Typhoid is one of the epidemical health issues that has affected humans through the centuries. The first outbreak was witnessed in 430 BC. Later in 1850, English physician William Budd described it as a water-borne disease caused by bacteria. During early recognition, people were unaware of its consequences and safety measures. 

But now, many counter-solutions are present to fight back against the disease or prevent it. For instance, several medicines and antibiotics have been invented, and multiple items like water filters, soaps, and handwash are readily available to save people from life-taking illnesses.

According to Dr R Lakshmi Priya, Senior Consultant Microbiologist & Molecular Biologist, at Metropolis Healthcare, Chennai, parents are reluctant to give street food to their children because typhoid spreads through contaminated food and water.

She says that typhoid spreads through Salmonella enterica bacteria which can lead to two types of fever: typhoid caused because of Salmonella typhi and paratyphoid caused because of Salmonella paratyphi.

What is Typhoid? 

Typhoid is a bacterial infection caused by Salmonella typhi. It spreads through infected food and water and multiplies after entering the blood. Under proper medical supervision and guidance, typhoid patients recover within 7 to 10 days, but in some cases, they may also take up to two weeks. However, if left unnoticed for a long time, it may prove to be fatal. Complications associated with typhoid include developmental issues in the bone, meningitis, and intestinal ulcers or perforation.

Causes of typhoid

Even though multiple health programs, promotions, and guidelines have been declared by the World Health Organisation (WHO), there are countless typhoid attacks today. It mainly hovers on the Asian and African belts. Nearly millions of people die every year from typhoid fever.  

An eye-opening fact is that the people here often lack the basic amenities of life. Hence, they cannot manage to protect themselves from the bacterial strike. The most probable causes of typhoid are:

● Poor hygiene and sanitation

● Insufficient water supply

● Unfiltered water and contaminated food intake

● Rising slums and crowds

● Inadequate medical supplies

● Lack of information and awareness

Recently, people have been diagnosed with a resistant strain of typhoid bacteria. According to Dr Laxmi Priya, the bacteria has modified itself in such a way that it has become resistant to new medications but remains sensitive to old ones. Therefore, it is necessary to stop the overuse and misuse of antibiotics. Nevertheless, she adds that most antibiotics are still effective against bacteria.

Symptoms of typhoid

It is beneficial to seek medical advice at an early stage of the disease to prevent complications. Generally, a person shows the following symptoms if typhoid bacteria enters the body.

● High fever throughout the day

● Chills

● Muscle aches and rashes

● Headache and stomach pain

● Weakness and tiredness

● Alternating constipation or diarrhoea

● Vomiting

● Cough

It is advisable to consult a physician to know about the curative measures to eliminate the illness. Several advanced technologies are available to help analyze one's condition and get the necessary treatment. 

When should one visit a doctor?

The bacteria, Salmonella typhi, has an incubation period of two weeks. However, patients can start showing symptoms as early as 2 to 3 days after contracting the bacteria. The best way to confirm the bacterial attack is a blood test. If a person gets a positive result, he or she must instantly consult a medical practitioner.

Wasting a single moment can bring out severe aftereffects. As per Dr Laxmi Priya, if a patient is not vaccinated or if the infection remains undiagnosed or untreated, then it may lead to complications like perforation and haemorrhage. The doctor will recommend medicines, antibiotics, and rest to ensure complete recovery.

Treatment and diagnosis of typhoid

For diagnosing typhoid, several kinds of blood tests may be performed. These include:

• Blood culture test: This is done to confirm the presence of bacteria. It is usually done twice, once for confirmation and the second time after taking medications.
• Typhidot rapid antibody test: This test detects antibodies against the bacteria and is done in the second week of diagnosis.
• Widal antibody test: This test also detects antibodies against the bacteria and is done within six to seven days of fever.
• Stool and urine culture test: This is done in the fourth week of infection. This test is also done to diagnose asymptomatic typhoid carriers who do not show symptoms but show the presence of bacteria in their stool or urine.

There are several antibiotics which are effective in typhoid. These medications work by killing or disintegrating bacterial cell membranes. Patients need to take proper doses of antibiotics as typhoid can come back if treated inappropriately.

If the duration of the antibiotic is not appropriate or in case the right antibiotics are not taken, then it will allow bacteria to survive in the body. Such bacteria may remain in the bone marrow, intestine or bloodstream and can recur in 2-3 weeks after initial recovery.

What are the steps to tackle typhoid? 

Medical specialists are concerned about the advent and spread of antibiotic-resistant strains of the bacteria. Research is ongoing, and doctors are struggling to find cures for the uncommon strains of typhoid bacteria. Moreover, the government and NGOs are working together to guide people about the new strain and educate them to take the required preventive measures. Preventive measures include:

● Washing hands before and after eating

● Washing hands after using the toilet

● Avoiding eating open and stale food, especially from street vendors

● Using filters and chlorinated water for regular drinking

● Washing fruits and vegetables before eating

● Using hand wash and hand sanitisers

Apart from the above-mentioned points, people should also take proper vaccinations. There are two types of vaccines available, one is an inactive vaccine (injection) and the other is a live vaccine(oral). But it must be noted that these vaccines are not 100% effective and cannot work as a replacement for eating and drinking hygienic food.  According to Dr Lakshmi Priya, there is a new typhoid vaccine available called typhoid conjugate vaccine, which provides longer immunity against the disease.

Conclusion

Typhoid has been a concerning health problem for years. However, it is a treatable condition if diagnosed on time and treated appropriately. In addition, since it is a food and water-borne disease, people may protect themselves from falling prey to typhoid bacteria through preventive measures. Therefore, people must eat hygienic food and drinks, avoid food kept in the open, clean their surroundings, use handwash before eating food, and take vaccines on time to avoid being infected. If symptoms occur, one should immediately visit a doctor and take medications as prescribed.