Organization (WHO), the estimate fluctuates between 12 and 33 million cases of typhoid fever per year, with most of them occurring in South Asia and the African continent.

Brazil is considered a country that presents a risk of contamination by typhoid fever in an endemic way, that is, that occurs occasionally, in certain regions.

All Brazilian regions report cases of typhoid fever annually. According to data from the São Paulo State Epidemiological Surveillance Center (CVE), between 2010 and 2013, exactly 502 episodes of the disease were recorded in the country, most of them in the northern region. The distribution in this period occurred according to the table below:

Region Number of cases Percentage
North 301 60%
North East 153 30,5%
Southeast 31 6,2%
On the 12 2,5%
Midwest 5 0,7%

This regionality, however, is entirely circumstantial: contagion due to typhoid fever is closely linked to precarious conditions of basic sanitation.

For this reason, the more industrialized and inspected certain cities and regions far from capitals and large urban centers are, the lower the risk of salmonella infection.

Other risk factors are:

Living in regions with basic sanitation problems

Basic sanitation is a set of measures that guarantee the health of the environment, providing better health conditions and quality of life for the population of a given region.

Among the basic sanitation measures, there are actions such as:

  • Treatment and distribution of drinking water;
  • Sanitary sewage;
  • Cleaning of rivers and lakes, including the removal of solid waste;
  • Urban cleaning services.

If the area where you live or work does not have any of these services, you are at risk of contracting typhoid fever.

Work in contact with contaminated water

People who work in direct contact with water contaminated by the bacterium Salmonella enterica typhi have a high risk of developing typhoid fever.

This group includes people like:

  • Professionals who clean rivers and lakes;
  • Firefighters and military personnel working in floods;
  • Researchers.

Work in contact with human excretions

Direct contact with excretions such as vomiting, pus, feces, urine and phlegm from infected patients is a form of contagion due to typhoid fever. Therefore, those who work with this type of material are at risk of contracting the disease.

This group includes people like:

  • Health professionals, especially nurses;
  • Teachers of specific educational levels who come into contact with excretion frequently (such as early childhood education, for example);
  • Caregivers for the elderly and babysitters.

Having contact with someone who has typhoid fever

Direct contact with sick people is one of the main forms of contamination by typhoid fever. Therefore, living or living regularly with a patient who has the disease can be a gateway to the problem.

Symptoms

Typhoid fever symptoms appear in stages, and change and intensify over time.

Although the academic literature divides the stages of the disease in a well-defined way, in practice, it is not uncommon for the symptoms of each stage to be confused.

Initial stage

The initial symptoms of typhoid fever are mild and generic. It is common for the disease to be mistaken for a cold during this stage .

The signs are:

  • Weak fever (around 37ºC), but constant, which gradually rises over the days;
  • Headache;
  • Muscle aches;
  • Stomach ache;
  • Fatigue;
  • Chills;
  • Dry cough.

State stage

The state stage or period usually occurs 6 to 14 days after the onset of symptoms in the initial stage.

  • High fever, reaching 40.5ºC;
  • Delusions;
  • Difficulty recognizing the environment in which it is at times;
  • Periods of unconsciousness;
  • Diarrhea or constipation;
  • Swelling in the belly, caused by an enlarged spleen and liver;
  • Vomiting;
  • Dizziness;
  • Appearance of red spots on the patient’s shoulders, chest and abdomen;
  • Ulcerations in the mouth, in rarer cases.

Decline stage

It usually starts from the fourth week of infection – as long as the patient is undergoing appropriate treatment.

It is when the symptoms start to regress and the patient shows significant improvements, although he is still subject to complications resulting from the disease (for more information, read the section “Complications of typhoid fever”).

Convalescence stage

At this stage, most of the symptoms have stopped manifesting. However, the patient may still have consequences of the disease, such as:

  • Weight loss;
  • Hair loss;
  • Apathy;
  • Peeling on the skin.

Signs of worsening typhoid

In most cases, the symptoms that typhoid fever is getting worse rather than getting better appear during the so-called state stage.

It is important to seek emergency care if the patient with typhoid fever shows signs such as:

  • Headache worsening;
  • Worsening of belly pain;
  • Increased swelling in the belly;
  • More red spots appear on different parts of the body;
  • Coughing, vomiting and / or bloody stools.

The worsening of the disease is more common in patients who are not carrying out the treatment correctly.

Read more: How many degrees is considered fever?

How is typhoid fever diagnosed?

The diagnosis of typhoid fever is made through laboratory tests that aim to identify the bacterium that causes the symptoms.

The tests that are likely to be ordered by your doctor for this purpose are:

  • Blood collection;
  • Feces;
  • Urine;
  • Widal reaction, a specific blood test to identify Salmonella- like bacteria ;
  • Myeloculture, which consists of collecting bone marrow material for analysis.

In addition, the professional should also request tests to rule out some other diseases, such as pneumonia , tuberculosis , mononucleosis, rheumatic fever and malaria .

Blood collection

Also called blood culture, blood collection to diagnose typhoid fever has better results when it is done in the initial two weeks of the disease, before the patient has been exposed to antibiotic treatment.

The test consists of collecting two or three blood samples, depending on the case, which must be done with a 30-minute interval between each one.

Stool examination

Stool examination, or co-culture, is usually completely effective in diagnosing typhoid fever between the second and fifth weeks of infection. It is not uncommon for the test to be recommended by doctors at various stages of contagion, to assess the course of the disease.

In the convalescence stage, for example, it may be necessary to repeat the exam every 24 hours, for up to seven samples.

Urine analysis

Urine collection – also called by the clinical term uroculture – is a commonly requested test in cases of typhoid fever. However, the test is usually useful for diagnosing the disease for a limited time, a maximum of 3 weeks from contagion.

Widal reaction

The exam consists of a blood collection, done like any other, which must be performed from 7 to 14 days after the patient has been contaminated by the bacterium Salmonella enterica typhi .

In order to confirm the diagnosis of typhoid fever, the result must have the reference “titles” with a value equal to or greater than 1/80.

Widal’s reaction is a complementary test and must be ordered along with stool and urine tests.

Myeloculture

Also called “spinal aspiration puncture”, myeloculture is an exam that must be done with the application of local anesthesia. The procedure consists of inserting a fine needle on the outside of a given bone.

There are three bones that can be used to perform the exam: the sternum, which is located in the chest region; iliac crest, which is located at the height of the pelvis; or in the tibia, which is in the leg, the latter being chosen only in children.

A puncture will be made in the chosen bone (that is, a needle will be inserted in it) and, then, blood material will be aspirated for analysis with the aid of a syringe.

Myeloculture is the most effective test for diagnosing typhoid fever, with up to 90% sensitivity to the bacterium Salmonella enterica typhi and resulting in reliable rates even after the individual has already taken antibiotics.

Can typhoid cure?

Yes, typhoid fever can be cured . Treatment consists of administering medications and rehydrating the patient. In more severe cases, hospitalizations may be necessary.

Treatment

As it is an infection caused by bacteria, treatment for typhoid fever requires the use of antibiotics, which will be prescribed by the doctor responsible for the patient.

In addition, it is also important to take care of the hydration of the patient, who needs to start replacing fluids as soon as the problem is detected. Therefore, drinking plenty of fluids and resting is essential.

If serious complications occur, such as perforations or bleeding in the intestine, surgical intervention may be necessary.

The criterion for a patient to be considered cured of typhoid fever is to perform two stool examinations after the end of the administration of antibiotics, with an interval of about 7 days between them. It is necessary that both samples show negative results for the presence of the causative bacteria.

Typhoid Fever Remedies

Drug treatment of typhoid fever is done through the prescription of specific antibiotics .

Some of the medications that can be prescribed by your doctor to treat the problem are:

  • Chloramphenicol ;
  • Ampicillin ;
  • Sulfametoxazol + Trimetoprima;
  • Amoxicillin ;
  • Quinolona;
  • Ciprofloxacin ;
  • Ofloxacin;
  • Cetriaxona.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Typhoid Fever Prognosis

The incubation period – that is, the interval between infection of the patient by the bacterium Salmonella enterica typhi and the manifestation of symptoms – is usually, on average, 1 to 3 weeks.

The time of transmissibility, in which the patient is able to transmit the bacteria, happens while the infected person is eliminating Salmonella through feces and urine.

In general, this phenomenon starts from the first week of symptom manifestation and can extend up to 3 months after the patient’s recovery.

Mortality rates in the country have dropped significantly in recent years. More recent surveys carried out by the Ministry of Health indicate that, between 2000 and 2014, Brazil had 117 deaths from typhoid fever.

In general, with proper treatment, most patients fully recover within 5 weeks. Complications are more common in the elderly, people with immunodepressive conditions or people who do not follow medical recommendations.

Living together

Typhoid fever is usually a disease that affects the patient intensely from the second week of symptom onset. In cases of the problem, it is common for the affected person to be prostrate and not have the energy to even get out of bed.

It is essential to monitor the progression of fever from time to time, follow the doctor’s recommendation regarding the administration of antibiotics (which, in general, are prescribed to be ingested for periods of 10 to 14 days), rest and drink plenty of fluids.

In addition, it is essential to be aware of the worsening of symptoms and the persistence of high fever.

Some measures that need to be taken during the typhoid fever contagion period are:

Hydrate

Dehydration is one of the main consequences and complications of typhoid fever. Therefore, drinking plenty of fluids is essential to recover soon.

Among the drinks that are ideal for drinking during the treatment of typhoid fever are:

  • Water in the greatest amount possible, in small sips, preferably filtered or boiled;
  • Teas of any kind, preferably sugar-free;
  • Sugar-free natural juices, especially boiled apple, lemon and guava;
  • Sports drinks (also known as isotonic drinks), such as Gatorade, Powerade and Hidrotônico, for example;
  • Coconut Water.

On the other hand, some drinks should be avoided at all costs in cases of recovery from typhoid fever. Are they:

  • Milk and bottle yoghurts, which can make diarrhea worse;
  • Soft drinks, which can intensify symptoms such as abdominal bloating, abdominal pain and diarrhea;
  • Sparkling water, which can worsen abdominal bloating;
  • Coffee, both powdered and soluble, which can worsen diarrhea;
  • Alcoholic beverages, mainly fermented ones (such as wine or beer, for example), which can worsen swelling, pain and diarrhea;
  • Canister juices, which can make diarrhea worse.

Have a light diet

Patients with typhoid fever should eat small portions, 5 to 6 times a day, always with a menu consisting of light foods.

In this way, it will be possible to replace all the nutrients lost through vomiting and diarrhea and ensure that these two symptoms do not intensify as a result of a heavy diet.

Some foods that can (and should!) Be eaten are:

  • Vegetable soups and broths in general, as long as they do not contain beans, onions, turnips, sweet potatoes, cabbage and peppers, which are rich in sulfur and can worsen diarrhea;
  • Fruits like banana, guava, lemon, passion fruit and peeled apple;
  • Purées and gelatines of the previously mentioned fruits;
  • Sago without wine;
  • Fish and chicken meats, without fat and without skin, preferably grilled or roasted;
  • Light side dishes such as white or brown rice, brown noodles, cornmeal, toast, tapioca, French bread, crackers and mashed potatoes without much seasoning.

Fatty foods are strictly prohibited, which include red meats, flours, stuffed crackers and fried foods.

Some fruits are also not recommended because they stimulate the functioning of the intestine and worsen diarrhea. Are they:

  • Papaya;
  • Orange;
  • Watermelon;
  • Melon;
  • Plum;
  • Grapes;
  • Pineapple.

If you have any questions about the ideal diet according to your health history, do not hesitate to ask your doctor.

Make compresses to fight fever

Making compresses is a quick, safe and effective way to ease the effects of fever.

To make an ideal compress to fight the high temperatures of a case of typhoid fever, follow the tips below:

  1. Fill a small container with cold water;
  2. Dip a towel or cotton cloth in the water;
  3. It will be necessary to place the towel or cloth in some specific areas of the body: the forehead, neck and under the arms;
  4. Leave the towel moist for a while in each of these regions. When you notice that the temperature of the cloth is returning to normal, moisten again and repeat the procedure until the water in the container runs out;
  5. Check if the fever has gone down;
  6. Repeat the process two to three times a day.

Wash your hands thoroughly

Hand hygiene is a type of care that patients with typhoid fever need to take to prevent other people who live with them from contracting the disease.

Attention needs to be heightened if the person with typhoid fever handles food during the period of transmissibility.

Therefore, the sick person needs to wash their hands thoroughly with antibacterial soap whenever they go to the bathroom. Throughout the day, it is worth reinforcing protection with a little alcohol gel.

Complications

Dehydration

Dehydration is a phenomenon that happens when the body runs out of water (and, consequently, mineral salts) to perform its vital functions. It is common in patients with typhoid fever due to episodes of vomiting and diarrhea.

The main symptoms of a condition of dehydration are dry skin and mouth, very low production and sweat and tears, deep dark circles, dizziness , drowsiness and tachycardia.

If not reversed urgently, it can cause serious problems such as seizures , brain swelling, coma and death.

Intestinal bleeding

Intestinal bleeding is one of the most common complications in cases of typhoid fever. It happens because the bacterium Salmonella enterica typhi  causes damage to the intestinal wall.

In most cases, the bleeding is small and stops on its own. However, if the patient is not receiving adequate treatment, the condition may progress to hemorrhage. In that case, immediate medical attention is required.

Intestinal perforation

As in the case of intestinal bleeding, perforation of the intestine is a consequence of injuries caused by the bacterium Salmonella enterica typhi . It is a relatively common and quite serious complication.

Generally, the main symptoms of intestinal perforation are increased pain and swelling in the abdomen, a sudden drop in blood pressure and heart palpitations.

In case of presenting any of these symptoms, the patient with typhoid fever must be urgently taken to the hospital, since an intestinal perforation condition requires surgical intervention.

Myocarditis

Cardiac complications are a little more rare in cases of typhoid fever, but they can happen. One of the possibilities is the development of a myocarditis, characterized by the inflammation of the muscular layer of the heart, which is called myocardium.

Myocarditis resulting from typhoid fever is caused by a circulatory failure, which, in turn, is caused by the action of bacteria in the body.

The symptoms of myocarditis are mild: they consist of tiredness , shortness of breath, swelling in the legs and palpitations and / or cardiac arrhythmias.

If left untreated, inflammation can cause permanent damage to cardiac tissues and even lead to death.

Endocarditis

The endocarditis is an infection that affects the lining of the heart, called endocardial.

The problem happens when a bacterium falls into the bloodstream and ends up reaching the heart, contaminating the tissues that line the muscle.

Infection of the endocardium can cause serious problems, such as deterioration of the heart valves, myocardial infarction, septicemia and death.

Acute pancreatitis

The pancreatitis acute is an inflammation that affects the pancreas suddenly, from one moment to the other, causing swelling of the organ.

One of the primary functions of the pancreas is to produce some types of digestive enzymes, which must be activated only during the process of digesting food.

A rare complication of typhoid fever, pancreatitis occurs when some metabolic alteration in the body activates these enzymes still inside the pancreas, unnecessarily, leading to inflammation.

The main symptoms of acute pancreatitis are fever, sensation of having a lump in the abdominal area, hiccups, gas , indigestion, lighter than normal stools and yellow skin.

Among the main complications of acute pancreatitis are kidney and / or heart failure, development of cysts in the pancreas, hemorrhages and malnutrition.

Bacterial meningitis

The meningitis is a severe inflammation of the meninges, three special membranes lining the brain (central part of the nervous system) and the spinal cord.

It happens due to a typhoid fever when the bacterium Salmonella enterica typhi falls into the bloodstream and reaches the region of the brain.

The bacterial meningitis is a medical emergency which, if not treated quickly, can cause paralysis of upper and / or lower, deafness, epilepsy and brain damage.

Its main symptoms are pain and stiffness in the neck, severe headache , high fever, mental confusion, sensitivity to light and the appearance of purple spots on the whole body.

Osteomielite

The osteomyelitis is a type of inflammation in bones, which can be caused by various agents, including bacteria. It can cause the formation of abscesses in our bones, some types of arthritis , skin cancer and even the death of the affected bone.

Its main symptoms are pain, swelling and feeling of heat in the area affected by the infection, in addition to fever and chills.

In patients with typhoid fever, it can happen when the bacterium Salmonella enterica typhi falls into the bloodstream.

Septicemia

Also known as sepsis or generalized infection, septicemia occurs when the bloodstream, which passes throughout the body, is infected by a bacterium that was already related to a pre-existing disease (in this case, typhoid fever).

Septicemia is a serious problem, with high mortality rates. It is not uncommon for patients with sepsis to end up with sequelae, especially neuropsychological ones.

Mental complications

Typhoid fever that is not properly treated can lead to neurological complications.

Among the phenomena that can occur are hallucinations and Paranoid Personality Disorder.

Deep vein thrombosis

stroke happens when blood clots (also called thrombi) form in major veins, blocking the passage of blood flow and causing serious problems.

The main (and most common) complication of a venous thrombosis is called pulmonary embolism , which consists of a process in which the clots detach themselves from the place where they are and travel to the lung through the bloodstream, obstructing veins there and hindering the arrival of oxygen to various parts of the body.

Among pulmonary embolism cases, mortality rates reach 30%.

The formation of thrombi is not a direct consequence of typhoid fever, but of the long periods of rest caused by the disease. It is not uncommon for infected patients not to have the strength to get out of bed, and to spend a lot of time lying in the same position. Immobility can be responsible for the appearance of clots.

The problem is usually asymptomatic until it causes complications. Some of the symptoms that may eventually appear are swelling, stiffness, redness and feeling of heat in the region affected by the thrombus.

How to prevent typhoid fever?

A considerable part of preventing typhoid fever includes simple measures, such as washing and cooking food well, for example.

Some actions that can be taken to prevent typhoid fever are:

Get the typhoid vaccine

Yes, there is a vaccine against typhoid fever available in the public health system and in private clinics. However, it is usually used only free of charge during periods of disease epidemic.

The application is recommended for health professionals, teachers, military personnel and people who travel to regions where the contagion of typhoid fever happens in an endemic way. It can be given to children from 2 years old.

The vaccine is administered in a single dose, and offers protection against infections from typhoid fever for up to three years.

In the private network of Minas Gerais, the value of the vaccine ranges from R $ 96.00 to R $ 116.00.

However, according to information from the Federal University of Rio de Janeiro (UFRJ), the vaccine is not fully effective and has been tested only on people who already live in endemic areas. Also according to the data collected by the institution, the injectable vaccine has an efficacy that fluctuates between 50% and 70%.

The application of the vaccine against typhoid fever is not indicated for pregnant women and people with low immunity and / or immunosuppressive diseases. In addition, it should only be applied with medical advice.

Drink boiled or filtered water

Boiling the water, purifying it or putting it in a filter before consuming it are excellent ways to eliminate any chances of being contaminated by bacteria and / or other microorganisms.

In addition to eliminating disease-causing germs, filtering water can also eliminate chemicals and sediment that may have contaminated the liquid.

How to know if the water is fit for consumption?

To be considered potable, water must fulfill three requirements: be colorless, odorless and tasteless.

Being colorless, as the name suggests, means that the liquid cannot be colored. Drinking water is transparent and crystal clear.

Being odorless means that the water cannot smell, that is, there is no smell.

Finally, tasteless means that the water should have no taste, however light it may be.

The water that is in conditions to be ingested or used in the preparation of food must, necessarily, have these three characteristics. If it does not meet any of these requirements, it should not be consumed.

The water that comes from the tap comes from treatment plants, where it has undergone refined cleaning and purification processes. Therefore, it can be consumed without fear.

However, it is important that the cisterns and water tanks in your home or building are always clean and sanitized. Otherwise, it is possible that the tap water is infected by microorganisms at this stage of the consumption cycle.

Avoid raw or undercooked food

Cooking food to at least 70 degrees is an effective way to kill most bacteria.

So, even if the meat or eggs you are preparing were contaminated by microorganisms before it reached your kitchen, the chances of you or your family contracting typhoid fever are dramatically reduced.

Do Japanese restaurants pose a health risk?

The methods of preparing dishes in oriental cuisine are very healthy. This is because thanks to low cooking levels, foods preserve most of their properties and nutrients.

Therefore, the act of eating raw fish in itself is not exactly harmful to health – although the dishes do offer small risks of concentrating bacteria and microorganisms.

However, the greatest risk of eating raw dishes, such as sushi and temakis, is in a human carelessness: the inadequate preservation of these foods and the poor hygiene of the place where they are prepared.

In order that fish served in oriental cuisine restaurants do not present risks to the health of those who consume them, it is essential that they are always fresh and that they are stored at low temperatures until they are served.

It is also important that the people responsible for preparing the food have their hands properly sanitized and do it on clean surfaces suitable for that purpose.

For the consumer, the tip is to always pay attention to the cleanliness of the environment before eating and, if possible, look for any criticisms of the hygiene of the establishment on the internet. If you feel a strange taste in the chosen dish, it is worth stopping eating immediately and inform the restaurant manager of the situation.

Do not eat in places with poor hygiene conditions

Whenever you eat in a different environment, pay attention to the cleanliness conditions of the place. The hygiene levels of the place can be an indication that you are at risk of contracting diseases by eating there.

If you find any strange situation in commercial establishments, it is important to contact the Health Surveillance of your region and report the fact. Complaints can be made in complete anonymity.

Do not accept food from strangers

When her mother gave this advice, she was quite right. Eating food that you don’t know the source of can be a gateway for bacteria, especially if the food in question is not packaged and comes directly from someone else’s hands.

Wash fruits and vegetables well

Washing fruits and vegetables under running water and using a brush is a habit that can prevent many headaches – literally .

By properly sanitizing these foods, the risk of contracting any disease from possible contamination is greatly reduced.

What is the difference between typhoid and paratyphoid fever?

Typhoid fever and paratyphoid fever are two distinct but extremely similar diseases. Both are transmitted in the same ways and share the same symptoms.

The primary difference is that paratyphoid fever is a simpler disease, which does not present a risk of death and manifests itself with much milder symptoms.

In addition, the two phenomena are caused by different bacteria. While typhoid fever is caused by Salmonella enterica typhi , paratyphoid fever is caused by the bacteria Salmonella paratyphi type A, B or C.

Due to the similarity between the two diseases, the Widal Reaction test is the most effective way to arrive at a precise and accurate diagnosis.


Although it can cause serious complications, typhoid fever is easily treatable. Therefore, if you experience symptoms corresponding to the disease, it is important to see a doctor as soon as possible.

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