Typhoid is an infection caused by the bacteria Salmonella typhimurium. The bacterium lives in the intestines and bloodstream of humans. It is spread by eating or drinking food or water contaminated with the feces of an infected person. In the developing world, typhoid is a much more common risk. The risk of death may be as high as 20% without any treatment. If With treatment, it will reduce to 1 %- 4%.
No animals can carry this disease, so transmission is always from human to human. S. typhi enters through the mouth and spends 1-3 weeks in the intestine. After this time, it makes its way through the intestinal wall and into the bloodstream. From the bloodstream, it spreads into other tissues and organs. The immune system of the host can do little to fight back because S. typhi can live within the host’s cells, safe from the immune system.
Symptoms normally begin 6-30 days after exposure to the bacteria. The major symptom of typhoid is fever. Often there is a gradual onset of a high fever over several days. The temperature can rise more than 40℃.
Other symptoms can include weakness, abdominal pain, constipation, rash and headaches; rarely symptoms might include confusion, , and vomiting (but not normally severe).
In serious, untreated cases, the bowel can become perforated; this can lead to peritonitis (an infection of the tissue that lines the inside of the abdomen), which can be very serious indeed.
Typhoid is diagnosed by detecting the presence of S. typhi via blood, stool, urine, or bone marrow sample.
Typhoid is spread by contact and ingestion of infected human feces. This can happen through an infected water source or when handling food. Countries with less access to clean water and washing facilities typically have a higher number of typhoid cases.
Sanitation and hygiene are important to prevent typhoid. Typhoid does not affect animals other than humans. Typhoid can only spread in environments where human feces are able to come into contact with food or drinking water. Careful food preparation and washing of hands are crucial to prevent typhoid.
The only effective treatment for typhoid is antibiotics. The most commonly used are ciprofloxacin (for non-pregnant adults) and ceftriaxone. Other than antibiotics, it is sensible to rehydrate by drinking adequate water. In more severe cases, where the bowel has become perforated, surgery may be required.
Dr Arvi (Wang Deqiang）from Sierra Leone-China Friendship Hospital reminds you that if anyone who is suffering from typhoid, especially with high fever, you’d better go to see a doctor ASAP.
From Dr.Xie Weibin of the 19th batch of CMT
Thursday November 23, 2017.