Typhoid fever is a serious and contagious illness caused by the Salmonella typhi bacterium. It is most prevalent in developing countries with poor sanitation and little access to clean water.
The symptoms of typhoid fever often appear one to two weeks after exposure to Salmonella typhi. Symptoms include the following:
Another common symptom of typhoid fever is a unique rash of small (2-4mm), flat, rose-coloured spots. This rash, referred to as “rose spots,” tends to show up on the abdomen and chest.
Typhoid fever is caused by the Salmonella typhi bacterium. Salmonella typhi can be found in the urine and faeces of infected individuals. A healthy individual becomes infected with Salmonella typhi by:
All humans are susceptible to Salmonella typhi. One has an increased risk of coming into contact with Salmonella typhi when visiting developing countries. The countries with the highest incidence rates of typhoid fever include India, Bangladesh, Pakistan, Nepal, Burma, Thailand, Laos, Cambodia, Indonesia, Burkina Faso, and Ghana. It should also be known that the incidence rates of typhoid fever often increase in countries during their monsoon season.
Typhoid fever is easily diagnosed after reviewing a patient’s symptoms and travel history. Further evidence of typhoid fever can be obtained through a culture. To grow a culture, a sample of blood is taken from the patient. Usually a blood sample is used, but a sample can also be taken from the patient’s stool, urine, or bone marrow. Once a sample is collected, it’s placed on a special growth medium that encourages any bacteria present within the sample to multiply. After several days, the culture is examined for the presence of Salmonella typhi.
If left untreated, typhoid fever can lead to many complications. The most common complication is the development of a type of delirious stupor known as “typhoid state.” Other common complications are intestinal bleeding and intestinal perforation, in which a hole develops in the intestines. Once a hole develops, faecal matter will leak into the abdominal cavity. This will result in severe abdominal pain, nausea, vomiting, and sepsis.
Typhoid fever is treated by antibiotics. Nowadays, the antibiotic of choice is ciprofloxacin. The antibiotic is taken for one to two weeks. Symptoms generally improve within the first three to five days. In recent years, Salmonella typhi has shown some resistance to ciprofloxacin. In cases where Salmonella typhi is resistant to ciprofloxacin, the antibiotics ceftriaxone or azithromycin are prescribed.
Travelers must be aware of when they are visiting developing countries where the sanitation is poor. Such countries can be found in southern Asia, the Middle East, and parts of Africa. It is recommended that travellers get vaccinated before traveling to these areas. The vaccine for Salmonella typhi wears off over time, so it is important to repeat the vaccination whenever necessary.
The vaccine for Salmonella typhi is not 100% effective against the bacteria. Additional preventative measures must be taken and are as follows:
The precautions listed above are recommended for those who are traveling to countries where typhoid fever is endemic.