Typhoid fever is an acute bacterial infection caused by Salmonella typhi bacteria found in the feces of infected individuals. The bacteria spreads through contaminated food and water and causes high fever, stomach pain, and other flu-like symptoms. It is diagnosed through blood, stool, and other tests. Treatment involves antibiotics and hydration. Prevention focuses on proper sanitation and food/water safety.

1. TYPHOID

2. What is typhoid fever?
 Typhoid Fever is an acute bacterial infection characterized by high
fever caused by ingesting the food or water contaminated with faeces
from an infected person.
 Typhoid is an infection caused by the bacterium Salmonella
typhimurium (S. typhi).
 No animals carry this disease, so transmission is always human to
human.
 S. typhi enters through the mouth and spends 1 to 3 weeks in the
intestine. After this, it makes its way through the intestinal wall and
into the bloodstream.
 From the bloodstream, it spreads into other tissues and organs.
 Typhoid is diagnosed by detecting the presence of S. typhi via blood,
stool, urine, or bone marrow sample.

3. Source of infection
Primary sources
• Faeces & urine of cases
and carriers.
• Faecal carriers are more
frequent than urinary
carriers.
Secondary sources
• Contaminated
 Water
 Food
 Fingers
 Flies

4. Mode of Transmission
 Typhoid and paratyphoid fever are most common in parts of the world
with poor sanitation.
 Typhoid is transmitted by contaminated food and water.
 High concentration of bacteria through the faeces of an infected person
is exposed to the external environment and contaminates the
surrounding water supply.
 Supply of contaminated water leads to infected food supply. The
bacteria remain alive for weeks in water and dried sewage.
 After acute infection, around 3-5% of people become long-term
asymptomatic carriers of S. typhi. These people do not suffer from
any symptoms; while in some other people, the bacteria continue
to reside even after the symptoms. Sometimes, the disease appears
again.

5. Ingestion of contaminated food or water
Salmonella bacteria
Invade small intestine and enter the bloodstream
Carried by white blood cells in the liver, spleen, and bone marrow
Multiply and reenter the bloodstream
Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel
and multiply in high numbers
Then pass into the intestinal tract and can be identified for diagnosis in
cultures from the stool tested in the laboratory

6. Risk Factors
 Due to decreased immunity, children are more prone to getting this
infection than adults. Though it is commonly witnessed in:
 People traveling to places where typhoid is more common.
 Having close contact with someone who is infected with typhoid or
just recovered or is a carrier
 Working in labs where one might have to handle the disease-causing
bacteria
 Drinking water contaminated with sewage.

7. Symptoms
• The common signs and symptoms of typhoid fever usually develop within
2-3 weeks after exposure to the bacteria. These symptoms include:
 High fever ranging between 39° to 40° C (103° to 104° F)
 Stomach pain
 Headache
 Lethargy
 Intestinal bleeding
 Poor appetite
 Rash
 Confusion
 Constipation
 Diarrhea
 Fatigue
 Swollen abdomen

8. Diagnosis
• Usually confirms the presence of the bacteria by performing blood
tests (Widal Test), stool tests, and body fluid cultures.
• Testing a sample of bone marrow is a more accurate way of
diagnosing typhoid fever But getting the sample is both time-
consuming and painful, so it's usually only used if other tests are
inconclusive.

9. Treatment
• Treatment options usually involve intaking prescribed antibiotics that
not only kill the bacteria but also prevent the underlying health
complications and aid in faster recovery.
• Hydrating the body by drinking an adequate amount of water,
electrolytes and oral rehydration fluids at regular intervals to remedy
the acute dehydration in the body.
• Mild cases of typhoid show improvement from the 3rd or 4th
week. In patients treated with antibiotics, the infection may relapse
after 1-2 weeks.

10. Vaccination
• The WHO has recommended two typhoid vaccines, namely the
liveoral Ty21a vaccine (Vivotif Berna) and the injectable typhoid
polysaccharide vaccine(Typhim Viby Sanofi Pasteurand Typherix.
• Both these vaccines provide 50-80% protection and are effective
for individuals travelling to typhoid endemic areas
Vaccine Name How given Number of
doses recommended
When
taken
Minimum age
for vaccination
Booster needed
Ty21a (Vivotif,
Emergent)
1 capsule
Oral
4 Every
other day
6 years Every 5 years
ViCPS (Typhim
Vi)
Injection 1 Once 2 years Every 2 years

11. Prevention
Choose food and drinks carefully:-
 Only eat foods that are cooked and served hot.
 Avoid raw fruits and veggies.
 Eat raw fruits and vegetables only if you have washed them in clean
water or peeled them.
 Only drink beverages from factory-sealed containers.
 Avoid ice because it may have been made from unclean water.
 Only drink pasteurized milk.