Friday, January 25, 2013

Typhoid Fever

Typhoid fever is very common type of fever which is caused by ‘typhoid bacillus Salmonella typhi’. This fever is heard all over the world.

The bacteria that cause Typhoid are ‘Typhoid bacillus Salmonella typhi’. The bacillus is transmitted from person to person by use of contaminated food or water by the feces of typhoid carriers or victims. The ratios of deaths from this fever are too high. The number is more than 6-lac globally only because of Typhoid fever.

The history of typhoid fever starts from 430-424BC when about all the nation of Athens was dies because of plague. And their leader Pericles was also killed among its nation. The research on this disease has long been confusing and useless because of mythical conversation and DNA study crisis.

Some historical proofs say that in English colony of Jamestown, Virginia, typhoid fever killed about more than 6000 persons between 1607 and 1624. And after that in the American Civil War, about more than 81,000 soldiers dies of typhoid and dysentery.

The worst condition was found in Chicago in 1891 when the death rate increased from 65/100000 a year to 174/100000 people a year. This was mainly from polluted water of the Chicago River. The research was continued over the years and then Mary Mallon (September 23, 1869 to November 11, 1938) was found with typhoid carrier and is also known as Typhoid Mary. It has been said that she has infected more than 53 people by typhoid and among those 3 were died.

What are symptoms of typhoid fever?


This fever slowly increases as compared to other types of fever. The bacteria enter in small intestine and slowly travel to blood stream in one to two weeks. This starts high fever about 40 °C (104 °F) and sweating along with that. And sometimes a rose color spots appear on skin of the typhoid patient but it is not so common. The patient can also feel headache, cough, vomiting, and diarrhea.

Diagnosis of typhoid


The Diagnosis of typhoid is made by any blood sample or bone marrow. This can also be done with stool and with the Widal test. This is the demonstration of salmonella antibodies against antigens O-somatic and H-flagellar. The Widal test is time consuming and sometimes it is too late to start antibiotic when the result is received.

How can we control and control typhoid fever?


This disease is only in humans. The animal and other life forms are not affected by these bacteria. The transmission is also carried out from human to human. Sanitary condition plays an important role in the prevention of typhoid. Below mention points are more important to prevent typhoid fever;
  • Keep the area clean.
  • Use clean and pure drinking water.
  • Avoid the urine and human feces to come in contact with your food or water.
  • Wash your hands before eating something.
  • Improvement of sewerage facilities.

What are treatment options of typhoid fever?


The treatment options of this disease are many. Some are in the form of antibiotics and others in form of vaccine. The approved antibiotics to be used for treatment of typhoid are from the fluoroquinolone and cephalosporin groups, such as ciprofloxacin and ceftriaxone. Below is the brief for treatment related to stages of typhoid fever?
  • When the resistance to disease is uncommon then the treatment of first choice is a fluoroquinolone such as ciprofloxacin.
  • When the resistance is common then the third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice.
  • 3rd is Cefixime which is a suitable oral alternative for both the above mentioned antibiotics.
If it is treated properly, then the death rates drop more than untreated cases. Death rates in untreated cases are 10% to 30% which is very high.

What are Typhoid Vaccines?
The recommended vaccines from World Health Organization (WHO) are;
  • Live and oral Ty21a vaccine which is sold as Vivotif Berna.
  • Injectable Typhoid polysaccharide vaccine which is sold as Typhim Vi by Sanofi Pasteur and Typherix by GlaxoSmithKline.
Both the above mentioned vaccines are 50% to 80% effective to prevent typhoid and are good for those who travel to area of typhoid affection. And for oral or live vaccines, a booster is required every five years while after every 2nd year a booster is recommended for inject-able vaccine.

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