TYPHOID FEVER (ENTERIC FEVER)

Typhoid fever is a common bacterial infection caused by Salmonella typhi (S. typhi). It is transmitted through contaminated food and drinks, and after ingestion, it usually takes about 10 to 14 days for signs and symptoms of the infection to start showing.

After ingesting contaminated food or water, S. typhi travels to the small intestine. There, it localises in the lymphoid tissue, where it causes inflammation and ulcers. Most times, the ulcers heal, but in about 5% of cases, the bacteria linger, and the infected people continue to excrete the bacteria in stool.

Ever heard of Typhoid Mary?

Mary Mallon, popularly known as Typhoid Mary, was a cook in New York who worked with affluent families. In less than ten years, she worked with about eight families and infected seven of them with typhoid fever while showing no symptoms of the disease. She is the first known asymptomatic carrier of typhoid.

Signs and Symptoms of Typhoid

It typically starts with non-specific symptoms such as:

Increasing temperature
Feeling of unwellness
Body ache
Constipation (Vomiting and Diarrhoea in children)
Headache

By the end of the first week, an infected person may develop:

Spots on the upper abdomen and back that fade when you press them
Cough
Nose bleeds

Between the 7^th and 10^th day:

Constipation resolves, and diarrhoea takes over
There may be abdominal distension and tenderness
Bronchitis
Delirium
Coma

If left untreated, the person may die.

How is Typhoid Fever Diagnosed?

The diagnosis of typhoid fever is mainly made based on the clinical features of the disease. However, some tests can be done to confirm an infection.

Treatment of Typhoid

Since Salmonella typhi is a bacterium, it can be effectively treated with antibiotics. Treatment may take up to two weeks, and carriers are usually treated for up to four weeks.