Typhoid Fever ::

Typhoid Fever or Enteric Fever is an acute, life-threatening febrile illness charaterized by a typical continuous fever for 3 to 4 weeks, relative bradycardia with involvement of lymphoid tissue and considerable constituinal symptoms. It is mainly caused by S. typhi or S. Paratyphi.

Typhoid fever occurs in all parts of the world where water supplies and sanitation are sub-standard. The disease is now uncommon in the developed countries where most of the cases that occur are either acquired abroad or imported by immigrants. In developing areas of Asia, Africa, Latin America. however, the disease continues to be a public health problem.

Incubation Period
Usually 10-14 days. But it may be as short as 3 days cr :.
long as three weeks depending upon the dose of the bac,. ,
ingested.

Mode of Transmission
1. It is transmitted via the faecal-oral route OR urine -oral routes.
2. Transmission through sexual contact, especially among men who have sex with men, has rarely been documented.

Clinical Features
1. First week :
- Gradual onset high grade fever (Stepladder pattern)
- Abdominal pain
- Constipation
- Diarrhoea, vomiting
- Relative bradycardia
- Generalized aches and pains
- Cough (Non-productive).

How Is Typhoid Fever Treated?

Typhoid fever is treated with antibiotics which kill the Salmonellabacteria. Prior to the use of antibiotics, the fatality rate was 20%. Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal perforation. With antibiotics and supportive care, mortality has been reduced to 1%-2%. With appropriate antibiotic therapy, there is usually improvement within one to two days and recovery within seven to 10 days.

Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics. The choice of antibiotics is guided by identifying the geographic region where the infection was contracted (certain strains from South America show a significant resistance to some antibiotics.) If relapses occur, patients are retreated with antibiotics.

Those who become chronically ill (about 3%-5% of those infected), can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will provide a cure.

For those traveling to high-risk areas, vaccines are now available.