Typhoid fever

Description

Typhoid fever, also known as enteric fever, is caused by the bacteria salmonella. Typhoid fever is rare in places where few people have the virus. It is also unlikely that the water is treated to remove the germs and where the removal of human waste is managed. An example of where typhoid fever is rare in the united States. The places with the largest number of cases, or with regular outbreaks are in Africa and South Asia. It is a serious threat to the health, especially for children, in places where it is more common.

Food and water with the bacteria that cause typhoid fever. Close contact with a person who is a carrier of the bacterium salmonella can also cause typhoid fever. The symptoms include:

  • High fever.
  • The pain of a headache.
  • Stomach pain.
  • Constipation or diarrhea.

Most of the people who have typhoid fever feel better about a week after starting the treatment to kill the bacteria, called antibiotics. But without treatment, there is a small possibility that the death of typhoid fever complications. The typhoid fever vaccines may provide some protection. But it can't protect against all cases of disease caused by other strains of salmonella. Vaccines can help reduce the risk of contracting typhoid fever.

Symptoms

It is likely that the symptoms start slowly, often showing 1 to 3 weeks after exposure to the bacteria.

Early disease

The first symptoms include:

  • The fever that starts low and increases over the day, possibly reaching as high as 104 degrees Fahrenheit (40 degrees Celsius).
  • Chills.
  • The pain of a headache.
  • Weakness and fatigue.
  • Muscle aches.
  • Stomach pain.
  • Diarrhea or constipation.
  • Rash.

People may also have a cough, loss of appetite, and sweating.

Later disease

A couple of weeks after the start of symptoms, the disease can cause problems in the intestines. People can have:

  • Stomach pain.
  • Very swollen stomach.
  • An infection caused by the bacteria of the intestine, extending throughout the body, called sepsis.

In very severe cases, people can:

  • Become confused.
  • Not being able to pay attention to anything around her.
  • Not be able to react to the world around them.

These are the life-threatening complications.

In some people, symptoms may recur up to a few weeks after the fever has been gone.

When to see a doctor

To see a health-care provider immediately if you think you might have typhoid fever.

If you get sick while traveling in a foreign country, know who to call to get a list of providers. For some, the nearest embassy or consulate.

If you have symptoms after returning home, consider the possibility of seeing a provider that focuses on international travel medicine or infectious diseases. This could help you to get the typhoid fever is diagnosed and treated more quickly.

Causes

A bacteria strain called Salmonella enterica serovar typhi causes typhoid fever. Other strains of salmonella, a bacterium that causes a similar disease called paratyphoid fever.

People pick up the bacteria that most often in places where outbreaks are common. The bacterium passes out of the body in the feces and urine of people who are carriers of the bacteria. Without careful hand washing after going to the bathroom, the bacteria can be passed from hands to objects or other people.

The bacteria can also be spread from a person who carries the bacteria. It can spread to foods that are not cooked, as the unpeeled fruit. In places where water is not treated to kill germs, you can pick up the bacteria from that source. This includes drinking water, the use of ice made with water not treated, or by the consumption of unpasteurized milk or juice.

The carriers of typhoid fever

Even after treatment with antibiotics, a small number of people who recover from typhoid fever still have the bacteria that live in their bodies. These people are known as chronic carriers. They no longer have symptoms of the disease. But even so, to eliminate the bacteria in the stool and stretched.

Risk factors

Typhoid fever is a serious global threat and affect millions of people each year. The places with the largest number of cases, or with regular outbreaks are in Africa and South Asia. But cases are recorded in all the world, often due to travelers to and from these areas.

If you live in a country where typhoid fever is rare, you're at higher risk if:

  • Work in or travel to areas where typhoid fever is established, especially if you are traveling to visit family or friends. The people who visit loved ones may have more social pressure to drink or eat foods that have a higher risk.
  • Work as a clinical microbiologist in the management of Salmonella enterica serotype typhi bacteria.
  • Have close contact with someone who is infected or has recently been infected with typhoid fever.

Complications

Damage to the intestines

Typhoid fever complications can include damage and bleeding in the intestines. Typhoid fever can also cause the cells in the walls of the small intestine, or large intestine dies. This allows the contents of the gut to the brain in the body. That can cause severe stomach pain, vomiting, and infections all over the body, called sepsis.

Damage to the intestines can develop in the later part of the disease. These life-threatening complications require immediate medical attention.

Other possible complications include:

  • Inflammation of the heart muscle, called myocarditis.
  • The inflammation of the lining of the heart and its valves, called endocarditis.
  • The infection of the major blood vessels, called mycotic aneurysm.
  • Pneumonia.
  • Inflammation of the pancreas, called pancreatitis.
  • Kidney or bladder infections.
  • The infection and inflammation of the membranes and fluid that surrounds the brain and spinal cord, called meningitis.
  • Psychiatric problems, such as delirium, hallucinations, and paranoid psychosis.

Prevention

People can get a vaccine against typhoid fever. This is an option if you live in a place where typhoid fever is common. There is also an option if you plan to travel to a place where the risk is high.

Where typhoid fever is common, access to treated water helps to avoid contact with the Salmonella enterica serotype typhi bacteria. The management of human waste also helps people to avoid bacteria. And careful with the washing of hands to the people who prepare and serve food is also important.

Vaccines

There are two vaccines available in the united States for people 2 years of age and older.

  • One is given as a single take at least a week before the trip.
  • One is administered orally in four capsules, one capsule every other day.

The effectiveness of these vaccines wears off over time. To repeat immunization is required.

Because the vaccine does not provide complete protection, follow these guidelines when you travel to high risk areas:

  • Wash your hands. Frequent hand-washing with soap and warm water is the best way to control the infection. Wash before eating or preparing food and after using the toilet. Carry an alcohol-based hand sanitizer for times when soap and water are not available.
  • Avoid the use of untreated water. Contaminated drinking water is a problem in areas where typhoid fever is common. For that reason, drink only bottled water or canned or bottled drinks, soft drinks, beer and wine. Carbonated bottled water is safer than noncarbonated bottled water. Ask for drinks without ice. Use bottled water to brush your teeth, and try not to swallow water in the shower.
  • Avoid raw fruits and vegetables. Due to the raw product may have been washed in contaminated water, avoid fruits and vegetables that cannot be peeled, especially the lettuce. To be safe, you may want to avoid raw foods.
  • Choose the food hot. Avoid food that is stored or served at room temperature. Freshly made, steaming hot food may be less risky than raw foods.
  • Know where the health care providers. Find out about medical care in the areas that you are going to visit. Bring a list of names, addresses and telephone numbers of health care providers.

To avoid infecting others

If you are recovering from typhoid fever, these measures can help to maintain the security of other persons:

  • Take your antibiotics. Follow your doctor's instructions for taking your antibiotics and be sure to finish the entire prescription.
  • Wash your hands often. This is the most important thing you can do to prevent the spread of the infection to others. Use hot water and soap and rub vigorously for at least 30 seconds, especially before eating and after using the toilet.
  • Avoid the handling of food. Avoid preparing food for other people until your doctor says that you are no longer contagious. If you work with food, you may need to take a test to prove that you are not the shedding of the typhoid bacteria. If you work in health care, you may also need to show that they are not shedding the bacteria.

Typhoid fever

Diagnosis

Medical and travel history

Your doctor may suspect typhoid fever based on your symptoms and your medical and travel history. The diagnosis was confirmed by the growth of Salmonella enterica serotype typhi in a sample of body fluid or tissue.

Body fluid or tissue culture

A sample of your blood, stool, urine, or bone marrow is used. The sample is placed in an environment where the bacteria grow easily. The growth, in a culture medium, is examined under a microscope for the typhoid bacteria. A bone marrow culture is often the most sensitive test for the detection of Salmonella typhi.

A culture test is the most common diagnostic test. But other tests may be used to confirm typhoid fever. One is a test to detect antibodies against typhoid bacteria in the blood. Another test checks for the typhoid fever of DNA in the blood.

Treatment

Antibiotic therapy is the only effective treatment for the treatment of typhoid fever.

Commonly prescribed antibiotics

The medication that you get for the treatment of typhoid fever may depend on where it picked up the bacteria. The strains collected in different places respond better or worse to certain antibiotics. These medications may be used alone or in combination. Antibiotics may be given for the typhoid fever are:

  • The fluoroquinolones. These antibiotics, including ciprofloxacin (Cipro), which may be a first option. They prevent the bacteria from the copy themselves. But some strains of bacteria can live through treatment. These bacteria are referred to as resistant to antibiotics.
  • The cephalosporins. This group of antibiotics the bacteria are kept from the construction of the cell walls. A type, ceftriaxone, it is used if there is no resistance to the antibiotics.
  • The macrolides. This group of antibiotics the bacteria are kept from the creation of proteins. A guy called azithromycin (Zithromax) may be used if there is resistance to antibiotics.
  • The carbapenems. These antibiotics also prevent the bacteria from building cell walls. But focus on a different stage of the process of cephalosporins. The antibiotics in this category can be used with severe disease that does not respond to other antibiotics.

Other treatments

Other treatments include:

  • The intake of liquids. This helps to prevent dehydration caused by a long fever, and diarrhea. If you are severely dehydrated, you may need to receive fluids through a vein.
  • Surgery. If the intestines are damaged, you may need surgery to repair.

Preparing for your appointment

Call your doctor if you have symptoms of typhoid fever. This is especially important if you or a close companion recently traveled to a place that has a high risk of typhoid fever. If your symptoms are severe, go to an emergency room or call 911 or your local emergency number.

Here's some information to help you to be prepared and know what to expect from your health care provider.

Collection of information by advance

  • Pre-appointment restrictions. At the time of making your appointment, ask if there are restrictions that must be followed in the time prior to your visit. Your health care provider will not be able to confirm typhoid fever without a blood test. The doctor may suggest actions that you can take to reduce the risk that you will spread the bacteria to another person.
  • Symptom of the story. Write down any symptoms you're experiencing and for how long.
  • Recent exposure to possible sources of infection. Be prepared to describe international trips in detail, including the countries you visited and the dates in which he was travelling.
  • History of medicine. Make a list of your key medical information, including other conditions for which you are being treated and any medications, vitamins or supplements you are taking. Your provider will also need to know your vaccination history.
  • Questions to ask your health care provider. Write down your questions in advance so that you can make the most of your time with your provider.

For typhoid fever, possible questions to ask your provider include:

  • What are the possible causes of the symptoms?
  • What kinds of tests do I need?
  • Treatments are available to help me recover?
  • I have other health problems. How can I best manage these conditions?
  • How much time do you expect a full recovery is going to take?
  • When can I go back to work or school?
  • Am I at risk of long-term complications of typhoid fever?

Don't hesitate to ask any questions you may have.

What to expect from your doctor

Your provider is likely to ask a series of questions. Be ready to answer them may reserve time to go over any points you want to talk in-depth. Your provider may ask:

  • What are the symptoms and when they started?
  • The symptoms got better or worse?
  • Did your symptoms briefly to do better, and then come back?
  • You have recently traveled abroad? Where?
  • How to update your vaccinations before you travel?
  • Are you being treated for any other medical condition?
  • Are you currently taking any medication?
Symptoms and treatment of Typhoid fever