Typhoid fever is an acute illness associated with fever caused by the Salmonella enterica serotype Typhi bacteria. It can also be caused by Salmonellaparatyphi, a related bacterium that usually causes a less severe illness.
The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area. India, Pakistan, Nigeria and Egypt are also known as high-risk areas for developing this disease.
Worldwide, typhoid fever affects more than 21 million people annually, with about 200,000 people dying from the disease.
How Do People Get Typhoid Fever?
Typhoid fever is contracted by drinking or eating the bacteria in contaminated food or water.
People with acute illness can contaminate the surrounding water supply through stool, which contains a high concentration of the bacteria.
Contamination of the water supply can, in turn, taint the food supply. The bacteria can survive for weeks in water or dried sewage.
About 3%-5% of people become carriers of the bacteria after the acute illness. Others suffer a very mild illness that goes unrecognized. These people may become long-term carriers of the bacteria — even though they have no symptoms — and be the source of new outbreaks of typhoid fever for many years.
How Is Typhoid Fever Diagnosed?
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 reenter 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.
What Are the Symptoms of Typhoid Fever?
The incubation period is usually 1-2 weeks, and the duration of the illness is about 3-4 weeks. Symptoms include:
– Poor appetite
– Generalized aches and pains
– Fever as high as 104 degrees Farenheit
Chest congestion develops in many people, and abdominal pain and discomfort are common. The fever becomes constant. Improvement occurs in the third and fourth week in those without complications.
About 10% of people have recurrent symptoms after feeling better for one to two weeks. Relapses are actually more common in individuals treated with antibiotics.
How Is Typhoid Fever Treated?
Typhoid fever is treated with antibiotics which kill the Salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20%.
Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal perforation. With antibiotics and supportive care, mortality has been reduced to 1%-2%.
With appropriate antibiotic therapy, there is usually improvement within one to two days and recovery within seven to 10 days.
Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics.
The choice of antibiotics is guided by identifying the geographic region where the infection was contracted (certain strains from South America show a significant resistance to some antibiotics.)
If relapses occur, patients are retreated with antibiotics. Those who become chronically ill (about 3%-5% of those infected), can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will provide a cure.
For those traveling to high-risk areas, vaccines are now available.
Typhoid Fever At A Glance
– Typhoid fever is caused by Salmonella enterica serotype Typhi bacteria.
– Typhoid fever is contracted by the ingestion of contaminated food or water.
– Diagnosis of typhoid fever is made when Salmonella bacteria are detected with stool, urine, or blood cultures.
– Typhoid fever is treated with antibiotics.
– Typhoid fever symptoms are poor appetite, headaches, generalized aches and pains, fever, and lethargy.
– Approximately 3%-5% of patients become carriers of the bacteria after the acute illness.
How to Distinguish Typhoid Fever from Malaria
The best way to distinguish between the two diseases is to categorize the correlations they have.
- The causes of both diseases are totally different. Whereas mosquitoes are responsible for malaria, typhoid is caused by the salmonella typhi bacteria. However, there is one common factor between the two. Salmonella typhi is known to breed in dirty water and unhealthy conditions which are prevalent in developing third world nations. Coincidentally, most of these countries lie in the tropical regions which are ideal conditions for the breeding of mosquitoes as well.
- The symptoms of both these diseases also do vary to a certain extent. Mostly, a malaria infection will manifest itself through chills, fevers, nausea, vomiting and sometimes even diarrhoea. However, the symptoms of typhoid may be different at various stages of the disease. The initial stages of the disease are manifested through stomach pain, skin rashes, extreme muscle weakness and fatigue along with high fever. As the illness progresses, patients may witness stomach distension and further weight loss. The third and the final stage can see complete lack of body motion. Sometimes, the patient might also enter a delirious phase.
- Most often, the diagnosis of malaria is considered to be far simpler than that of typhoid. A simple blood test is enough to decide whether the person is suffering from malarial infection or not. However, in order to detect the presence of salmonella typhi, doctors have to test the blood, stool, urine as well as bone marrow of the patient in question. The samples need to be stored in a controlled environment for about 48-72 hours, before the presence of salmonella typhi can be detected.
- The cure is different too. A malaria infection will require antimalarial drugs whereas antibiotics are used to treat typhoid. Typhoid is also adequately treated by administering fluids, a high nutrition diet and sometimes even through intravenous nutrition.
These are some of the basic differences between these two killer diseases. However, should you be experiencing similar or near similar symptoms, seek medical assistance immediately.