Typhoid Fever is so commonly heard off in our country. (I think most common as well as most over diagnosed disease in India).

Cause: It is caused by bacteria called Salmonella Typhi (S.Typhi) typically living in humans and are shed through a person’s feces (poop) or urine (pee). Bacteria get into blood and spreads quickly inside leading to high grade fever within a week or two.Without treatment, typhoid fever may last a month or more and become very serious, even life-threatening. Even after treatment during recovery phase a person can transmit this disease to others.  

Cause of Spread: 

  • Due to unclean water intake, unhygienic food and poor sanitation facilities.
  • Drinking water (and other drinks) and eating food handled by someone who has typhoid or is still a carrier.
  • Infected people can pass it on to others by touching them with unwashed hands.
  • Contaminated water by sewage, more so in area with poor sanitation and inadequate water treatment

Typhoid fever is named after a lady called typhoid mary who was suffering from this disease and used to serve food in USA leading to epidemic of this disease in that area.                         

Symptoms: 

Severity depends upon vaccination status, age, general health etc

  • Mild to High grade Fever
  • Stomach pain
  • Body pain, weakness
  • Diarrhea or constipation
  • Poor appetite
  • Reddish spotted rash 

Complications: Intestinal perforation (rare) 

Diagnosis:

  • History and examination
  • Blood tests :
    • Typhi Dot IgM: during first few days of fever
    • Widal test: after 5 days of fever (It gives false report before that). Unfortunately this test is most misused test in India. And many false positives reports are given by various labs even on first day of illness.
    • Blood Culture is gold standard: But in most cases antibiotics have been started early so yield of this test is low. And beside it is costly, so many quacks start treatment rather than testing. This treatment is often incomplete and in inadequate doses leading to drug resistance and disease recurrence.  

Treatment:

  • Antibiotics: important to give for proper duration and in adequate doses. Please do not stop medicine on your own once child starts feeling better after 2- 3 days.Some Cases might not respond to oral medication and need for Intravenous medication along with fluids might arise.

Stopping the Spread

Prevent the spread to others: Wash hands regularly. People with typhoid fever should avoid preparing food. Children should stay away from school until doctor certifies them to join back school.

How to prevent Infection 

  • Vaccination: It is Available and routinely given around 2 years of age and every 3 years after that. Even if your child is vaccinated (Vaccine is not 100% effective and loses its effectiveness over time). But now better conjugate vaccine is available.
  • Sanitize water.
  • Cook all food.
  • Avoid raw food.
  • Wash hands frequently
  • Feel free to contact your child doctor for any queries 

Regards

Dr Rahul Varma

” Healthy Kids, Happy Family”