There are some days when you feel very upset, your body aches for days, you have a high fever, and something is wrong with your stomach. Sometimes these symptoms can be caused by typhoid fever. This is a common disease among our people. So today, let's talk about what typhoid fever is, why it occurs, and how to take care of it.
What is Typhoid Fever? Simply put...
Simply put, typhoid fever is an infectious disease caused by a bacteria. The bacteria responsible for this is ``Salmonella Typhi`` (or ``S. Typhi``). This disease starts by invading our small intestines (or ``gut``) . Then, things like high fever and stomach ache start to occur. Typhoid fever is also called ``enteric fever``.
You may have heard of ``Paratyphoid fever``. It is also similar to typhoid, but the symptoms are less severe. It is caused by the bacteria ``Salmonella Paratyphi`` (or ``S. Paratyphi``).
Importantly, these `S. Typhi` and `S. Paratyphi` bacteria are different from the `Salmonella` bacteria that cause `salmonellosis`, a foodborne illness that we commonly hear about. So, don't confuse them, okay?
Who is most likely to get typhoid fever?
Typhoid fever is a disease that is common in developing countries, especially in rural areas with poor sanitation . It is most common in countries in South and Southeast Asia, Central and South America, Africa, and the Caribbean. Travelers to countries such as Pakistan, India, and Bangladesh are at particular risk.
In our country, especially young children, are more likely to develop typhoid than adults. Therefore, parents with young children should be especially concerned about this.
How common is typhoid fever?
Worldwide, it is estimated that between 11 and 21 million people develop typhoid each year. However, in countries like the United States, Canada, Japan, Western Europe, and Australia, this is very low. This is due to the high level of sanitation in those countries.
Can you spread typhoid fever even after you recover? (Long-term carrier)
This is something to be aware of. Some people can spread the disease for a year or more after they have recovered from typhoid fever without showing any symptoms. They are called ``long-term carriers``. This means that they can spread the disease to others even if they think they are not sick. Therefore, it is very important to get tested for the `S. Typhi` bacteria after you have recovered from typhoid fever to make sure you are not spreading the disease to others.
Are Typhoid and Typhus the same thing?
Although the names sound similar, typhoid and typhus are two completely different diseases caused by two different types of bacteria. In the past, doctors even thought that these two were the same disease, because the symptoms were somewhat similar. Now we know that these are different diseases, but the confusing name still exists.
What are the symptoms of typhoid fever?
Typhoid fever gets its name from the high fever that can last for weeks if not treated properly. This fever tends to increase gradually day by day.
Other symptoms are:
- Headache.
- Feeling like you're going cold (Chills).
- The food is tasteless.
- Abdominal pain.
- "Rose spots" are small, pink spots that usually appear on the surface of the skin, usually on the chest or abdomen. These do not occur in everyone.
- Cough.
- Muscle pain.
- Nausea, vomiting.
- Bloating (diarrhea) or constipation.
These symptoms may occur one after the other, or only some of them may occur.
What causes typhoid fever?
As we mentioned earlier, typhoid fever is caused by a bacterium called `S. Typhi`. This bacterium lives in the intestines of infected people. From there, food and water become contaminated.
How is typhoid fever transmitted?
Typhoid fever is mainly spread through food or water contaminated with the bacteria `S. Typhi`. For example, if someone with typhoid touches something you eat or drink after going to the toilet without washing their hands properly, or if dirty water (water mixed with dead urine) gets into the water or food you drink, you can get this disease.
Simply put, poor personal hygiene is the main cause. If someone doesn't wash their hands after going to the bathroom, they can pass the bacteria on to the next person they touch, even through things like doorknobs and phones.
"So, can you get typhoid by kissing?" You may ask. No, typhoid is not spread by kissing. It is usually less likely to be spread directly from person to person. But as mentioned, it is most likely to be spread through objects touched with dirty hands.
What are the stages of typhoid fever?
Typhoid fever symptoms can progress through four stages, but all of these stages can be prevented if treatment with antibiotics is started early .
- Stage 1: Symptoms can begin 5 to 14 days after the S. Typhi bacteria enter your body. The first symptom is a fever that gradually rises day by day. This is also called a "stepwise" fever, because the fever rises like climbing a staircase. During this stage, the bacteria enter your bloodstream.
- Stage 2: Around the second week of the flu, bacteria start to multiply in your ``Peyer's patches`` (these are parts of our immune system that recognize harmful substances). You start to have stomach problems like stomach pain, diarrhea, or constipation. Some people may get those ``rose spots``.
- Stage 3: If not treated with antibiotics, the bacteria can cause serious damage by about the third week after symptoms begin. Some people can develop serious complications such as internal bleeding and brain swelling (encephalitis).
- Stage 4: This is the stage where most people start to recover. Your high fever will start to subside. However, the S. Typhi bacteria can live in your gallbladder without causing any symptoms. This means that you can still spread the disease to others after you recover.
How is typhoid fever diagnosed?
Your doctor will use your symptoms, your recent travel history, and lab tests to diagnose typhoid fever. He or she will examine you and listen to your heart and lungs.
If you have recently traveled to an area where typhoid is common, or if you think you may have had typhoid, it is very important to tell your doctor. Otherwise, they may not test you for typhoid. That information will help them decide what treatment to give you.
What tests are used to diagnose typhoid fever?
The doctor will test samples of your body fluids or tissues to look for signs of the S. Typhi bacteria. Here are some of the samples you may take:
- Blood: A small amount of blood is taken from your arm using a needle.
- Poop/stool: The doctor will give you a sterile container and instructions on how to collect a sample.
- Pee/urine: The doctor will ask you to urinate into a cup.
- Skin biopsy: Sometimes, a small sample of skin can be taken from the area where the pink spots are. However, this is not always done.
- Bone marrow: This is a very rare test. The skin is numbed and a sample is taken from inside the bone with a special needle.
In addition, you may also have X-rays to check for changes in your lungs.
What is the treatment for typhoid fever?
Typhoid is treated with ``antibiotics`` . However, some new strains of bacteria are resistant to these ``antibiotics``. Therefore, the type of ``antibiotics`` given may vary depending on the type of typhoid you have and where you contracted the disease. ``Paratyphoid fever`` is also treated with ``antibiotics``.
If you are seriously ill or have complications, you may need additional treatment. In such cases, you may be hospitalized.
What are the medications given for typhoid?
The doctor may prescribe antibiotics like these:
- `Ciprofloxacin`, `levofloxacin` or `ofloxacin`.
- `Ceftriaxone`, `cefotaxime` or `cefixime`.
- `Azithromycin`.
- `Carbapenems`.
If your condition is severe, steroids such as dexamethasone may also be given.
Typhoid and antibiotic resistance
Bacteria like S. Typhi sometimes develop antibiotic resistance, meaning that antibiotics that used to work can no longer kill the bacteria.
The antibiotics that were used to treat many typhoid patients no longer work. But some drugs still work. Some types of typhoid are extremely drug-resistant (XDR typhoid). Only a few drugs work against them. This is why it is so important to get a vaccine to protect against typhoid.
Health officials are worried that typhoid will become untreatable if the current drugs don't work. Based on your test results, you will be given an antibiotic that is appropriate for the type of typhoid you have.
How do I take care of myself when I have typhoid fever?
The most important thing is to take all of your medications exactly as your doctor prescribes, for the full duration of your medication. Even if you feel better, you should finish the entire dose. Ask your doctor if it's okay to take an NSAID for fever and pain, such as ibuprofen (Advil® or Motrin®), naproxen sodium (Aleve®), or acetaminophen (Tylenol®).
How quickly will I recover after being treated for typhoid?
If you start treatment with antibiotics quickly, you will start to feel better in a few days. It may take about a week to ten weeks to fully recover.
How can you reduce the risk of contracting typhoid fever?
The best way to reduce your risk of getting typhoid fever is to get a vaccine, either if you live in an area where typhoid fever is common or if you are traveling to one. There is an oral vaccine and an injectable vaccine. Depending on the type you get, you should get this vaccine about two weeks before you travel.
You should also take precautions to avoid eating or drinking food that may be contaminated with `S. Typhi` or other bacteria. This applies both at home and when you travel. Safe food preparation practices include:
- If you are sick, don't cook for others.
- Wash your hands thoroughly with soap before and after preparing food, before and after eating, and after using the toilet.
- Wash utensils and equipment used for preparing and eating food thoroughly before and after use.
- If you are in doubt about whether the food you are eating is safe, eat well-cooked or packaged food whenever possible.
- Do not drink untreated water or eat food prepared with untreated water. If in doubt, it is safest to use bottled water for drinking and cooking.
Imagine, you are going on a short trip with friends. On the way, you are going to eat something at a shop. At that time, take a moment to check whether the place where the food is prepared is clean and whether the people serving the food are concerned about hygiene. Even if it is a small thing, it will help you avoid a big problem.
What can you expect if you get typhoid fever?
Depending on how quickly you start treatment for typhoid, you may feel better within a few days of starting antibiotics. The most important thing is to finish all the medication as prescribed, even if you start feeling better. Even after your symptoms have gone away, you can still spread the disease to others.
Typhoid fever is a potentially serious illness. If you get treatment as soon as possible, the chances of serious complications are reduced.
Typhoid relapse
Some people with typhoid fever may get sick again after they seem to have recovered. This is called a ``relapse.'' This usually happens about a week after you finish taking the ``antibiotics.'' But it can sometimes happen weeks or months later. Your symptoms may be milder than when you first got typhoid.
If your symptoms return, see your doctor immediately. You may need to take another course of antibiotics.
Complications caused by typhoid
If typhoid is not treated properly, you are at risk of developing serious complications. These include:
- Internal bleeding.
- Intestinal perforation (a hole in your intestines).
- Gallbladder swelling or rupture.
- Neurological symptoms - confusion, delirium, seizures.
- Swelling around the brain (meningitis).
- Bronchitis, pneumonia, or other respiratory problems.
- Bone infection (osteomyelitis).
- Swelling of the heart muscle.
- Kidney failure.
- Miscarriage.
These may sound scary, but remember, many of these things can be prevented with early treatment.
How long does typhoid fever last?
Typhoid fever, if treated as soon as symptoms start, lasts about seven to ten days . If left untreated, or if treatment is started too late, it can take three weeks or longer. If you have complications or relapses, it can take even longer to fully recover.
Is typhoid fever fatal?
Typhoid can be fatal if not treated quickly. But with modern medicine, most people survive and make a full recovery. Of the millions of people who get typhoid each year, only 1% to 2% die.
When can I go back to work or school after recovering from typhoid?
Depending on where you work, you may not be able to return to work until you test ``negative`` for the S. Typhi bacteria. Even if you feel well, you could still infect someone else with typhoid. Ask your workplace or school what you need to do before you go back.
Can you spread typhoid even after you recover?
Yes, unlike many other diseases, you can still spread typhoid after your symptoms go away. About 5% of people who recover from typhoid continue to spread the disease for a year, or even longer. These people are called ``long-term carriers.'' After you recover, it is very important to get tested to make sure you are not spreading typhoid to anyone else.
How do I take care of myself (after recovery)?
After you recover from typhoid fever, it is important to see your doctor for a follow-up. You will need to be tested to make sure you are no longer contagious. Also, watch for any signs of the illness coming back.
If you have a relapse, or if you are still a carrier, you may need additional antibiotic treatment.
When should I see my doctor about typhoid fever?
If you live in an area where typhoid is common, or have recently traveled to one, and you have symptoms of typhoid, see a doctor right away. The sooner you get treatment, the more likely you are to recover quickly.
When should I go to the Emergency Department (ETU) ?
If you have any of these symptoms, go to an emergency room immediately:
- High fever.
- Bloody or tarry black stools.
- Severe stomach pain.
- If you cough or vomit and bleed.
- Symptoms related to the nervous system, such as confusion or seizures.
What questions should I ask my doctor?
- How do I take the medicine that was prescribed to me?
- What can I do to manage my symptoms at home?
- When should I see you again?
- How can I prevent typhoid from spreading to others?
- What symptoms should I look for if the disease recurs?
- How and when should I get tested again after I recover?
- Do people in close contact with me need to get vaccinated against typhoid?
Who is this "Typhoid Mary"?
This is a little history. Mary Mallon was a cook in New York in the late 1880s. She didn't have typhoid fever, but she was an asymptomatic carrier. That means she could spread the disease to others. Because she posed a threat to public health, New York State quarantined Mary. She was banned from working as a cook.
But Mary didn't understand how she could spread a disease without being sick. She continued to work as a cook after the first quarantine. She infected more than 100 people with typhoid, killing at least five. She is also believed to have caused an epidemic in New York City that infected 3,000 people. She was quarantined a second time, for the rest of her life. From that moment on, she became known as "Typhoid Mary."
How did countries control typhoid fever?
Typhoid fever, which once caused deadly epidemics, is now very rare in many places, including the United States, Canada, Australia, and Western Europe. This is due to modern sanitation. Even in rural areas, there is plenty of clean water for drinking and cooking.
Typhoid fever may seem like a thing of the past, but it still makes people very sick all over the world. Whether you live in an area where typhoid is common or are traveling to one, getting vaccinated is the best way to protect yourself from getting the disease and spreading it.
If you think you might have typhoid, see a doctor immediately. If you have recovered from typhoid, get tested to make sure you don't unknowingly spread the disease to others, like "Typhoid Mary."
The most important things to remember (Take-Home Message)
Okay, so we've talked a lot about typhoid fever. Finally, here are some things to remember:
- Typhoid is a disease caused by bacteria and spread through contaminated food and water.
- If you develop symptoms such as high fever, stomach aches, or headaches , especially if you have been in a high-risk area, see a doctor immediately.
- It is very important to take antibiotics exactly and on time .
- Disease can be prevented by maintaining personal hygiene (especially hand washing) and maintaining food and beverage cleanliness .
- It is wise to get vaccinated if you are traveling to areas where typhoid is common.
- Even after you recover, get tested to make sure you haven't spread the disease to anyone else .
If you take care of these things, you can stay safe from typhoid fever and protect others. Everyone should stay healthy!
` Typhoid, fever, infectious diseases, Salmonella typhi, hygiene, antibiotics, vaccination
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