Effect of typhoid. Typhoid Fever: Causes, Symptoms, and Prevention for Travelers

11.06.202121.07.2023 by alexxlab

What are the causes of typhoid fever. How can travelers prevent typhoid infection. What are the main symptoms of typhoid fever. Where is typhoid fever most common. How is typhoid fever transmitted. Can typhoid fever be fatal. Who is at highest risk for typhoid fever.

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Understanding Typhoid Fever: A Serious Threat to Travelers

Typhoid fever is a potentially life-threatening bacterial infection that poses a significant risk to travelers visiting certain regions of the world. This disease, caused by Salmonella Typhi bacteria, is closely related to paratyphoid fever, which is caused by Salmonella Paratyphi bacteria. Both conditions present similar symptoms and can have severe consequences if left untreated.

Are typhoid and paratyphoid fever the same disease. While they share many similarities, typhoid and paratyphoid fever are caused by different strains of Salmonella bacteria. However, both diseases manifest in similar ways and require comparable prevention and treatment approaches.

The Transmission of Typhoid Fever: Understanding the Risks

Typhoid fever spreads primarily through contaminated food and water. Infected individuals can transmit the bacteria to others, often unknowingly. This transmission typically occurs when an infected person uses the bathroom and fails to wash their hands properly. The bacteria can remain on their hands, contaminating everything they touch, including food and drinks.

In regions with inadequate sanitation, even tap water used for rinsing and preparing food can be contaminated with these harmful bacteria. Travelers who consume food or beverages tainted with Salmonella Typhi or Salmonella Paratyphi are at risk of contracting the disease.

Common Ways Typhoid Fever Spreads

Consuming food prepared by infected individuals
Drinking contaminated water
Using utensils or dishes that have not been properly sanitized
Close contact with infected persons in areas with poor hygiene practices

How long does it take for typhoid symptoms to appear after exposure. The incubation period for typhoid fever typically ranges from 6 to 30 days, with an average of 8 to 14 days. This means travelers may not experience symptoms until after returning home from their trip.

Recognizing the Symptoms of Typhoid Fever

Typhoid fever can manifest with a range of symptoms, some of which may be mistaken for other illnesses. It’s crucial for travelers to be aware of these signs, especially if they have recently visited high-risk areas.

Key Symptoms of Typhoid Fever

High fever (103째F to 104째F / 39째C to 40째C)
Weakness and fatigue
Abdominal pain
Headache
Diarrhea or constipation
Cough
Loss of appetite
Rose-colored spots on the skin (in some cases)

Can typhoid fever be mistaken for other illnesses. Yes, the symptoms of typhoid fever can be similar to those of other diseases, such as malaria, dengue fever, or even the flu. This is why prompt medical attention and proper diagnosis are crucial, especially for travelers returning from high-risk areas.

High-Risk Regions for Typhoid Fever

Typhoid and paratyphoid fever are most prevalent in parts of the world where access to clean water and food may be limited, and sanitation standards are poor. Travelers visiting certain regions should be particularly cautious and take necessary precautions.

Areas with Highest Risk of Typhoid Fever

Eastern and Southern Asia (particularly Pakistan, India, and Bangladesh)
Africa
The Caribbean
Central and South America
The Middle East

Why are some regions more prone to typhoid outbreaks. These areas often face challenges in maintaining proper sanitation infrastructure, providing clean water, and ensuring food safety. Additionally, overcrowding and inadequate healthcare systems can contribute to the spread of the disease.

Travelers at Increased Risk for Typhoid Fever

While all travelers to high-risk areas should be cautious, certain groups are more susceptible to contracting typhoid fever. Understanding these risk factors can help travelers take appropriate preventive measures.

Groups with Elevated Typhoid Risk

Visitors staying with friends or relatives
Long-term travelers
Humanitarian aid workers
Adventurous eaters who consume local street food
Travelers with weakened immune systems

Why are visitors staying with friends or relatives at higher risk. These travelers often stay longer in the country, may be less cautious about the food and water they consume, and are more likely to integrate into local communities where sanitation standards may be lower.

Preventing Typhoid Fever: Essential Precautions for Travelers

Preventing typhoid fever requires a combination of vaccination and careful hygiene practices. Travelers should take proactive steps to protect themselves before and during their trip to high-risk areas.

Typhoid Fever Prevention Strategies

Get vaccinated before travel
Drink only bottled or boiled water
Avoid raw or undercooked foods
Wash hands frequently with soap and water
Use alcohol-based hand sanitizers when soap is unavailable
Eat at reputable restaurants and avoid street food
Peel fruits and vegetables yourself
Avoid ice in drinks

How effective is the typhoid vaccine. The typhoid vaccine is about 50-80% effective in preventing infection. While not perfect, it significantly reduces the risk of contracting the disease and can make symptoms less severe if infection occurs.

Diagnosis and Treatment of Typhoid Fever

Early diagnosis and prompt treatment are crucial for managing typhoid fever effectively. Travelers who develop symptoms should seek medical attention immediately, especially if they have recently visited high-risk areas.

Diagnostic Methods for Typhoid Fever

Blood culture tests
Stool samples
Bone marrow cultures (in some cases)
Widal test (though less reliable)

How is typhoid fever treated. Typhoid fever is typically treated with antibiotics. The specific antibiotic and duration of treatment depend on the severity of the infection and the presence of any complications. In severe cases, hospitalization may be necessary.

Long-Term Consequences and Complications of Typhoid Fever

While most people recover fully from typhoid fever with proper treatment, the disease can lead to serious complications if left untreated or if treatment is delayed. Understanding these potential consequences underscores the importance of prevention and prompt medical care.

Possible Complications of Untreated Typhoid Fever

Intestinal bleeding
Intestinal perforation
Inflammation of the heart muscle (myocarditis)
Inflammation of the lining of the heart and valves (endocarditis)
Pneumonia
Kidney or bladder infections
Infections of the brain and nervous system
Chronic carrier state

Can typhoid fever be fatal. Yes, if left untreated, typhoid fever can be life-threatening. However, with prompt and appropriate antibiotic treatment, the mortality rate is less than 1%. This emphasizes the critical importance of early diagnosis and treatment.

What is the chronic carrier state in typhoid fever. Some individuals who recover from typhoid fever may become chronic carriers, harboring the bacteria in their gallbladder or urinary tract without showing symptoms. These carriers can unknowingly spread the disease to others, making them a significant public health concern.

Global Impact and Epidemiology of Typhoid Fever

Typhoid fever remains a significant global health challenge, particularly in developing countries. Understanding its epidemiology can help healthcare professionals and policymakers develop effective strategies to combat the disease.

Key Epidemiological Facts About Typhoid Fever

Estimated 11-20 million cases worldwide annually
Approximately 128,000-161,000 deaths per year
Highest incidence in children and young adults
More common in urban areas with poor sanitation
Seasonal variations in some regions

How does typhoid fever impact global health economics. The economic burden of typhoid fever is substantial, particularly in endemic countries. It includes direct medical costs, lost productivity, and the impact on tourism in affected regions. Implementing effective prevention strategies can lead to significant economic benefits in addition to health improvements.

Are there any ongoing efforts to eradicate typhoid fever globally. Several international organizations, including the World Health Organization (WHO) and the Global Alliance for Vaccines and Immunization (GAVI), are working towards reducing the global burden of typhoid fever. Efforts include improving access to clean water and sanitation, enhancing surveillance systems, and increasing vaccination coverage in high-risk areas.

Emerging Challenges in Typhoid Fever Control

As the global community continues to combat typhoid fever, new challenges have emerged that complicate prevention and treatment efforts. These issues require ongoing research and adaptive strategies to ensure effective control of the disease.

Current Challenges in Typhoid Fever Management

Antibiotic resistance
Limited diagnostic capabilities in resource-poor settings
Underreporting of cases
Climate change affecting disease patterns
Urbanization and population growth in endemic areas

How does antibiotic resistance affect typhoid treatment. The emergence of antibiotic-resistant strains of Salmonella Typhi, particularly in South Asia, has complicated treatment protocols. This resistance necessitates the use of more expensive and potentially more toxic antibiotics, highlighting the urgent need for new treatment options and improved prevention strategies.

What role does climate change play in typhoid fever epidemiology. Climate change can alter rainfall patterns and temperatures, potentially affecting the survival and spread of Salmonella Typhi bacteria in the environment. This could lead to changes in the geographical distribution of typhoid fever and impact seasonal patterns of the disease.

Innovations in Typhoid Fever Prevention and Control

Despite the challenges, significant advancements have been made in the fight against typhoid fever. These innovations offer hope for better prevention, diagnosis, and treatment of the disease in the future.

Recent Advancements in Typhoid Fever Management

Development of conjugate vaccines with longer-lasting protection
Improved rapid diagnostic tests
Novel antibiotic therapies
Water, sanitation, and hygiene (WASH) interventions
Enhanced surveillance systems

How do conjugate vaccines improve typhoid prevention. Conjugate vaccines, such as Typbar-TCV, offer several advantages over older vaccines. They provide longer-lasting immunity, can be given to younger children, and may reduce the number of chronic carriers. These factors make them a promising tool in typhoid control efforts.

What role do WASH interventions play in typhoid prevention. Water, sanitation, and hygiene (WASH) interventions are crucial in preventing the spread of typhoid fever. These include improving access to clean water, proper sewage disposal, and promoting good hygiene practices. WASH interventions not only help prevent typhoid but also contribute to overall public health improvements in communities.

Typhoid Fever in the Context of Global Travel

As international travel continues to increase, the risk of typhoid fever spreading to non-endemic areas becomes a growing concern. This highlights the importance of travel medicine and pre-travel health consultations.

Travel-Related Typhoid Fever Considerations

Pre-travel vaccination recommendations
Travel insurance coverage for typhoid-related medical care
Post-travel health monitoring
Educating travelers about food and water safety
Importance of travel health clinics

When should travelers get vaccinated against typhoid fever. Travelers should ideally get vaccinated at least two weeks before departure to allow time for the vaccine to become effective. However, even last-minute vaccination can provide some protection and should be considered if traveling to high-risk areas.

What should travelers do if they suspect typhoid fever after returning home. Travelers who develop symptoms of typhoid fever after returning from a high-risk area should seek medical attention immediately. They should inform their healthcare provider about their recent travel history to ensure proper diagnosis and treatment.

The Role of Public Health Policies in Typhoid Control

Effective control of typhoid fever requires comprehensive public health policies at both national and international levels. These policies play a crucial role in preventing outbreaks, improving surveillance, and ensuring access to proper treatment.

Key Components of Typhoid Control Policies

National vaccination programs
Improved water and sanitation infrastructure
Food safety regulations
Disease surveillance and reporting systems
Health education and awareness campaigns
International cooperation for disease control

How do national vaccination programs impact typhoid control. National vaccination programs, particularly those targeting children in endemic areas, can significantly reduce the incidence of typhoid fever. These programs not only protect individuals but also contribute to herd immunity, reducing the overall burden of the disease in communities.

What role does international cooperation play in typhoid control. International cooperation is essential for effective typhoid control, especially in regions where the disease is endemic. This includes sharing of epidemiological data, coordinating research efforts, providing technical assistance, and ensuring equitable access to vaccines and treatments across countries.

Future Directions in Typhoid Fever Research and Control

As our understanding of typhoid fever evolves, new avenues for research and control strategies continue to emerge. These developments hold promise for more effective prevention, diagnosis, and treatment of the disease in the future.

Emerging Areas in Typhoid Fever Research

Development of universal vaccines
Advanced molecular diagnostics
Novel antimicrobial therapies
Environmental interventions for disease control
Integration of typhoid control with other public health programs

What potential does a universal typhoid vaccine hold. A universal typhoid vaccine that provides protection against multiple strains of Salmonella, including antibiotic-resistant variants, could revolutionize typhoid control efforts. Such a vaccine could potentially offer broader and more long-lasting protection, simplifying vaccination programs and improving global coverage.

How can environmental interventions contribute to typhoid control. Environmental interventions, such as improving water quality and sanitation systems, can play a crucial role in reducing the transmission of typhoid fever. Research into cost-effective and sustainable environmental solutions could lead to significant reductions in disease burden, particularly in resource-limited settings.

Typhoid Fever | Disease Directory | Travelers’ Health

What is typhoid fever?

Typhoid fever and paratyphoid fever are similar diseases caused by bacteria. Salmonella Typhi bacteria cause typhoid fever. Salmonella Paratyphi bacteria cause paratyphoid fever.

People infected with these bacteria can spread them to others. This typically happens when an infected person uses the bathroom and does not wash their hands. The bacteria can stay on their hands and contaminate everything that the person touches, including food and drinks.

In countries with poor sanitation, the water used to rinse and prepare food and beverages, including tap water, can also be contaminated with these bacteria. Travelers who eat foods or drink beverages contaminated with these bacteria can then get sick.

Typhoid fever and paratyphoid fever cause similar symptoms. People with these diseases usually have a fever that can be as high as 103 to 104°F (39 to 40°C). They also may have weakness, stomach pain, headache, diarrhea or constipation, cough, and loss of appetite. Some people have a rash of flat, rose-colored spots. Internal bleeding and death can occur but are rare.

Who is at risk?

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Typhoid and paratyphoid fever are most common in parts of the world where water and food may be unsafe and sanitation is poor. Travelers to Eastern and Southern Asia (especially Pakistan India, and Bangladesh), Africa, the Caribbean, Central and South America, and the Middle East are at increased risk for typhoid and paratyphoid fever.

People visiting friends or relatives are more likely than other travelers to get typhoid fever because they may stay in the country longer, may be less cautious about the food they eat or the beverages they drink because they eat local food prepared in people’s homes, and may not think to get vaccinated before traveling.

In the United States each year, about 425 people are diagnosed with typhoid fever and about 125 people are diagnosed with paratyphoid fever each year. Most of these people travelled internationally.

What can travelers do to prevent typhoid fever?

Getting vaccinated, choosing food and drinks carefully, and washing your hands are the best ways to avoid getting typhoid.

Check if the typhoid fever vaccination is recommended for your destination. Two typhoid vaccines are available in the United States. Visit your doctor or a travel clinic at least one month before traveling to discuss your options.

Pill vaccine. People 6 years old and older can take the pill vaccine. Finish taking all four pills (one pill every other day) at least 1 week before travel.

Shot vaccine. People 2 years old and older can get the shot vaccine. Get one shot (or a booster shot) at least 2 weeks before travel.

Typhoid vaccines are only 50 to 80% effective, so you should still be careful about what you eat and drink to lower your risk of getting typhoid fever. Also, there isn’t a vaccine that protects against paratyphoid fever. For these reasons, it’s very important that you also take the following steps to prevent typhoid.

Choose food and drinks carefully

Only eat foods that are cooked and served hot

Avoid food that has been sitting on a buffet

Eat raw fruits and vegetables only if you have washed them in clean water or peeled them

Only drink beverages from factory-sealed containers

Avoid ice because it may have been made from unsafe water

Only drink pasteurized milk

Wash your hands

Wash hands often with soap and water for 20 seconds, especially after using the bathroom and before eating

If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol

Keep your hands away from your face and mouth

After Travel

If you traveled and feel sick, particularly if you have a fever, talk to a healthcare provider and tell them about your travel.

If you need medical care abroad, see Getting Health Care During Travel.

More Information

Prevention Tips for Travelers

Typhoid Fever and Paratyphoid Fever

CDC Yellow Book: Typhoid & Paratyphoid Fever

Water Disinfection

Typhoid

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Typhoid

Key facts

As of 2019, an estimated 9 million people get sick from typhoid and 110 000 people die from it every year.
Symptoms include prolonged fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhoea. Some patients may have a rash. Severe cases may lead to serious complications or even death.
Typhoid fever can be treated with antibiotics although increasing resistance to different types of antibiotics is making treatment more complicated.
The typhoid conjugate vaccine is recommended for use in children from 6 months of age and in adults up to 45 years or 65 years (depending on the vaccine).
Two typhoid conjugate vaccines have been prequalified by WHO since December 2017 and are being introduced into childhood immunization programmes in typhoid endemic countries.

Overview

Typhoid fever is a life-threatening infection caused by the bacterium Salmonella Typhi. It is usually spread through contaminated food or water. Once Salmonella Typhi bacteria are ingested, they multiply and spread into the bloodstream.

Urbanization and climate change have the potential to increase the global burden of typhoid. In addition, increasing resistance to antibiotic treatment is making it easier for typhoid to spread in communities that lack access to safe drinking water or adequate sanitation.

Symptoms

Salmonella Typhi lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. Symptoms include prolonged high fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhoea. Some patients may have a rash. Severe cases may lead to serious complications or even death. Typhoid fever can be confirmed through blood testing.

Epidemiology, risk factors and disease burden

Improved living conditions and the introduction of antibiotics resulted in a drastic reduction of typhoid fever morbidity and mortality in industrialized countries. However, the disease continues to be a public health problem in many developing areas of the WHO African, Eastern Mediterranean, South-East Asia and Western Pacific Regions.

As of 2019 estimates, there are 9 million cases of typhoid fever annually, resulting in about 110 000 deaths per year.

Typhoid risk is higher in populations that lack access to safe water and adequate sanitation, and children are at highest risk.

Treatment

Typhoid fever can be treated with antibiotics. Antimicrobial resistance is common with likelihood of more complicated and expensive treatment options required in the most affected regions.

Even when the symptoms go away, people may still be carrying typhoid bacteria, meaning they can spread it to others, through shedding of bacteria in their faeces.

It is important for people being treated for typhoid fever to do the following:

Take prescribed antibiotics for as long as the doctor has prescribed.
Wash their hands with soap and water after using the bathroom and avoid preparing or serving food for other people. This will lower the chance of passing the infection on to someone else.
Have their doctor test to ensure that no Salmonella Typhi bacteria remain in their body.

Prevention

Typhoid fever is common in places with poor sanitation and a lack of safe drinking water. Access to safe water and adequate sanitation, hygiene among food handlers and typhoid vaccination are all effective in preventing typhoid fever.

Typhoid conjugate vaccine, consisting of the purified Vi antigen linked to a carrier protein, is given as a single injectable dose in children from 6 months of age and in adults up to 45 years or 65 years (depending on the vaccine).

Two additional vaccines have been used for many years in older children and adults at risk of typhoid, including travellers. These vaccines do not provide long-lasting immunity (requiring repeat or booster doses) and are not approved for children younger than 2 years old:

an injectable vaccine based on the purified antigen for people aged 2 years and above; and
a live attenuated oral vaccine in capsule formulation for people aged over 6 years.

Two typhoid conjugate vaccines have been prequalified by WHO since December 2017 and are being introduced into childhood immunization programmes in typhoid endemic countries.

All travellers to endemic areas are at potential risk of typhoid fever, although the risk is generally low in tourist and business centres where standards of accommodation, sanitation and food hygiene are high. Typhoid fever vaccination should be offered to travellers to destinations where the risk of typhoid fever is high.

The following recommendations will help ensure safety while travelling:

Ensure food is properly cooked and still hot when served.
Avoid raw milk and products made from raw milk. Drink only pasteurized or boiled milk.
Avoid ice unless it is made from safe water.
When the safety of drinking water is questionable, boil it, or if this is not possible, disinfect it with a reliable, slow-release disinfectant agent (usually available at pharmacies).
Wash hands thoroughly and frequently using soap, in particular after contact with pets or farm animals, or after having been to the toilet.
Wash fruits and vegetables carefully, particularly if they are eaten raw. If possible, vegetables and fruits should be peeled.

WHO response

In October 2017, the Strategic Advisory Group of Experts on Immunization (SAGE), which advises WHO on vaccine use, issued a recommendation for the typhoid conjugate vaccine to be added to routine childhood immunization programmes in typhoid endemic countries. SAGE also called for the introduction of typhoid conjugate vaccine to be prioritized for countries with the highest burden of typhoid disease or high levels of antibiotic resistance to Salmonella Typhi.

Starting in 2019, Gavi, the Vaccine Alliance has provided funding to support typhoid conjugate vaccine use in eligible countries.

As at March 2023, WHO has prequalified two conjugate vaccines for the prevention of typhoid. Typhoid conjugate vaccine has longer-lasting immunity than the older typhoid vaccines and can be given as a single dose to children from the age of 6 months.

In addition to decreasing the disease burden in endemic countries and saving lives, widespread use of the typhoid conjugate vaccine in affected countries is expected to reduce the need for antibiotics for typhoid treatment and slow the increase in antibiotic resistance in Salmonella Typhi.

Typhoid fever: causes, symptoms, treatment

The article was checked by a doctor: Khegai Svetlana Viktorovna

Characteristics of the pathogen and transmission

Salmonella typhi is a motile Gram-negative flagellated rod of the Enterobacteriaceae family of the Salmonella genus. It is a serious human pathogen that can only parasitize naturally in the human body. In the environment, water bodies, viability remains for several months, on fruits and vegetables – up to 10 days. A favorable environment for reproduction is individual products: milk, cottage cheese, eggs, meat, minced meat.

Help! Freezing and refrigeration does not kill typhoid bacillus, but slows down reproduction. Boiling, ethyl alcohol, ammonia, mercury chloride have a detrimental effect on the pathogen.

The source and reservoir of infection is a person whose intestines contain Salmonella typhi. For others, the patient is equally dangerous, both with obvious signs of the disease, and with an asymptomatic erased form. There is a particular risk of infection during weeks 1–5 of illness. The removal of the pathogen from the infected organism continues until the moment of complete recovery, sometimes even longer. In the chronic form of typhoid fever, a person is contagious all the time, and poses an epidemiological danger to others.

Ways of transmission of Salmonella typhi are food and water, less often contact-household. Infection enters the body through the use of contaminated water, food (kefir, sour cream, mayonnaise, yogurt, cookies, meat, minced meat), through a handshake, household appliances and items, cutlery. Insects that carry fecal microparticles on their paws take part in the spread of infection.

Immunity after typhoid bacillus is persistent. Re-infection is possible long after the initial infection or when a high dose of Salmonella typhi enters the body.

Episodes of typhoid fever are recorded year-round, an epidemic rise is observed in the summer-autumn period. The prevalence of the infection is ubiquitous, but children are predominantly affected in foodborne outbreaks, adults and adolescents are predominantly affected in waterborne outbreaks.

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Causes and pathogenesis of typhoid fever

The disease develops as a result of the interaction of Salmonella typhi with a susceptible organism under certain conditions. The causative agent enters the intestines through the oral cavity, then penetrates into the lymphatic system of the lower part of the small intestine and parasitizes. After 2–12 days, the infection enters the bloodstream and spreads throughout the body, causing changes in parenchymal organs: the liver, pancreas, and spleen.

Help! Once in the blood, the pathogen dies, but releases bacterial toxic substances that lead to intoxication of the body.

The risk of disease increases with weakened immunity, poor environmental conditions, hypothermia, swimming in polluted pools and reservoirs, stress, allergies, after prolonged contact with the carrier.

Symptoms

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Typhoid fever takes on different clinical manifestations depending on the stage of the disease, the degree of intoxication. It has a mild course, moderate and severe; is complicated and uncomplicated.

The incubation period for is 5 to 30 days (mean 10-14 days) with consecutive onset of symptoms. The reproduction of the pathogen in the lymphatic system of the intestine is accompanied by inflammation, the first signs of the disease appear: subfebrile temperature, chills, muscle and headache.

The initial period lasts 4–7 days. It is characterized by an increasing intoxication syndrome. Patients complain of lethargy, apathy, loss of appetite, sleep disturbances. The headache gets worse, the heart rate decreases. The general condition complicates flatulence, diarrhea, constipation. The root of the tongue is covered with a dense white coating, the skin is pale and dry.

The peak period of falls on the next 9–10 days. The temperature is high, the signs of intoxication are pronounced, the reactions are inhibited. Single elements of a rash appear on the body – red and pink spots 2-3 mm in diameter, which turn pale for a short time when pressed. The rash lasts up to 5 days on average, but new elements may appear throughout the entire period of fever. Rashes are localized on the lateral surfaces of the body, in the lower chest, upper abdomen. The central and basal part of the tongue is covered with a brown coating, and there is also an imprint of teeth along the edges. The liver and spleen are enlarged, blood pressure is lowered. The abdomen is swollen, there is rumbling and pain in the right iliac region, involuntary urination and defecation occurs. In a severe form of the disease, an infectious-toxic shock develops.

During the period of resolution , the temperature drops sharply, intoxication decreases, appetite appears, sleep and general well-being normalize.

The recovery period lasts 14-21 days. The size of the liver and spleen is restored, the tongue is cleansed, and the intestinal epithelium is regenerated. Relapse occurs in 3-5% of patients. Harbingers of relapse are subfebrile body temperature, weakness, malaise, enlarged liver and spleen. Relapse has the same clinical signs as the acute form of the disease, but resolves faster.

Under unfavorable conditions, complete recovery does not occur, and a period of latency sets in – bacteria and toxins are constantly excreted into the blood.

Important! The risk of chronic typhoid fever is increased by the diseases that have arisen against its background, dysbacteriosis, psycho-emotional overstrain, stress, vitamin deficiency, antibiotic and chemotherapy.

Complications

With improper treatment or use of antibacterial drugs, to which the pathogen has sensitivity, chronic bacteriocarrier is formed. A high concentration of Salmonella typhi in the human body provokes convulsions, infectious-toxic shock, cardiac arrhythmias, myocarditis (inflammation of the heart membrane).

Other undesirable effects of typhoid:

epididymitis – inflammation in the epididymis;
orchitis – inflammation of the testicles;
intestinal bleeding;
perforation of typhoid ulcer;
thrombophlebitis – thickening of the veins;
osteomyelitis – inflammation of the bone marrow;
cholecystitis – inflammation of the gallbladder;
anemia;
hepatitis is a viral infection of the liver;
meningitis – inflammation of the membranes of the spinal cord and brain;
pneumonia;
inflammation of the spleen;
cystitis – inflammation of the bladder;
infectious psychosis.

In a pregnant woman, Salmonella typhi infection increases the risk of premature birth and miscarriage. Death can occur from infectious-toxic shock, intestinal bleeding, rupture of the spleen.

Diagnostics

Typhoid fever is determined by symptoms and laboratory tests. To identify the pathogen, a bacteriological study of blood, urine, and feces is prescribed. During the recovery period, the contents of the duodenum are examined. To establish the fact of the disease, a serological test for antibodies to typhoid bacteria is performed.

If other complications are detected, an x-ray of the lungs, fibrogastroduodenoscopy, and electrocardiography are additionally prescribed.

In the first days of the disease, especially before the appearance of a rash, differential diagnosis is carried out with SARS. During the peak of the disease, pathologies that are characterized by prolonged fever and intoxication are excluded: pneumonia, collagenoses, paratyphoid fever, infectious mononucleosis, sepsis, brucellosis, typhus.

Treatment and prevention

Patients with typhoid fever are hospitalized in the infectious department. Treatment is complex, and depends on the period and severity of the disease. Particular attention is paid to patient care – prevention of bedsores, control of the condition of the stool, daily toilet of the oral cavity.

An important condition for a quick recovery is adherence to bed rest for the entire period of fever, plentiful drinking, balanced fortified. Physical activity, sudden movements, heavy lifting are prohibited. Sitting is allowed at normal temperature.

Tip! Drink at least 1.5 liters of fluid per day. It can be non-carbonated water, weak tea without sugar, compote, fruit drink.

Etiotropic therapy

Given the sensitivity of Salmonella typhi, antibacterial drugs are prescribed: fluoroquinolones, glycosides, cephalosporins, ampicillin. The duration of antibiotic therapy depends on the phenotype of the pathogen, the severity of typhoid fever. In order to prevent the recurrence of the disease, vaccination is carried out simultaneously.

To reduce intoxication, normalize the water-salt balance, detoxification mixtures (glucose, saline) are used, and glucocorticosteroids are used to restore hemodynamics. Taking into account clinical manifestations, therapy is supplemented with cardiac, sedative drugs, vitamin complexes.

The patient is discharged from the hospital after the complete disappearance of symptoms and three negative results of the study of feces, urine and blood. After discharge, follow-up is recommended.

Prophylaxis

To prevent the spread of typhoid fever, it is important to comply with the conditions for the storage and transportation of products, standards for the intake and use of water in everyday life and at work, control over the sanitary regime of public catering and the food industry.

Individual infection prevention:

compliance with sanitary and hygienic standards;
routine vaccination;
sufficient heat treatment of meat products;
thorough washing of raw vegetables and fruits before consumption;
boiling milk;
self-isolation of an infected person.

During epidemic outbreaks, it is important to avoid crowded places and use protective medical masks. If, after prolonged contact with the carrier, typical signs of infection appear, you should immediately consult a doctor.

Typhoid fever

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