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Introduction

Introduction

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Published by hsiria

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Published by: hsiria on Jun 03, 2009
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02/03/2013

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INTRODUCTION
Typhoid fever is a potentially life-threatening illness that is caused by the bacteria
Salmonella typhi
(
S. typhi
). Common worldwide, it is transmitted by the fecal-oral route — the ingestion of food or water contaminated with feces from an infected person. The bacteria then multiply in the blood stream of the infected person and are absorbed into thedigestive tract and eliminated with the waste. The organism is a Gram-negative short bacillus that is motile due to its peritrichous flagella. The bacteria grow best at 37°C(human body temperature).The disease is characterized by a sustainedfever as high as 40°C (104°F), profusesweating, gastroenteritis, anddiarrhea.Less commonly a rashof flat, rose-colored spots may appear.Untreated typhoid fever lasts at least 4 weeks. Most of the classic signs and symptoms of typhoid fever are prevented with prompt treatment. Clinical response begins about 2 daysafter starting antibiotics, and the patient's condition markedly improves within 4-5 days.The incubation period of typhoid fever varies with the size of the infecting dose andaverages 7-14 (range, 3-60) days. In paratyphoid infection, the incubation period rangesfrom 1-10 days. During the incubation period, 10-20% of patients have transient diarrhea(enterocolitis) that usually resolves before the onset of the full-fledged disease.As bacteremia develops, the incubation period ends. Patients often experience chills,diaphoresis, anorexia, dry cough, a dull frontal headache, and myalgias before the onsetof a high fever. About 20-40% of patients present with abdominal pain. Inimmunocompetent adults, constipation is common and is most likely due to hypertrophyof Peyer patches. Young children and individuals with AIDS are more likely to havediarrhea that is probably due to blunted secondary immunity. The incidence of constipation versus diarrhea varies geographically, perhaps because of local differences indiet or 
S typhi
strains or genetic variation.Unusual modes of onset include isolated severe headaches that may mimic meningitis.
typhi
infection may cause an acute lobar pneumonia. In the early stages of the disease,rigors are rare unless the person also has malaria. This is not an unusual pairing of diseases. Patients may present with arthritis only, urinary symptoms, severe jaundice, or fever.
 
What is typhoid fever?
Typhoid fever is a potentially life-threatening illness that is caused by the bacteria
Salmonella typhi
(
S. typhi
). Persons with typhoid fever carry the bacteria in their  bloodstream and intestinal tract and can spread the infection directly to other people bycontaminating food or water.
Who gets typhoid fever?
Anyone can get typhoid fever if they drink water or eat food contaminated with the
S.typhi
bacteria. Travelers visiting developing countries are at greatest risk for gettingtyphoid fever. Typhoid fever is still common in the developing world, where it affectsabout 12.5 million persons each year. Only about 400 cases occur each year in the UnitedStates.
How does typhoid fever spread?
You can get typhoid fever by eating or drinking contaminated food or water. Food or water can be contaminated by a food handler with
S. typhi
, or may be contaminated if sewage accidentally gets into the food or water. Some infected persons may not show anysymptoms of typhoid fever but can shed the
S. typhi
bacteria in their feces for manyyears. These persons are called typhoid fever "carriers". S. typhi is only found in humans.
What are the signs and symptoms of typhoid fever?
If you have typhoid fever you may have the following symptoms:constant fever up to 104°diarrheaconstipationstomach painheadachemalaisenonproductive coughslow heart rate (bradycardia)anorexia
How soon after exposure do symptoms appear?
Symptoms usually occur within 1-2 weeks after exposure to the bacteria, but can occur from 3 days - 3 months after exposure.
 
How is typhoid fever diagnosed?
Only your doctor can tell if you have typhoid fever. A blood or stool sample is needed todiagnose typhoid fever. The samples are examined fo
S. typhi
bacteria.
How is typhoid fever treated?
Typhoid fever is treated with antibiotics. A person will usually recover in 2-3 days with prompt antibiotic treatment. People that do not get prompt medical treatment maycontinue to have a fever for weeks or months, and as many as 20% may die fromcomplications of the infection.
If you are being treated for typhoid fever, it is important to do the following:
Take the prescribed antibiotics for as long as the doctor has asked you to takethem.Wash your hands carefully with soap and water after using the bathroomDo not prepare or serve food to other people.Have your doctor collect follow-up stool samples to ensure that no S. typhi bacteria remain in your body.
How can typhoid fever be prevented?
If you travel to an area where the disease is common, use the following steps to protectyourself:1.Get vaccinated against typhoid fever. Both injectable and oral vaccines areavailable. Visit a doctor or travel clinic to discuss your vaccination options.Vaccines are not 100% effective, so it is important to take the additional measureslisted to prevent typhoid fever.2.Use careful selection of food and drink while you are in a developing country.This will also help protect you from other illnesses such as cholera, dysentery andhepatitis A.3.Only use clean water. Buy it bottled or make sure it has been brought to a rolling boil for at least one minute before you drink it. Bottled carbonated water is safer than uncarbonated water.4.Ask for drinks without ice unless the ice is made from bottled or boiled water.5.Only eat foods that have been thoroughly cooked.6.Avoid raw vegetables and fruits that cannot be peeled.7.When you eat raw fruits or vegetables that can be peeled, wash your hands withsoap, then peel them yourself. Do not eat the peelings.8.Avoid foods and beverages from street vendors. Many travelers get sick from food bought from street vendors.

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