DETECT AND TREAT TYPHOID

Typhoid or enteric fever is a highly contagious and life-threatening infection caused by Salmonella Typhi. This infection spreads through contaminated water or food. Once the Salmonella Typhi bacterium is consumed, it keeps multiplying and spreading in the bloodstream. Climate change and urbanization can increase the risk of this infection or fever to a considerable extent. Additionally, the increasing resistance of people to antibiotic use makes it easier for the infection to spread in overpopulated cities. Flooded and inadequate sanitation and water systems also cause this fever. Children are more prone to developing it because of weak immune systems. However, they show milder symptoms than adults.

Symptoms of typhoid

Knowing typhoid symptoms will help us consult a doctor in its initial stage. The condition becomes less dangerous when we opt for treatment within 7 to 14 days. The incubation period for typhoid is one to two weeks, and its duration is approximately three or four weeks. Major typhoid symptoms include:

• Headaches
• Poor appetite
• High fever around 104 degrees Fahrenheit
• Generalised pains and aches
• Diarrhea
• Lethargy

Many of us may also feel chest congestion, abdominal discomfort, and pain. Within a few days, the fever becomes constant, and improvement occurs only in the third or fourth week. This improvement can be seen if there are no complications. Around 10% of typhoid-affected people experience recurrent typhoid symptoms after feeling better for a couple of weeks. Hence, chances of relapses are always there, even in individuals who are thoroughly treated for the condition.

How is typhoid detected?

Doctors suspect typhoid based on symptoms, travel, and medical history. Examination of urine, stool, and blood samples can confirm the fever. The samples are analyzed under a microscope for the Salmonella Typhi bacteria and IgM and IgG antibodies. A series of tests are done if the bacterium isn't detected initially. Typhoid can also be detected through the simple Widal Antigen test, but the result takes about 10 days. Typhi Dot Tests can also help detect early IgM antibodies. Analyzing bone marrow samples is a more accurate method of detecting the condition, but the process can be both painful and time-consuming. So, doctors use this method only when the results of the other examinations are inconclusive.

Typhoid treatment

Antibiotics are the most effective and the only treatment for this condition. Originally, chloramphenicol was the drug used for treating typhoid for several years. But because of its rare yet severe side effects, this drug has been replaced by antibiotics.

The most common antibiotics used to treat typhoid are:

• Cipro or Ciprofloxacin: This antibiotic is ideal for pregnant women suffering from typhoid. Another drug, called ofloxacin, is also used for treating this condition.
• Azithromycin or Zithromax: We can use this antibiotic when Ciprofloxacin does not offer relief.
• Ceftriaxone: This injectable antibiotic is an alternative for more severe and complicated infections. It is helpful for people who are not suitable to take Ciprofloxacin, like children.

Note that these antibiotics can cause several side effects, and their long-term use can even cause bacteria to become resistant to antibiotics.

Reports state that in India, almost 4.5 million people suffer from typhoid every year, of which about 8,900 people die. These deaths are caused due to intestinal perforation, intestinal bleeding, and overwhelming infection. Before the use of the antibiotics mentioned above, the fatality rate for typhoid was higher. However, with supportive care and the proper use of antibiotics, the disease's mortality rate has reduced to about 0.2%. Appropriate antibiotic therapy can improve the condition within one or two days, and recovery is possible within 8-10 days.

Other treatment options include: 

Consuming lots of fluids: Drinking fluids prevents dehydration from prolonged diarrhea and fever. Seriously dehydrated patients might require fluids to be delivered intravenously.

Surgery: If the intestine tears due to the condition, surgery is required to repair the hole. Doctors can also ask for surgery if there is any internal bleeding within the body. But all these cases are very rare. 

Conclusion

Timing is among the most crucial factors in preventing typhoid symptoms from escalating and becoming dangerous. In most cases, patients improve within a week or so. However, the symptoms might come back if we do not complete the entire treatment course. Also, we should consult a doctor about vaccination after traveling to an area where typhoid is common. 

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