Description

Typhoid fever is a serious, systemic bacterial infection caused by Salmonella enterica serovar Typhi. It spreads mainly through contaminated food and water and is most common in areas with poor sanitation. ⸻ Causative Agent • Bacterium: Salmonella enterica serovar Typhi ⸻ Mode of Transmission • Fecal–oral route • Contaminated: • Drinking water • Food (especially raw vegetables, street food) • Milk and dairy products • Carriers (people who recover but still shed bacteria) can transmit the disease Example: “Typhoid Mary” (a chronic carrier) spread infection without symptoms. ⸻ Risk Factors • Poor sanitation and hygiene • Unsafe drinking water • Traveling to endemic areas (South Asia, Africa, parts of Latin America) • Close contact with infected person • Low stomach acidity ⸻ Incubation Period • Usually 7–14 days • Can range from 3–30 days ⸻ Signs and Symptoms First Week • Gradual high fever (step-ladder pattern) • Headache • Weakness • Dry cough • Abdominal discomfort • Constipation (more common in adults) Second Week • Sustained high fever (39–40°C) • Abdominal pain • Diarrhea (pea-soup stool) • Enlarged spleen and liver • Rose spots (faint pink rash on chest/abdomen) Third Week (If untreated) • Severe weakness • Intestinal bleeding • Intestinal perforation • Delirium (“typhoid state”) ⸻ Complications • Intestinal hemorrhage • Intestinal perforation • Peritonitis • Septic shock • Encephalopathy • Chronic carrier state ⸻ Diagnosis • Blood culture (most reliable in early stage) • Stool culture • Bone marrow culture (most sensitive) • Widal test (less specific) • PCR (modern method) ⸻ Treatment Typhoid requires antibiotics Supportive care: • Adequate hydration • Nutrition • Fever management ⸻ Prevention A. Vaccination Available vaccines: • Typhoid conjugate vaccine (TCV) • Oral live vaccine • Injectable polysaccharide vaccine Recommended for: • Travelers to endemic regions • Children in high-risk areas B. Hygiene Measures • Drink boiled or treated water • Wash hands regularly • Eat properly cooked food • Avoid raw vegetables in endemic areas ⸻ Difference Between Typhoid and Paratyphoid • Typhoid: caused by S. Typhi • Paratyphoid: caused by S. Paratyphi • Symptoms similar but paratyphoid is usually milder ⸻ Global Impact • Millions of cases yearly • Highest burden in developing countries • Major public health issue where sanitation is poor

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