TYPHOID FEVER

Overview & Facts

Typhoid fever is an acute illness associated with fever caused by the Salmonella typhi bacteria. It can also be caused by Salmonella paratyphi. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area through ingestion. After the ingestion of contaminated food or water, the Salmonella bacteria invade the small intestine and enter the bloodstream temporarily. The bacteria are carried by white blood cells in the liver, spleen, and bone marrow, where they multiply and reenter the bloodstream. People develop symptoms, including fever, at this point. Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel. Here, they multiply in high numbers. The bacteria pass into the intestinal tract.

Types & Symptoms

The incubation period is usually 1-2 weeks, and the duration of the illness is about 3-4 weeks. Symptoms include:

  • Poor appetite
  • Headaches
  • Generalized aches and pains
  • Fever as high as 104 degrees Farenheit
  • Lethargy
  • Diarrhea

Chest congestion develops in many people, and abdominal pain and discomfort are common. Improvement occurs in the third and fourth week in those without complications. About 10% of people have recurrent symptoms after feeling better for one to two weeks. Relapses are actually more common in individuals treated with antibiotics.

Diagnosis & Medications

DIAGNOSIS

Diagnosis can be made through a culture of the stool sample. If a test result isn’t clear, blood samples can be taken to make a diagnosis by testing for antigen or antibodies that points to the causative bacteria, Salmonella typhi.

 

RECOMMENDED MEDICATIONS

Typhoid fever is treated with antibiotics which kill the Salmonella bacteria and supportive care.

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 Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics.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.

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