Typhoid or enteric fever is an infection caused by the Salmonella typhi (S.typhi) bacteria. This disease is spread through contaminated drinks, food or water. When you consume any contaminated product, the bacteria enters the intestines and from here to the blood stream, gallbladder, lymph nodes, spleen, liver and other parts.
Some infected people even if they have been cured can carry the S.typhi bacteria in their bodies and release them in the stools thereby acting as carriers of the disease for many years. This disease is widely prevalent in developing countries.
Symptoms of Typhoid
Knowing typhoid symptoms is critical so that you can get treated immediately.
Fever: One of the earliest typhoid symptoms is high fever (over 1030 F) that can continue for several days. This can be accompanied with joint and muscle pain, headaches and a dry cough. Your appetite will be poor and you will lose weight.
Constipation / Diarrhea: The patient will first be constipated – i.e. have infrequent stools, hard stools or find it difficult to pass stools. As the disease progresses, the patient has severe diarrhea. When this occurs, you will have frequent bowel movements with watery stools.
Rashes: When the skin gets infected by rashes, its color and texture will change. You will have inflamed and red skin, skin lesions etc. Some people infected by the S.typhi bacteria can develop rashes which resemble tiny red spots. These are found mostly on the chest and abdomen and are called ‘rose spots’.
Abdominal tenderness or pain will be felt anywhere in the abdominal region between the chest and groin. The pain can be generalized or localized. You will find it very tender (painful) when you touch it.
Restlessness and agitation: This can be described as a restless feeling when a person becomes tense, irritable or excited. These feelings can last a few hours or go on for weeks or months. High fever, pain and stress can all cause a person to feel agitated and hence it is a classic typhoid symptom.
Bloody stools: When stools are maroon or red-colored, the doctor will refer to it as ‘hemtochezia’. Bloody stools occur when there is an injury or infection of the digestive tract. Since the stools are bloody, it could indicate that the lower part of the gastrointestinal (GI) tract has been infected.
Chills: This causes very cold feeling combined with shivering. Chills often accompany fever.
Confusion: This is a state when the mind cannot think clearly, thoughts are cloudy and a person feels disoriented. The patient will not be able to process thoughts at the normal speed or clarity.
Attention deficiency: Confusion can also lead to attention deficiency when a person finds it difficult to pay attention, remember things and make decisions.
Delirium: When a person becomes acutely confused and lacks attention over a long period, it is called delirium. It results in sudden and rapid alterations to the brain’s normal functioning and could be due to physical or mental illness.
Fluctuating moods: This is similar to changes in moods or mood swings. A person who experiences this can suddenly feel severe depression alternating with feelings of extreme happiness.
Hallucinations: A person who has a profound distorted view of reality followed by strong sense of reality could be said to be hallucinating. This is also a sensory feeling where a person can hear, smell, feel or taste something that is not present.
Nosebleeds: The nose is full of blood vessels. When these are injured or affected by some illness, the nasal membranes can start bleeding. This can be mild or profuse.
Extreme fatigue and lethargy: This is a feeling of tiredness, lack of energy, slowness, sluggishness (lethargic feelings) and extreme weariness. It can be due to lack of sleep, some illness, poor nutrition etc.
Weakness: This is a decreased feeling of strength in the muscles. All the muscles in the body can feel weak and a person will feel tired and unable to function normally.
What to do?
Other than certain industrialized countries, typhoid is prevalent everywhere else. Hence, if you have been exposed to typhoid, you have been in an area with endemic typhoid, you have had the illness, and it recurs see a doctor immediately. Deaths due to typhoid occur rarely and there are a lot of preventive and precautionary steps that you can follow.
At the hospital, your stool and blood samples will be tested. If the tests are positive, people are treated with antibiotics even if they display very few typhoid symptoms. Patients will also be told to drink plenty of fluids – a major requirement for those who have fever and diarrhea to prevent dehydration. If you are not treated, symptoms like fever can continue for up to a month. Of this 20% could die of the disease and another 20% can get a relapse. Those who die will be the very old or very young and those who are malnourished. A poor prognosis is when the patient goes into a comatose state or into shock. Peritonitis, intestinal perforation, kidney failure and intestinal hemorrhage are some of the other complications of untreated typhoid.
With the right antibiotics, typhoid fever can be cured within a month with no chances of a relapse, especially if the patient is careful not to get infected in the future. If a patient is a carrier, they will be given antibiotics for at least 4-6 weeks and advised not to work with food.
Typhoid : Prevention and Precaution
Those who are traveling to countries known to have typhoid must get vaccinated. Vaccination is also recommended for those living in homes with carriers and laboratory workers. You may even be advised to take electrolyte packets with you. Immunization is not always completely fool proof against getting typhoid. Hence you can follow other preventive measures like:
- Drink only bottled or boiled water
- Eat well-cooked food
- Avoid raw fruits and vegetables. If you want to eat them, wash them thoroughly yourself. Do not eat the skin.
- Avoid ice cubes in drinks unless you are sure they have been made with bottled or boiled water
- Avoid popsicles and flavored ices
- Do not drink beverages or eat food from street vendors.
Even if your initial typhoid symptoms disappear, you may still be a carrier of the bacteria. Hence, make sure you do not work with foods or take care of toddlers. If you are being treated for typhoid, ensure you take all medications regularly. Wash hands after using the toilet and get tested to ensure you are completely free of the bacteria. .