Typhoid Fever: Symptoms and Treatment

Typhoid fever (Enteric fever) is a bacterial infection caused by Salmonella typhi, the bacteria which also causes salmonella food poisoning. It is highly contagious and can easily be transmitted from an infected person via bodily excretions. The disease affects many body organs and can be propagated via contaminated food and water. Once the bacteria enters the body it multiplies and propagates vigorously in the bloodstream.

Typhoid fever is most prevalent in parts of the world having poor sanitation and restricted access to clean water. Children are thought to be at higher risk of developing typhoid fever. However, they tend to have milder symptoms than adults. Some of the symptoms include high fever and headache, constipation, stomach pain and diarrhoea.

Typhoid medications primarily consist of fluids and antibiotics that facilitate recovery within one or two weeks. Typhoid vaccines also act against Salmonella typhi but fail to safeguard against other strains of Salmonella. The vaccines are 30-70% effective in the first two years depending on the type of vaccine provided.

A recent study showed 360 typhoid cases per 1 lakh person in India annually with a 0.2% death rate nearing 8930 people.

Common Complications in Untreated Typhoid Fever

People who haven’t received proper antibiotics treatment for typhoid may develop the below-mentioned two complications during the third week of infection.

Internal Bleeding in the Digestive System

People with typhoid disease often face internal bleeding which although not life-threatening, can make them feel very unwell. Some of the symptoms include breathlessness and feeling tired, vomiting blood, irregular heartbeat and dark-coloured faeces.

Intestine Perforation 

It is one of the dreaded complications of typhoid fever leading to diffuse peritonitis that requires surgical intervention. In simple terms, the bacteria living in the digestive system may move to the stomach causing infection in the peritoneum (lining of the abdomen) causing peritonitis. The most common symptom is abrupt abdominal pain which gets worse without treatment.

How is Typhoid Diagnosed?

The diagnosis of typhoid disease is done by analysing samples of blood, stool, or urine. The samples are microscopically examined for the detection of Salmonella typhi bacteria, the causal agent of typhoid. The doctor may assume typhoid fever based on:

Travel History of the Patient

People who have recently visited places where there is higher typhoid incidence due to a lack of proper hygiene and sanitation have a higher likelihood of being affected by the bacteria. The diagnosis is confirmed by the growth of Salmonella typhi in a blood sample or tissue fluid.   

Other Tests

A sample of the blood, urine, stool or bone marrow from the suspected individual is cultured in a condition that favours bacterial growth. The culture is further checked under the microscope for the detection of bacteria.

Some other tests include the detection of typhoid antibodies in the blood sample of patients or using a DNA probe to detect bacteria from blood samples. Nowadays Polymerase chain reaction-based detection methods are gaining importance because of time efficiency and ease of performing the reaction.

Treatments for Curing Typhoid Disease

Antibiotics only effectively treat and cure Typhoid disease.

Vaccine for Treating Typhoid Fever

Several groups of drugs and antibiotics are used to treat typhoid disease. As with the evolution of bacteria, antibiotic resistance has emerged, thus newer antibiotics are designed for curing typhoid fever.

Apart from typhoid medications, typhoid vaccines play a major role in preventing and protecting people from typhoid. Two vaccines are primarily used for prevention:

• An injectable vaccine containing purified antigen from bacteria for those over 2 years of age.
• A live attenuated oral vaccine in the form of a capsule for the ones aged over five years.

However, these vaccines fail to deliver long-lasting resistance and are not recommended for children below two years of age. The World Health Organisation (WHO) prequalified a new conjugate typhoid vaccine providing long-lasting immunity in December 2017, which can be administered to children from 6 months of age.

Commonly Prescribed Antibiotics or Typhoid Medicines

Fluoroquinolones

This group of antibiotics are the first choice of many doctors. They include ciprofloxacin which helps to constrain bacterial growth quite effectively. However, some antibiotic-resistant bacteria may still grow which needs further medication to be constrained.

Cephalosporins

These antibiotics inhibit bacterial cell wall growth and are quite useful in treating enteric fever. The third-generation cephalosporin, ceftriaxone, is preferably used in case of antibiotic resistance.

Macrolides

They inhibit bacterial protein formation. One type called azithromycin is effectively used in treating typhoid fever. Its high intracellular tissue penetration and higher elimination half-life of 72 hours help in combating the disease effectively.

Carbapenems

They prevent bacterial cell wall growth at some different stage than cephalosporins. This category of antibiotics is used for treating diverse diseases that are not cured by other groups.

Some Other Treatments

Higher Fluid Intake

Typhoid symptoms include fever, headache and diarrhoea which causes dehydration and stress. Thus, higher fluid intake and eating regular meals are prescribed.

Maintaining Personal Hygiene 

To reduce the risk of infection spreading, maintaining cleanliness and hygiene is essential. This includes washing hands with soap and warm water at regular intervals and maintaining a neat and clean environment.

Surgery

Hospital treatment and surgery are needed in extreme cases. When the intestines are damaged by microbes, showing internal bleeding or splitting, only surgery can cure the disease.

Learn More: Diet For Typhoid: Foods To Eat And Avoid for Fast Recover

Frequently Asked Questions

1. What are the symptoms that people face at the highest level of Typhoid?

The fourth stage is the highest stage which brings a lot of health complications. This includes kidney failure, pneumonia, severe infections and inflammation of the pancreas (meningitis).

2. Can tablets cure Typhoid Disease?

A successful course of antibiotics prescribed by the healthcare professional can efficiently cure typhoid disease. It is prescribed not to stop taking medicines without a doctor's consultation.

3. What is the best Typhoid Medicine?

Typhoid can be best treated with antibiotics. The different classes of antibiotics used for treatment are cephalosporins, fluoroquinolones, macrolides and carbapenems.