Typhoid Fever 5rh42

Typhoid fever is an infectious feverish disease, with severe symptoms in the digestive system in the second phase of the illness. The French used to call the disease a “boil of the intestine”.  The disease is transmitted from human to human via food or drinking water, and it's therefore mainly hygiene and sanitary conditions that determine its spread.  It's rarely seen in Europe, and 94 per cent of imported cases are from the Indian subcontinent. 

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Typhoid fever is caused by an infection with a bacterium.

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This bacterium has different names in different places (UK experts prefer the name Salmonella enteritica serovar Typhi, but the US may still call it Salmonella typhi). It's only found in humans and may lead to serious illness.

When the bacterium es down to the bowel, it penetrates through the intestinal mucosa (lining) to the underlying tissue.  If the immune system is unable to stop the infection here, the bacterium will multiply and then spread to the bloodstream, after which the first signs of disease are observed in the form of fever.  The bacterium penetrates further to the bone marrow, liver and bile ducts, from which bacteria are excreted into the bowel contents.  In the second phase of the disease the bacterium penetrates the immune tissue of the small intestine, and the often violent small-bowel symptoms begin. 

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Salmonella typhi can only attack humans. So, the infection always comes from another human, either an ill person or a healthy carrier of the bacterium.

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The bacterium is ed on with water and foods and can withstand both drying and refrigeration. Food must be kept refrigerated and prepared correctly, as required by general hygiene, so that any bacteria present are not able to multiply significantly.

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The incubation period is 10 to 20 days and depends on, among other things, how large a dose of bacteria has been taken in.  There are two phases of classic typhoid fever: 

1. The patient's temperature rises gradually to 40ºC, and the general condition becomes very poor with bouts of sweating, no appetite, coughing and headache. Constipation and skin symptoms may be the clearest symptoms. 2. In the second to third weeks of the disease, symptoms of intestinal infection are manifested and the fever remains very high and the pulse becomes weak and rapid. In the third week, the constipation is replaced by severe pea-soup-like diarrhoea. The faeces may also contain blood.

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Intestinal perforation or profuse bleeding from the intestinal mucosa may occur if typhoid fever is left untreated.

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There are good prospects of cure with antibiotics, and the patient can be discharged from hospital when the general condition is stable. But good general hygiene (as always) should be maintained in the home because bacteria may continue to be excreted for several more weeks. If the patient is a food handler, they'll need to stay off work until at least two stool samples show absence of the infection.

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The routes of infection depend on hygiene conditions, and general kitchen hygiene should be maintained to prevent infection. There are several forms of vaccine that protect against Salmonella typhi. Most clinics use the injectable form, rather than the oral form. The injectable vaccine is easier to ister, since it only requires one dose and has less side-effects. It should be istered at least two weeks prior to potential typhoid exposure and is effective for three years.

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For the final diagnosis to be established, the bacteria have to be detected in samples from the stool, blood or other tissue. A serology test (Widal) can be very useful overseas in areas where the infection is more common.

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Treatment may require ission to hospital, and loss of fluid and salt is treated with fluid therapy as appropriate.

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The bacterium is controlled with antibiotics, and in rare cases steroid medicines are also included in the treatment.

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"Typhoid Fever and Paratyphoid Fever." Netdoctor. Web. . "Typhoid Fever." Wikipedia. Wikimedia Foundation, 16 May 2012. Web. . "Febra Tifoida." Febra Tifoida. Web. .