What is Typhoid or Enteric Fever?

 Introduction:

Enteric fever is another name for typhoid fever. It is a multisystemic illness that has been a problem for public health, particularly in developing countries. Salmonella typhi and Salmonella paratyphi are to blame. Typhoid fever and paratyphoid fever are both referred to as enteric fever.

What is Typhoid or Enteric Fever?

A bacterial infection known as typhoid fever can infect many organs and can spread throughout the body. It may result in serious complications and even death if not treated. A bacterium known as Salmonella typhi, which is related to the bacteria that cause salmonella food poisoning, is to blame for this condition.

Salmonella Typhi is the bacteria that causes the life-threatening infection known as typhoid fever. , it is spread through contaminated water or food. Long-term fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhea are some of the symptoms.

Causes of Typhoid fever:

Typhoid fever is caused by the bacterium S. Typhi. It lives in the gut (intestines) of infected people. Causes include:

• Consume food washed in contaminated water or drink contaminated water
• Touching your mouth before washing your hands and
• Using a toilet that has been contaminated with bacteria.
• Eating seafood from a water source that has been contaminated with infected feces or urine.

Who does typhoid fever affect?

In rural areas of developing countries without modern sanitation, typhoid fever is the most common. Typhoid is most prevalent in South and Southeast Asia, Central and South America, Africa, and the Caribbean. Pakistan, India, and Bangladesh pose the greatest threat to travelers.

Typhoid is more prevalent in children than in adults.

How common is typhoid fever?

It's assessed that 11 million to 21 million individuals all over the planet get typhoid every year.

In the United States, Canada, Japan, Western Europe, and Australia, it's uncommon.

Does typhoid spread by kissing?

No, kissing does not spread typhoid. Typhoid fever is rarely spread from one person to another. But, if they don't wash their hands after using the restroom, you could contract it if you touch something they've touched.

Stages of Typhoid or Enteric Fever:

Stages:

Typhoid fever symptoms can appear over time in four stages. Early treatment with anti-toxins can hold you back from advancing to later stages.

• Stage 1. After coming into contact with S. Typhi, symptoms of typhoid can begin anywhere from five to fourteen days later. The first symptom is a fever that rises over several days and is referred to as "stepwise."At this point, the bacteria are entering your bloodstream.
• Stage 2. The bacteria begin to multiply in your Peyer's patches—a part of your immune system that detects harmful invaders—around the second week of fever. Abdominal pain and other stomach symptoms like diarrhea or constipation will begin. Small, pink spots on your skin that look like a rash are known as "rose spots."
• Stage 3. The bacteria can cause severe damage without antibiotic treatment, around the third week after your symptoms begin. Internal bleeding and encephalitis( inflammation of the brain) are serious complications that can occur in some people.
• Stage 4. The majority of people begin to recover in Stage 4. Your high fever starts to drop.S. Typhi can live in your gallbladder without causing symptoms, so even if you feel better, you might still be contagious.

Symptoms of Typhoid or Enteric Fever:

The high fever that can last for weeks without treatment is what gives typhoid fever its name. Over a few days, it gets worse in stages.

Other symptoms of typhoid fever include:

• Headache.
• Chills.
• Loss of appetite.
• Pain in the stomach (abdomen).
• "Rose spots" rash, also known as faint pink spots, usually appear on your stomach or chest.
• Cough.
• Pain in Muscles
• Nausea and vomiting
• Constipation or Diarrhea

How does typhoid fever spread?

Most of the time, S. Typhi-contaminated food or water spread typhoid fever. This can happen if you don't wash your hands after someone with typhoid touches something you eat or drink. Wastewater, also known as water containing urine or feces, can also result in the contamination of food and drinking water.

If another person does not wash their hands after using the bathroom, they could contract typhoid from them.

They may send bacteria to the next person they touch when they touch surfaces and objects like phones or doorknobs.

How do I take care of myself?

Once you’ve recovered from typhoid fever, it’s important to check in with your healthcare provider for follow-up. You should be tested to make sure you’re no longer contagious. Be on the lookout for symptoms of relapse.

If you have a relapse or are still contagious, you may need extra treatment with antibiotics.

Can typhoid fever spread through the air?

No, typhoid fever is not typically spread through the air. It is primarily spread through contaminated food or water. Specifically, the bacteria that causes typhoid fever, Salmonella enterica serovar Typhi, is found in the feces and urine of infected individuals and can contaminate food and water if proper hygiene and sanitation practices are not followed.

Typhoid fever can also be spread from person to person through close contact with an infected individual's bodily fluids (e.g. saliva, mucus, or feces), or by touching surfaces contaminated with these fluids and then touching one's mouth or nose.

In summary, while typhoid fever is not generally spread through the air, it is still highly contagious and can be transmitted through a number of different means. It is important to practice good hygiene and sanitation, particularly when traveling to areas where typhoid fever is more common.

DIAGNOSIS

What tests can be done to diagnose typhoid fever?

• Blood. A small tube of blood from your arm will be taken from you by your provider with a needle.
• Stool (poop). Your medical care supplier will give you a clean holder and directions on the best way to gather an example.
• Urine (pee). Your healthcare provider may ask you to urinate in a cup provided to you.
• Your provider might numb your skin and use a small scalpel or razor to take a sample from your skin.
• Bone marrow. Your doctor will numb your skin before taking a sample of your bones with a special needle. This test is rarely needed to diagnose.
• Chest X-rays. which are images taken inside your body, may also be taken by your doctor to check for changes in your lungs.

How is typhoid fever diagnosed?

Your symptoms, travel history, and lab results will be used by your doctor to rule out typhoid fever. They will examine your body and listen to your lungs and heart.

If you have recently traveled or believe you have been exposed to typhoid, it is critical that you inform your provider, as they may not know how to test for it. Additionally, they will make use of the information to select a treatment.

MANAGEMENT AND TREATMENT:

What is the treatment for typhoid fever?

Antibiotics are used to treat typhoid. You will be treated with different antibiotics depending on the type of typhoid you have and where you got sick because some newer bacteria can survive antibiotic treatments. Antibiotics are also used to treat paratyphoid fever.

Additional treatments may be necessary if you have complications or are ill. These treatments will need hospitalization.

What medications are used to treat typhoid fever?

Antibiotics will be used by your doctor to treat typhoid fever, which may include:

• Ofloxacin, ciprofloxacin, or levofloxacin
• Cefixime, ceftriaxone, or cefotaxime
• Azithromycin.
• Carbapenems.
• Steroids like dexamethasone may be used to treat severe cases.

Antibiotic resistance in typhoid:

Sometimes, bacteria like S. Typhi can become resistant to medications. This implies that anti-microbials don't attempt to obliterate them any longer (anti-infection obstruction).

Antibiotics that were before used are unable to eradicate many cases of typhoid, but some medications continue to treat them. Only a few antibiotics are effective against some of them because they are drug-resistant (XDR typhoid). One of the reasons getting vaccinated against typhoid is so important is because of this.

If the current medications stop being effective, health officials are concerned that we may no longer be able to treat typhoid. Based on the results of the strain testing, you will be given an antibiotic that treats the type of typhoid you have.

COMPLICATIONS

Typhoid relapse:

After appearing to be recovered, some typhoid fever patients relapse. This is called backslide. In most cases, it occurs around a week after stopping antibiotics, but in some cases, it occurs weeks or months later. Your symptoms will likely be less severe than when you first got typhoid.

If your symptoms return, immediately contact your healthcare provider. It is likely that you will need to take another course of antibiotics.

Complications of typhoid:

• Bleeding internally.
• Perforation of the intestines (a hole in the intestines).
• Gallbladder that has swelled or burst.
• Symptoms of the brain, such as confusion, delirium, and seizures.
• Meningitis is swelling around your brain.
• Bronchitis, pneumonia, or other respiratory issues.
• Osteomyelitis is inflammation of the bones.
• Inflammation of the heart
• Failure of the kidneys.
• Miscarriage

PREVENTION

How can I reduce my risk of typhoid fever?

If you live in or plan to travel to an area where typhoid fever is common, getting vaccinated is the best way to lower your risk. Typhoid can be contained by washing one's hands and handling food.

Vaccines for preventing typhoid fever:

Typhoid fever vaccines are available in two forms. You will need to take extra doses to remain protected because they do not last forever. They lower your risk, but they do not prevent you from contracting typhoid. Although this has not been tested, vaccines may provide some protection against paratyphoid fever.

• Oral vaccine. Typhoid oral vaccine consists of four pills taken every other day. It will no longer be available from the manufacturer as of December 2020.
• Injectable vaccine (shot). a vaccine that can be injected single shot. You need to get it at least two weeks before you go to a place where typhoid is common so that your body can make antibodies and build up its defenses. Typhoid vaccination is available to children over the age of 2. To remain protected, you will need to get a booster shot every two years.

Safe food practices for preventing typhoid fever:

Typhoid vaccinations are the most effective method of protection. Yet, you should also take precautions to avoid consuming or drinking anything that might contain S. Typhi or other bacteria. This is true whether you are at home or on the road. Some safe ways to handle food are:

• If you're ill, don't make food for others.
• Before and after preparing food, eating, and using the bathroom, wash your hands with soap and water.
• Before and after use for food preparation and eating, wash surfaces and utensils.
• Consume well-cooked or packaged food if you are unsure whether the food you are eating is safe.
• Drinking and eating food prepared with untreated water are both unsafe. Drinking and cooking with bottled water is safer if you are unsure.

PROGNOSIS

In patients who do not receive treatment, the disease lasts from 4-8 weeks. A few days after treatment, the symptoms begin to go away when you take antibiotics to treat Salmonella.

In rare instances, serious complications like digestive bleeding or intestinal perforation may occur.

Resistance to commonly used antibiotic treatments for this disease is a growing problem that can impede treatment and worsen development.

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• Complications 
• Preventions