Typhoid Fever: Understanding Its Causes and Prevention

10 Common Causes of Typhoid Fever

Knowing how typhoid fever spreads is key to preventing it. Salmonella Typhi gets transmitted through contaminated food and water. Here's how you can become infected:

1. Contaminated Food:

Eating food handled by someone infected who hasn't washed his/her hands properly could result in typhoid fever.

2. Polluted Water:

Drinking water containing infected faecal matter remains a potent cause.

3. Unhygienic Produce:

Consuming raw fruits or vegetables rinsed with unclean water can cause typhoid fever.

4. Contaminated Ice:

A primary cause of this ailment is ingesting beverages with ice made from polluted water.

5. Contaminated Soil:

Eating fruits or vegetables grown in soil fertilised with infected faeces may be a veritable cause of this ailment.

6. Diluted Milk Products:

Drinking milk products diluted with contaminated water can be a potent cause of this illness.

7. Poor Sanitation:

Beyond individual hygiene, living in areas with inadequate sanitation systems can also be a common cause of typhoid fever.

8. Close Contact with the Sick:

Close contact with an infected person or carrier may cause typhoid fever.

9. Travel Risks:

A leading cause of this ailment could be travelling to high-risk areas without proper precautions.

10. Limited Resources:

Lack of access to clean water and proper sewage systems could lead to this ailment.

By understanding these causes, particularly in areas where typhoid is prevalent, you can take steps to safeguard yourself and others from this illness.

Symptoms

Recognising the symptoms of typhoid fever is vital for prompt diagnosis and treatment. Typhoid fever gets its name from the prolonged high fever. Often lasting for weeks if left untreated, the fever worsens gradually over several days. Common signs include:

• High fever (39°C to 40°C):

This is often the first noticeable symptom and may persist for weeks if left untreated.

• Headache:

Often severe and persistent, it can significantly impact daily activities.

• Weakness and fatigue:

There may be profound tiredness that may interfere with normal functioning.

• Abdominal pain:

Usually mild to moderate but can sometimes become severe.

• Loss of appetite:

This can lead to significant weight loss over time.

• Diarrhoea or constipation:

Gastrointestinal symptoms may alternate or vary between individuals.

• Dry cough:

Often accompanied by chest discomfort.

• Skin rash (Rose-coloured spots):

These typically appear on the chest and abdomen.

• Enlarged spleen and liver:

This may cause discomfort in the upper abdomen.

• Bradycardia (slow heart rate):

This condition manifests as an unusually slow heart rate despite a high fever.

In some cases, particularly in areas where typhoid is endemic, individuals may experience milder symptoms, making diagnosis more challenging. That is the reason why there is no substitute for seeking medical help if you experience any of the above signs.

Diagnosis

For diagnosing typhoid fever, several factors are taken into consideration, such as your symptoms, travel history, and laboratory tests. Your doctor will perform a physical examination. Informing them about recent travel or suspected exposure to typhoid fever is crucial, as it helps guide the diagnosis and treatment plan.

Several tests can be used to diagnose typhoid fever, including —

1. Blood culture:

This test is considered the gold standard for typhoid diagnosis, as it can detect the presence of bacteria in the bloodstream. Multiple blood samples may be taken over several days to increase the chances of detection.

2. Stool and urine tests:

These samples are examined for the presence of Salmonella Typhi. While less reliable than blood cultures, they can provide valuable information, especially in the later stages of the illness.

3. Bone marrow culture:

This method is particularly useful when blood cultures are negative but clinical suspicion remains high.

4. Widal test:

This serological test detects antibodies against Salmonella Typhi in the blood. However, it can produce false-positive results and is less reliable than other methods.

5. PCR (Polymerase Chain Reaction):

This molecular technique can rapidly identify the genetic material of the bacteria, offering a faster and more sensitive diagnostic option.

6. Complete Blood Count (CBC):

While not specific to typhoid, a CBC can reveal changes in white blood cell counts that may indicate infection.

7. Liver function tests:

These may be performed to assess any impact on liver function, as typhoid can affect this organ.

Early and accurate diagnosis is crucial for initiating appropriate treatment and preventing complications. In areas where typhoid is common, healthcare providers may begin treatment based on clinical suspicion while awaiting confirmatory test results. This approach can be life-saving in severe cases.

Treatment

While specific medical treatments should be prescribed by healthcare professionals, general approaches to managing typhoid fever include —

1. Fluid replacement:

Ensuring adequate hydration is essential to combat the effects of fever and diarrhoea. This may involve oral rehydration solutions or, in severe cases, intravenous fluids.

2. Rest:

Adequate rest is crucial for supporting the body's immune response and recovery. Patients are often advised to limit physical activity during the acute phase of the illness.

3. Dietary modifications:

A soft, easily digestible diet may be recommended during the acute phase of the illness. As recovery progresses, a gradual return to a balanced diet is encouraged.

4. Fever management:

Over-the-counter fever reducers may be used to alleviate discomfort under medical supervision.

5. Follow-up care:

Regular monitoring and follow-up appointments are necessary to ensure complete recovery and prevent complications. This may include repeat testing to confirm the eradication of the bacteria.

6. Nutritional support:

In severe cases or prolonged illness, nutritional supplementation may be necessary to aid recovery and boost the immune system.

7. Isolation precautions:

In hospital settings, patients may be isolated to prevent the spread of infection to others, particularly in areas with poor sanitation.

It is important to emphasise that self-medication should be avoided, and professional medical advice should be sought for proper treatment. Typhoid fever requires careful management to prevent complications and ensure complete recovery.

Prevention

Ascertaining the reasons for typhoid is equally important as thinking of preventive measures. The most effective way to prevent typhoid fever is by getting vaccinated, particularly if you live in or are travelling to an area where the disease is prevalent. Here are the key strategies to reduce your risk —

• Vaccination:

There are two vaccines available for typhoid fever. The oral vaccine, though no longer widely available, offered protection through a series of pills. The injectable vaccine, a single shot, requires administration at least two weeks before travel to allow your body to develop immunity. Booster shots are needed every two years for continued protection.

• Safe food and water practices:

These practices are crucial for preventing typhoid fever, both at home and while travelling. Here are some key points to remember:

◦ Wash your hands thoroughly with soap and water before and after preparing food, eating, and using the toilet.

◦ Wash and sanitise all surfaces and utensils used for food preparation and consumption.

◦ Opt for well-cooked or pre-packaged foods when unsure about the safety of local food sources.

◦ Avoid untreated tap water and beverages prepared with it. Stick to bottled/purified water for drinking and cooking.