Typhoid Fever

Typhoid fever, also known as enteric fever, is a sickness caused by a type of bacteria called Salmonella. This bacteria isn't everywhere; in places with good sanitation, like the US, typhoid fever is uncommon. However, in parts of Africa and South Asia, where sanitation might be less reliable, typhoid fever is more common and can be a serious problem, especially for children.

The bacteria that cause typhoid fever can be found in contaminated food and water. You can also get it if you come into close contact with someone who already has the infection. Key symptoms include:

• A high body temperature (fever)
• Headaches
• Belly (stomach) pain
• Problems with bowel movements (either constipation or diarrhea)

Most people who get typhoid fever feel better within a week of starting antibiotic treatment, which kills the bacteria. However, without treatment, there's a small chance of serious complications or even death. Vaccines are available to help protect against typhoid fever, but they don't protect against all types of Salmonella infections. Vaccines can significantly reduce the risk of getting typhoid fever.

Bacterial infections often begin gradually. You might notice symptoms around one to three weeks after coming into contact with the bacteria.

If you suspect you have typhoid fever, see a doctor immediately.

If you get sick while traveling abroad, find out who to contact for medical help. This might be the closest embassy or consulate. They can provide a list of healthcare providers.

If you develop symptoms after returning home, visit a doctor specializing in travel medicine or infectious diseases. This type of doctor can help diagnose and treat typhoid fever faster.

Typhoid fever is caused by a type of bacteria called Salmonella enterica serotype Typhi. A similar illness, called paratyphoid fever, is caused by other types of salmonella bacteria.

People usually get these bacteria in places where the illness is common. This is because the bacteria leave the body in the poop and pee of infected people. If someone doesn't wash their hands thoroughly after using the bathroom, the bacteria can easily spread to objects or other people.

The bacteria can also spread directly from one person to another. This can happen through uncooked food, like raw fruits without skins. In areas where water isn't treated to remove germs, people can get the bacteria from drinking water, using ice made from untreated water, or consuming unpasteurized milk or juice. Unpasteurized means the liquid wasn't heated to kill harmful germs.

Typhoid fever is a serious illness that affects many people around the world each year. Most cases happen in Africa and South Asia, but it can occur anywhere. People traveling to or from these regions can bring the illness to other parts of the world.

If you live somewhere where typhoid fever isn't common, you might be more likely to get it if:

• You work in or visit areas where it's common: This is especially true if you're visiting family or friends. Sometimes, social situations can make people more likely to eat or drink things that could spread the illness. For instance, if you're visiting family and they offer you food or drinks, you might feel pressured to accept, even if it's not something you'd normally choose.

• You work as a laboratory professional handling a specific type of bacteria: Some laboratory workers, like clinical microbiologists, might work directly with the bacteria that cause typhoid fever. These professionals need extra precautions to prevent illness.

• You have close contact with someone who has typhoid fever: If you are in close contact with a person who is sick with typhoid fever, you have a greater chance of getting the illness yourself. This means you spend a lot of time close to them and touch similar surfaces or objects.

Typhoid fever can harm your intestines. The bacteria that cause typhoid fever can damage the lining of your intestines, both the small intestine and large intestine. This damage can lead to the intestines leaking their contents into your bloodstream. This leakage can cause severe abdominal pain, nausea, and vomiting. It can also lead to a serious infection spreading throughout your body, called sepsis. This is very dangerous and needs immediate medical attention.

These intestinal problems often develop later in the course of the illness. If you notice these symptoms, you need to seek urgent medical care.

Besides intestinal problems, typhoid fever can cause other serious complications:

• Heart problems: Inflammation of the heart muscle (myocarditis) or the lining and valves of the heart (endocarditis) can occur.
• Blood vessel problems: The bacteria can infect major blood vessels, which could form a dangerous bulge or weakness (called a mycotic aneurysm).
• Lung problems: Typhoid fever can cause pneumonia.
• Pancreas problems: Inflammation of the pancreas (pancreatitis) is another possible complication.
• Kidney or bladder infections: These are also possible side effects.
• Brain problems: The infection can spread to the membranes and fluid surrounding the brain and spinal cord, causing meningitis. This is a very serious condition.
• Mental health problems: Typhoid fever can sometimes cause mental health issues like delirium (confusion), hallucinations (seeing or hearing things that aren't there), and paranoid psychosis (strong, unfounded suspicions).

These complications can be life-threatening. If you experience any of these symptoms, seek immediate medical attention. Early diagnosis and treatment are crucial to prevent serious complications.

A typhoid fever vaccine is available. This is a good idea if you live in an area where typhoid fever is frequently found, or if you're traveling to a place with a high risk of getting it.

In areas where typhoid fever is more common, having clean, treated water is key. This helps prevent you from coming into contact with the bacteria that cause typhoid fever, Salmonella enterica serotype Typhi. Properly managing human waste is also very important to reduce the spread of the bacteria. And, for people who handle food, washing their hands carefully is a crucial step in preventing typhoid.

Doctors might suspect typhoid fever if you have certain symptoms and a history of travel or other risk factors. To be sure, they often need to find the bacteria that cause typhoid fever, Salmonella enterica serotype typhi, in a sample of your body fluids.

This usually involves taking a sample of your blood, stool, urine, or bone marrow. This sample is put in a special environment where the bacteria can easily grow. This growth, called a culture, is then examined under a microscope to look for the typhoid bacteria. A bone marrow sample is often the best way to find the bacteria because it's more likely to show them if they're present.

A culture test is a common and reliable way to diagnose typhoid fever, but other tests can also help confirm the diagnosis. One method looks for antibodies to the typhoid bacteria in your blood. Another test checks for the bacteria's DNA in your blood. Both of these tests can be useful supporting evidence, along with a culture test, to confirm the diagnosis.

Typhoid fever is treated with antibiotics. These are the only medicines that effectively fight the infection.

The best antibiotic for typhoid depends on where the infection was caught. Different areas have different types of typhoid bacteria, and some antibiotics work better against certain types than others. Sometimes, doctors combine different antibiotics to treat the infection more effectively.

Here are some common antibiotic types used for typhoid:

• Fluoroquinolones (like Cipro): These are often a first choice because they stop the bacteria from reproducing. However, some typhoid bacteria can develop resistance to these drugs, meaning they won't be killed by the antibiotic. This is why doctors may need to try other options.

• Cephalosporins (like ceftriaxone): These antibiotics prevent bacteria from making the walls they need to survive. Ceftriaxone is often used when the bacteria are resistant to other antibiotics.

• Macrolides (like azithromycin): These antibiotics stop the bacteria from making necessary proteins. Doctors might use azithromycin if other antibiotics aren't working.

• Carbapenems: These antibiotics also stop the bacteria from building cell walls, but they target a different stage of the process than cephalosporins. These are usually reserved for severe cases that aren't responding to other treatments.

Besides antibiotics, other treatments help manage the symptoms and prevent complications:

• Staying hydrated: A high fever and diarrhea can lead to dehydration. Drinking plenty of fluids is crucial. If dehydration is severe, fluids may be given intravenously (through a vein).

• Medical care: If the infection damages the intestines, surgery might be necessary to repair the damage.

It's important to follow your doctor's instructions carefully throughout your treatment. They will determine the best course of action based on your specific situation and the type of typhoid bacteria you have.