Typhoid-- facts to know

Typhoid fever is an infectious disease caused by Salmonella typhi or para typhi. Typhoid fever is common in developing countries and affecting 21.5 million persons in a year. 

Typhoid can be prevented with proper hygiene and sanitation. Typhoid can be safely treated with antibiotics.


Causes

Typhoid-causing bacterium usually enters the body through food and water. Infected persons shed the bacteria through stool (feces). This may contaminate the food or water when they touch without washing the hands. If we use contaminated food or water, bacteria start growing inside the body and start showing symptoms after one or two weeks.

Symptoms
Onset of illness is gradual with feeling of fatigue, loss of appetite, headache, nausea, vomiting, diarrhoea or constipation, fever, weakness, stomach pain etc.


Diagnosis
Testing blood or stool for presence of bacteria or antigens


Treatment
Treatment with antibiotics is always safe and prevents complications. After 2-3 days of antibiotics, usually, patients feel better. Using antibiotics 10 to 14 days is recommended to kill all bacteria and prevent recurrence. Stopping antibiotics before completing the prescribed course may be harmful. This makes the bacteria resistant and may need more powerful antibiotics in case of recurrence.  
Analgesics and antipyretics for pain and fever, fluids to prevent dehydration are common treatment methods. Symptomatic treatment helps to ease patients’ symptoms.


Prevention
•    Avoid food and drinks from street vendors. Locally made drinks and foods may be contaminated because of low hygiene and sanitation. Make sure you are using clean water and food.
•    Sealed bottled water and drinks are always safe (Locally made drinks that are sold in used, old bottles may cause diseases).
•    Good hand washing always helps to prevent infection.
•    Avoid ice or use ice made only from clean water. Avoid locally made drinks, yoghurt etc. This may be a source of bacteria.
•    Make salads only after washing vegetables thoroughly and use vinegar to kill microbes. Avoid salads from local restaurants as they may not have washed them well before serving.
•    Fruits must be washed thoroughly and pealed before using.
•    Keep your toilet clean; even a healthy person has typhoid bacteria in the feces. Make sure you wash your hands thoroughly after every toilet usage.
•    Avoid using contaminated milk and milk products. Use milk products only if it is pasteurised and processed. (Avoid fresh milk and yogurt from street.)  
•    Locally available fish grows in contaminated water and sewages. Avoid eating such contaminated foods, if possible.


Vaccination
Vaccines are available; it’s recommended only before travelling to typhoid epidemic countries. Routine vaccination is not recommended as it’s not 100 % effective against typhoid. Studies show that efficiency of vaccines is only 55%.


Typhoid Mary
Mary Mallon (Typhoid Mary, 1869-1938) was the first person identified as an asymptomatic typhoid carrier in the US.  She infected a lot of people before she was identified as a typhoid carrier. Beware of Typhoid Marys around you, who cook and serve on the street. Avoid them for your health’s sake.

This column is contributed by AUN Clinic. For more information, contact aunclinic@aun.edu.ng

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