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Typhoid

Typhoid

During the monsoon, apart from air-borne and mosquito-borne diseases, incidents of water-borne diseases like typhoid, diarrhea, and cholera are wide-spread. Typhoid is mainly a fever caused by infection from Salmonella Typhi through the consumption of contaminated food or water. The symptoms of typhoid are very non-specific; thus it becomes hard to distinguish it from other fevered illnesses. The severity of the disease varies from person-to-person, but in some severe cases can lead to grave complications or even death. There is also a similar disease called paratyphoid that is caused by Salmonella Paratyphi A and B

The infection is caused by contaminated food or water, therefore the disease is rampant in areas with poor sanitation and lack of clean drinking water. Worldwide, there are around 11 to 21 million cases recorded each year and out of that 128,000 to 161,000 deaths occur due to the disease annually. Almost 80% of the cases come from Bangladesh, China, India, Indonesia, Laos, Nepal, Pakistan, and Vietnam. This means that typhoid is majorly in developing nations with poor sanitation standards like Asia, Africa, Latin America, The Caribbean, and Oceania.

India has battled with typhoid for many years and still, the problem exists in many parts of the country, especially the poor regions with unhealthy sanitary conditions. Around 494 children per 1 lakh, between the age of 5-15 years suffer from typhoid. Though over the years, due to infrastructural development, hygiene education and female literacy have considerably decreased the numbers. But there is still a lot to be done to eliminate the disease from the country.

Causes

The infection is caused by Salmonella typhi bacteria and is transmitted through contaminated water and food. The bacteria are present in the stools or pee of an infected person and if they do not wash their hands properly after defecating then they can contaminate any food they touch, and if anyone eats this food the bacteria can infect them. Though it is less likely to pass the infection through a person’s pee.

Unhealthy sanitary conditions and common practice of open defecation can contaminate the water supply of the area, making the reach of the infection even more widespread. People who drink this water or eat food washed from this water can also catch the infection.

Other ways through which the infection can be contracted are:

  • Using a toilet already contaminated with the bacteria and then touching mouth without washing your hand
  • Eating seafood from contaminated water bodies
  • Eating raw vegetables fertilized by human waste

Sometimes it is seen that the person might not show any more symptoms but the bacteria can still be present in the body, and they become carriers of infection. Therefore, a doctor’s certificate of good health is necessary before joining back work.

Symptoms

Typhoid and paratyphoid have similar symptoms with a sustained fever that can go up to 103°-104° F. Along with fever, we can see signs of:

  • Stomach pain
  • Weakness
  • Loss of appetite
  • Headache
  • Diarrhea
  • Cough
  • Pink rashes called rose spots

As soon as these symptoms appear, one should immediately consult a doctor because if the symptoms are left untreated for a long time, it can develop into severe conditions that can also turn fatal. Some of the severe conditions include:

  • Feeling perpetually exhausted
  • Pale skin
  • Vomiting blood
  • Internal bleeding

Treatment

Typhoid and paratyphoid fever is treated with doses of antibiotics. Due to excessive use of antibiotics, the bacteria has adapted and has become immune to antibiotic, and in these cases, the antibiotics are not able to kill the bacteria or even stop their growth. For this situation, the doctor may advise you to go for a few tests to determine the nature of the bacteria and prescribe medicines accordingly.

If the proper diagnosis is not done, the infection can prolong the symptoms for weeks or months, causing severe complications. Therefore, proper diagnosis and treatment are essential for a healthy recovery.

Prevention

Some of the precautions that people can take in high-risk prone areas on their own are:

  • While drinking water, one should be sure of the source and avoid drinking water from outside, especially when you don’t know where it came from. Prefer water or beverages with a sealed bottle, or better yet get your bottle.
  • Boiling the water that you drink can also help kill many germs.
  • Avoid eating food or drinking beverages from roadside vendors, where the risk of infection is high. If the vendor is already infected, he/she can transmit the bacteria through food or if the water used to prepare is contaminated.
  • Wash hands properly, with soap after using public toilets and before eating food.
  • Refrain from having oral or anal sex with a person who has or has recently recovered from typhoid.
  • Make sure to clean your water purifiers regularly.

The WHO has also been continuously working to develop vaccines to fight Typhoid in endemic and epidemic areas and has recommended three types of typhoid vaccines:

  • an injectable typhoid conjugate vaccine (TCV), consisting of Vi polysaccharide antigen linked to tetanus toxoid protein licensed for children from 6 months of age and adults up to 45 years of age;
  • an injectable unconjugated polysaccharide vaccine based on the purified Vi antigen (known as Vi-PS vaccine) for persons aged two years and above; and
  • an oral live-attenuated Ty21a vaccine in capsule formulation for those over six years of age.

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