“Salmonella typhi” bacteria are responsible for typhoid fever and are caused by the ingestion of contaminated food and water. Among developed nations, typhoid fever is rare. However, in the developing world, especially for children, typhoid fever is still a serious health risk.
Salmonella typhi has been a significant human pathogen for thousands of years and thrived in inadequate sanitation, crowds, and social chaos. Although typhoid fever in developed countries has decreased significantly by the use of antibiotics, in low- and middle-income countries, typhoid fever affects 21 million people annually and kills 168,000.
Antimicrobial resistance and a shortage of appropriate vaccines and treatments worsen the infectious disease in South Asia.
The bacterial Salmonella typhi pathogen releases the typhoid toxin that destroys the cell’s DNA to induce typhoid. Our DNA is continually damaged by environmental factors such as smoking and UV light, but cells usually have their DNA repair mechanism. When a typhoid toxin infects our cells, these toxins hijacked cells DNA repair machinery.
- A frequently asymptomatic person handles oral transmission via food or drinks.
- Hand to mouth transmission after using a filthy toilet and neglecting hand sanitization.
- Oral transmission by contaminated water or shellfish.
The infamous gastrointestinal manifestations of the disease may develop within the first week of illness. These include diffuse abdominal pain and tenderness and, in some cases, include severe right upper quadrant pain. The individual develops a dry cough, dull frontal headache, and delirium—the fever upland at 103-104 ° F at about the end of the first week of illness.
Other symptoms of typhoid fever include
- Stomach pain
- Diarrhea or constipation
- Dry Cough
- Loss of appetite
- Abdominal pain
- Muscle aches
The only effective treatment of typhoid fever is antibiotic therapy.
- Ciprofloxacin: It is also recommended for non-pregnant adults in the United States. Unfortunately, many Salmonella typhi bacteria, especially those acquired in Southeast Asia, are no longer susceptible to antibiotics of this kind.
- Ceftriaxone: For more complicated infections, this injectable antibiotic is used and candidates who cannot use ciprofloxacin.
- Azithromycin: It can be used if a patient cannot take ciprofloxacin or if the bacteria are ciprofloxacin-resistant.
There are two typhoid vaccines available in Pakistan.
- A single dose of injectable Vi polysaccharide vaccine is used for children with more significance than two years. For continued protection, revaccination is necessary every three years.
- A single dose typhoid conjugate vaccine: it is authorized for use in children with the age of more than six months. Provides immunization to parents, infants, and children over six months of age for three years. The plan of revaccination is under review.
How to avoid typhoid fever
Because vaccines do not offer complete protection or protection from other infections with contaminated water/food, therefore, the following preventive strategies should be followed:
- Hand washing.
- Boiling of water before consumption.
- Avoid undercooked meat.
- Control flies.