Typhoid fever (also known as abdominal typhus) is an acute illness caused by the bacterium Salmonella Typhi.
It can also be caused by Salmonella Paratyphi, a bacterium that usually causes a less serious illness: paratyphoid fever.
- 1 How is typhoid spread? The contagion
- 2 Carriers of typhoid fever
- 3 Inoculation of typhoid fever
- 4 Symptoms of typhoid fever
- 5 Possible complications and consequences
- 6 How is the diagnosis of typhoid diagnosed?
- 7 Medical treatment for typhoid fever
- 8 Natural remedies for typhoid fever
- 9 Prognosis of typhoid fever
- 10 Vaccine for typhoid fever
- 11 Prevention of typhoid fever
- 12 Paratyphoid fever
Causes of typhoid fever
The bacteria that cause typhoid fever (Salmonella Typhi) are spread through contaminated food, soft drinks or water.
By eating or drinking a contaminated element, the bacteria enter the body.
After S. Typhi reaches the intestine and then passes into the bloodstream, where it can reach the lymph nodes, gallbladder, liver, spleen and other parts of the body.
Some people can become carriers of Salmonella Typhi and continue to release bacteria in the stool for years, thus spreading the disease.
Typhoid fever is common in developing countries, but not exclusive of them, since every year there are almost 400 cases in the United States.
Most cases in the United States come from other countries where typhoid fever is common.
Typhoid fever is very contagious. An infected person can transmit bacteria from the body to the stool during evacuation or, less frequently, when urinating.
According to Lezaeta’s natural medicine and Shelton’s hygienism, microbes do not cause infections and diseases.
An organism gets sick when the person eats foods that are slowly digested (meat, fish, eggs, dairy products, processed foods, cooked and fried foods, sweets, etc.) and then intestinal putrefaction occurs.
Bacteria feed on dead and decaying tissues, in fact, in nature, perform the “clean” of dead animals.
In a favorable environment, pathogenic microorganisms proliferate and invade the intestine, but if a person has a healthy diet, natural and with appropriate combinations of foods, the disease does not occur.
This explains why in a family or in a class not everyone gets sick, but only a few.
How is typhoid spread? The contagion
When an infected person evacuates, the Salmonella Typhi bacteria can be passed on to the stool. If you do not wash your hands thoroughly after going to the bathroom, S. Typhi can contaminate any food that is touched. The infection is fecal-oral, that is, the microorganism is eliminated through the stool and the disease is contracted through the mouth.
If another person eats the infected food they can also get the infection.
Less commonly, the Salmonella Typhi bacteria can spread through the urine.
If an infected person manipulates the food without washing his hands properly after urinating, he can infect another person who consumes the contaminated food.
In some parts of the world with poor hygienic-sanitary conditions, infected human waste can contaminate water sources.
People who drink contaminated water or eat foods that have been washed in contaminated water can get typhoid fever.
Other ways in which you can get typhoid fever are:
- Use a toilet contaminated by bacteria and touch your mouth before washing your hands;
- Eat seafood or fish that come from water from a source contaminated by infected feces or urine;
- Have sex (oral or anal) with a person carrying the Salmonella Typhi bacteria.
Carriers of typhoid fever
If typhoid fever is not cured, it is estimated that one in 20 people who survive the infection will become a healthy carrier of the disease.
This means that the Salmonella Typhi bacteria continue to live in the bladder and in the intestine, therefore, they can spread to faeces or urine. However, carriers of typhoid fever do not have any symptoms.
Inoculation of typhoid fever
The incubation period can vary from 3 to 90 days, the average duration is 1/3 weeks.
Symptoms of typhoid fever
Although children with typhoid fever sometimes become suddenly ill, signs and symptoms are more likely to develop gradually, often occurring between one and three weeks after exposure to the disease.
The course of the disease is divided into seven weeks and each week has specific characteristics.
1st week of typhoid fever
After the signs and symptoms appear, it is very likely to experience:
- Fever, starts low and increases every day, often reaches 39.4-40 degrees,
- Headaches ,
- Weakness and fatigue,
- Dry cough ,
- Loss of appetite ,
- Stomach ache,
- Diarrhea or constipation ,
- Rash consisting of small red spots on the torso.
2nd week of typhoid fever
If no treatment is applied for typhoid fever, you can move to the second phase in which there are complications such as:
- High and constant fever ,
- Diarrhea or severe constipation,
- Considerable weight loss,
- Belly swollen and very dilated.
3rd week of typhoid fever
The trend changes in the third week, in which you can:
- To delirious,
- Staying motionless and exhausted, with half-closed eyes, one of the typical symptoms of typhoid fever,
- Deadly complications usually develop this week.
4th week of typhoid fever
The improvement can be glimpsed slowly during the fourth week. The fever gradually decreases and the temperature returns to normal after a week or ten days.
The signs and symptoms may reappear until two weeks after the fever subsides.
Compared with cholera, typhoid fever is much less severe and its mortality rate much lower.
Possible complications and consequences
- Intestinal bleeding (severe bleeding),
- Intestinal perforation,
- Renal insufficiency,
How is the diagnosis of typhoid diagnosed?
If you think you have contracted typhoid fever, the doctor may, based on the patient’s physical symptoms, require a stool culture (from the second week) and / or blood tests to specifically identify the Salmonella Typhi bacteria.
The doctor asks the patient for information about his medical history and the trips made in order to evaluate the exposure to the bacteria.
Medical treatment for typhoid fever
Treatment with antibiotics is the only effective for typhoid fever.
Antibiotics that are usually prescribed
- Ciprofloxacin In the United States, doctors usually prescribe this medication for adults. In the case of women, if they are not pregnant.
- Ceftriaxone This antibiotic in the form of an injection is an alternative for pregnant women and for children who can not take ciprofloxacin.
These medications can cause side effects and their long-term use can lead to the emergence of strains of bacteria resistant to antibiotics.
Problems with antibiotic resistance
Traditionally, the drug chosen was chloramphenicol. However, nowadays doctors do not usually prescribe it due to its side effects: high rate of worsening of health after a period of improvement (relapse) and generalized bacterial resistance.
In fact, the existence of bacteria resistant to antibiotics is a growing problem in the treatment of fever, especially in developing countries. In recent years, S. Typhi has been shown to be resistant to trimethoprim / sulfamethoxazole and ampicillin.
Natural remedies for typhoid fever
Other treatments aimed at the management of symptoms are:
- Drink liquids in abundance. This helps prevent dehydration, which is a consequence of prolonged fever and diarrhea. In case of severe dehydration, you may need to receive fluids intravenously (through a vein in the arm).
- Eat a healthy and light diet.
According to natural medicine, if the patient has no contraindications (pregnancy, diabetes, advanced cancer, advanced tuberculosis and heart disease) he can fast to facilitate the elimination of toxins.
When the patient is better, the diet has to be light and natural, with raw fruits and vegetables, legumes and nuts.
Avoid animal protein, sweets, salt and processed products found in the supermarket
Prognosis of typhoid fever
The prospects are good if the antibiotic treatment is followed, the patient can be discharged from the hospital when the disease stabilizes.
At home, good general hygiene (as usual) should be maintained, since bacteria can continue to appear in the stool for several weeks.
If the patient works with food, they should not go to work until at least two stool samples certify the disappearance of the infection.
Approximately one out of every 20 people who follow treatment for typhoid fever relapses.
Symptoms usually return about a week after the end of antibiotic treatment.
When symptoms disappear, another stool test should be performed to check for the presence of Salmonella Typhi bacteria in the stool. If they appear, it means that the patient is still a carrier of typhoid fever.
Vaccine for typhoid fever
There are two vaccines to prevent typhoid fever.
One of them is the vaccine with inactivated (dead) bacteria that is made with an injection and the other is the vaccine with a live and attenuated (weakened) bacterium, which is taken orally (by mouth).
It is recommended to vaccinate against typhoid fever at:
- Travelers who go to parts of the world where typhoid fever is common (note: the typhoid vaccine is effective in 50/75% of cases and lasts for around 3 years, it is not a medicine that allows us to be unconcerned of what we eat or drink).
- People in direct contact with a carrier of typhoid fever.
- Laboratory workers who work with Salmonella Typhi bacteria.
Vaccine for inactivated typhoid fever ViCPS (injection)
It should not be given to children under two years of age.
One dose is sufficient to obtain protection. It should be administered at least two weeks before the trip to allow time for the vaccine to be effective.
A booster dose is required every two years for people at risk.
Side effects include headache, malaise, and fever.
Vaccine for typhoid fever live attenuated (oral)
It should not be administered to children under six years of age.
Four doses are required for protection, administered on alternate days.
The last dose should be administered at least one week before the trip to allow time for the vaccine to be effective.
Every five years, a dose of memory is needed for people at risk.
The vaccine can be given at the same time as other vaccines.
Among the side effects of the oral vaccine are:
- Gastrointestinal disorders such as abdominal pain, vomiting or diarrhea.
- Hives or rash
Prevention of typhoid fever
It is recommended to follow these guidelines if traveling to high risk areas:
- Handwashing. Frequent hand washing is the best way to control the infection. Wash your hands thoroughly with hot water and soap, especially before eating or preparing food and after using the bathroom. Take an alcohol-based disinfectant with you when there is no water available.
- Avoid drinking untreated water. Polluted drinking water is a problem, especially in areas where typhoid fever is endemic (due to epidemics). For this reason, it is necessary to drink only bottled water or bottled or canned soft drinks. Order drinks without ice. Use bottled water to brush your teeth.
- Avoid unpeeled fruits and vegetables, especially lettuce.
- Consume cooked foods. Avoid food that is served at room temperature. Steam hot foods are the best. It is better to avoid food from street vendors.
Paratyphoid fever is an infectious disease such as acute typhoid fever caused by the microorganism Salmonella Paratyphi.
The symptoms of paratyphoid fever are those of intestinal inflammation: fever, vomiting, diarrhea, abdominal pain and hypotension.
The prognosis of paratyphoid fever is 10/14 days, similar to typhoid fever, but less severe and of shorter brevity.
Complications of paratyphoid fever occur in exceptional cases.
The diagnosis is made through a stool analysis.
In general, no treatment is required, but in severe cases the doctor may prescribe antibiotics: ampicillin, amoxicillin, quinolones and cephalosporins.