Typhoid Fever: Symptoms,Causes, Diagnosis and Vaccination

Typhoid fever, also known as typhoid, is a bacterial infection due to Salmonella typhi. The bacteria grows in the intestines and blood. Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person.

Updated: June 16, 2022

Typhoid fever, also known as typhoid, is a bacterial infection due to Salmonella typhi. The bacteria grows in the intestines and blood. Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person.

Symptoms of Typhoid:

Signs and symptoms are likely to develop gradually. These appears one to three weeks after exposure to the disease.
Common symptoms of typhoid fever can include:

  • a high temperature, which can reach up to 39-40C (103-104F)
  • headache
  • muscle aches
  • stomach pain
  • feeling sick
  • loss of appetite
  • sweating
  • dry cough
  • constipation or diarrhoea (adults tend to get constipation and children tend to get diarrhoea)
  • a rash made up of small pink spots on the trunk of the body
  • exhaustion
  • confusion

If you do not get proper treatment, you may:

  •     Become delirious
  •     Lie motionless and exhausted with your eyes half closed

Life threatening complications may arise at this condition. In some people, signs and symptoms may return up to two weeks after the fever has subsided.

Causes of Typhoid :

Typhoid fever is caused by a type of bacteria called Salmonella typhi. This is not the same bacteria that cause salmonella food poisoning, but the two are related.

How the infection spreads:

The bacterium that causes typhoid fever may be spread through poor hygiene habits and public sanitation conditions, and sometimes also by flying insects feeding on feces.
The Salmonella typhi bacteria will be in the faeces of an infected person. If the person do not wash their hands properly, they can contaminate any food they touch. Anyone else who eats this food may also become infected. People who drink contaminated water or eat food washed in contaminated water can develop typhoid fever.
Other ways typhoid fever can be contracted include:

  • using a toilet contaminated with bacteria and touching your mouth before washing your hands
  • contaminated milk products
  • eating raw vegetables that have been fertilized with human waste
  • eating seafood from a water source contaminated by infected faeces or urine
  • having oral or anal sex with a person who is a carrier of Salmonella typhi bacteria

Typhoid carriers:

A small number of people who recover from typhoid fever continue to carry the bacteria in their intestinal tracts or gallbladders, often for years, even after treatment with antibiotics,. These people are called chronic carriers. Although they no longer have any signs or symptoms of the disease,they can shed the bacteria in their feces and are capable of infecting others.

How the bacteria affect the body:

The bacteria will move down into the digestive system, where they will quickly multiply after eating food or drinking fluid contaminated with the Salmonella typhi bacteria. This induce a high temperature, stomach pain and constipation or diarrhea.
Left untreated, the bacteria can get into the bloodstream and spread to other areas of the body. This can cause the symptoms of typhoid fever which get worsen during the weeks after infection. As a result of the infection, if the organs and tissues become damaged,  it can cause serious complications, such as internal bleeding or a section of the bowel splitting open.

Diagnosis of Typhoid:

Diagnosis is made by any blood, bone marrow or stool cultures. A widal test can be done for demonstration of antibodies against Salmonella antigens.
Blood or stool sample will be examined under a microscope for the Salmonella typhi bacteria that cause the condition.  You may need to have a series of tests as the bacteria aren't always detected the first time.

Vaccination for Typhoid:

If you are traveling to parts of the world where the condition is common vaccination against typhoid fever is recommended.
Vaccination is strongly recommended if you are going to be stay or work with local people, or if you are going to stay for prolonged periods in areas where sanitation and food hygiene are likely to be poor.
Vaccines available to prevent typhoid fever are mainly of two types:

  •     Vi vaccine given as a single injection
  •     Ty21a vaccine given as three capsules to take on alternate days

The vaccines work by stimulating your body to create antibodies that prevent you getting ill if you become infected with the typhoid bacteria. As the Ty21a vaccine contains a live sample of Salmonella typhi bacteria, it isn't suitable for people with a weakened immune system, such as people with HIV or those receiving certain types of treatment, such as chemotherapy. It also isn't usually recommended for children under six, whereas children can have the Vi vaccine from two years of age.
The typhoid vaccine should ideally be given at least one month before you travel abroad.

Side effects of typhoid fever vaccine:

Some people have temporary soreness, redness, swelling or hardness at the injection site after taking the vaccine. Some less common side effects include:

  •     high temperature
  •     abdominal pain
  •     headache
  •     feeling sick
  •     diarrhoea


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