What is typhoid fever?

Question

What causes it?

Symptoms?

Is it still around?

Thanks!!

Answer 1

Typhoid fever (or enteric fever) is an illness caused by the bacterium Salmonella Typhi. Common worldwide, it is transmitted by 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 the digestive tract and eliminated with the waste.

After infection, symptoms include:

incubation period is 10 to 20 days
a high fever from 39 °C to 40 °C (103 °F to 104 °F) that rises slowly
chills
bouts of sweating
bradycardia (slow heart rate)
coughing
skin symptoms
Children often vomit and have diarrhea.
pulse becomes weak and rapid
In 2nd phase constipation is replaced by severe pea-soup-like diarrhoea feces may also contain blood.
weakness
diarrhea
headaches
myalgia (muscle pain), not to be confused with the more severe muscle pain in Dengue fever, known as "Breakbone fever."
lack of appetite
constipation
stomach pains
in some cases, a rash of flat, rose-colored spots called "rose spots"
in some cases, loss of hair resulting from the prolonged high fever
extreme symptoms such as intestinal perforation or hemorrhage, delusions and confusion are also possible.
Diagnosis is made by blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and H-flagellar). In epidemics and less wealthy countries, after excluding malaria, dysentery or pneumonia, a therapeutic trial with chloramphenicol is generally undertaken while awaiting the results of Widal test and blood cultures.
Typhoid fever can be fatal. Antibiotics, such as ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and ciprofloxacin, have been commonly used to treat typhoid fever in developed countries. Prompt treatment of the disease with antibiotics reduces the case-fatality rate to approximately 1%. Usage of Ofloxacin along with Lactobacillus acidophilus is also recommended.

When untreated, typhoid fever persists for three weeks to a month. Death occurs in between 10% and 30% of untreated cases. Vaccines for typhoid fever are available and are advised for persons traveling in regions where the disease is common (especially Asia, Africa and Latin America). Typhim Vi is an intramuscular killed-bacteria vaccination and Vivotif is an oral live bacteria vaccination, both of which protect against typhoid fever. Neither vaccine is 100% effective against typhoid fever and neither protects against unrelated typhus.

Resistance to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole and streptomycin is now common, and these agents have not been used as first line treatment now for almost 20 years. Typhoid that is resistant to these agents is known as multidrug-resistant typhoid (MDR typhoid).

Ciprofloxacin resistance is an increasing problem, especially in the Indian subcontinent and Southeast Asia. Many centres are therefore moving away from using ciprofloxacin as first line for treating suspected typhoid originating in India, Pakistan, Bangladesh, Thailand or Vietnam. For these patients, the recommended first line treatment is ceftriaxone.

There is a separate problem with laboratory testing for reduced susceptibility to ciprofloxacin: current recommendations are that isolates should be tested simultaneously against ciprofloxacin (CIP) and against nalidixic acid (NAL), and that isolates that are sensitive to both CIP and NAL should be reported as "sensitive to ciprofloxacin", but that isolates testing sensitive to CIP but not to NAL should be reported as "reduced sensitivity to ciprofloxacin". However, an analysis of 271 isolates showed that around 18% of isolates with a reduced susceptibility to ciprofloxacin (MIC 0.125–1.0 mg/l) would not be picked up by this method. It not certain how this problem can be solved, because most laboratories around the world (including the West) are dependent on disc testing and cannot test for MICs.

While flying insects feeding on feces may occasionally transfer the bacteria to food being prepared for consumption, the disease is most commonly transmitted through poor hygiene habits and public sanitation conditions. Public education campaigns encouraging people to wash their hands after toileting and before handling food are an important component in controlling spread of the disease.

A person may become an asymptomatic carrier of typhoid fever, suffering no symptoms, but capable of infecting others. According to the Centers for Disease Control approximately 5% of people who contract typhoid continue to carry the disease after they recover.

The most notorious carrier of typhoid fever, but by no means the most destructive, was Mary Mallon, also known as Typhoid Mary. In 1907 she became the first American carrier to be identified and traced. She was a cook in New York at the beginning of the 20th Century. Some believe she was the source of infection for several hundred people. She is closely associated with fifty cases and five deaths. Public health authorities told Mary to give up working as a cook or have her gall bladder removed. Mary quit her job, but returned later under a false name. She was detained and quarantined after another typhoid outbreak. She died of a stroke after 26 years in quarantine.

It is thought that cystic fibrosis may have risen to its present levels (1 in 1600 in UK) due to the heterozygous advantage that it confers against typhoid fever. The CFTR protein is present in both the lungs and the intestinal epithelium, and the mutant cystic fibrosis form of the CFTR protein prevents entry of the typhoid bacterium into the body through the intestinal epithelium.

430 - 426 B.C, a devastating plague, which some believe to have been typhoid fever, killed one third of the population of Athens, including their leader Pericles. The balance of power shifted from Athens to Sparta, ending the Golden Age of Pericles that had marked Athenian dominance in the ancient world. Ancient historian Thucydides also contracted the disease, but survived to write about the plague. His writings are the primary source on this outbreak. The cause of the plague has long been disputed, with modern academics and medical scientists considering epidemic typhus the most likely cause. However, a study in 2006 by Manolis Papagrigorakis of the University of Athens detected DNA sequences similar to those of the bacterium responsible for typhoid fever. Other scientists have disputed the findings, citing serious methodologic flaws in the dental pulp-derived DNA study. In addition, as the disease is most commonly transmitted through poor hygiene habits and public sanitation conditions, it is an unlikely cause of a widespread plague, emerging in Africa and moving into the Greek city states, as reported by Thucydides.
1860-1900 Chicago typhoid fever mortality rate averaged 65 per 100,000 population a year. The worst year was 1891, when the typhoid death rate was 174 per 100,000 persons.
1897 Edward Almwroth Wright develops the effective vaccine.
Other famous people who have succumbed to the disease include

Alexander the Great
Pericles
Archduke Karl Ludwig of Austria
William the Conqueror
Franz Schubert
Margaret Breckenridge, highest-ranking Army nurse under Ulysses S. Grant
Evangelista Torricelli
Benjamin Harrison's wife Caroline
Robert E. Lee's daughter Annie
Mary Henrietta Kingsley
Herbert Hoover's father and mother
Mark Hanna
William McKinley's daughter Katherine
Wilbur Wright
Will Rogers' mother
Leland Stanford, Jr.
William T. Sherman's father
Albert of Saxe-Coburg-Gotha, British prince consort, Queen Victoria's husband
Ann Rutledge, alleged fiancée of Abraham Lincoln
William Wallace Lincoln, son of Abraham Lincoln
Tad Lincoln, son of Abraham Lincoln
Stephen A. Douglas
Louis Pasteur's daughters Cecile and Jeanne
John Adams's wife Abigail Adams
K.B. Hedgewar, founder of Rashtriya Swayamsewak Sangh
Stonewall Jackson's mother, father, and daughter
John Buford
Charles Darwin's daughter Annie
Joseph Lucas
Ignacio Zaragoza


click here:http://www.histopathology-india.net/TyFev.htm

Answer 2

Typhoid fever was not well understood in the ancient world, probably because its symptoms are not primarily diarrheal, but rather systemic and non-specific. It was only in the mid-19th century that physicians began to distinguish it from typhus and malaria. Sir William Osler’s clinical description remains unsurpassed. Typhoid fever was frequently associated with military campaigns and was a significant cause of death in the American Civil War and Boer War where deaths from typhoid exceeded those from combat. With recognition that fecal contamination of food and water supplies was the main mode of transmission of the illness and measures taken to prevent these typhoid fever has been restricted, in industrialized countries, to localized epidemics and infections in travelers returning from endemic areas.
In contrast to that seen in the rich countries, typhoid fever remains an important cause of illness in the developing world where annual incidences in Papua New Guinea and Indonesia may reach 1200/100,000 population. A recent epidemiologic study showed that south-east and south-central Asia are the regions of highest endemicity with rates greater than 100/100,000 cases per year; the rest of Asia, Africa, Latin America, the Caribbean and Oceania (except Australia and New Zealand) are the next highest with incidence rates of 10-100/100,000 and Europe, North America and the rest of the developed world have low rates of disease. (15) Typhoid fever represents the 4th most common cause of death in Pakistan. (16)
The majority of patients, 60-90%, are treated as outpatients and, therefore, hospital based studies will underestimate true incidence. Two hospital based case-control studies from Vietnam found that risk of infection was related to recent contact with an infected person, lack of education and drinking untreated water. (17;18) S. paratyphi A, which normally causes about 15-20% of cases of typhoid fever in Asia, increasingly is becoming a pathogen in India (19) and China (20), possibly due to vaccination against S. typhi. Recent epidemiologic studies also show the rise of multi-drug resistant (MDR) organisms. (21) In a study of 1100 hospitalized children in Pakistan, the mortality rate of 1.6% was found to be related to younger age and MDR infection. (22)
Traditionally the age range considered to be at greatest risk was 5-25 years. However this has been questioned in a study from a private laboratory in Bangladesh, which found that the 57% of S. typhi isolates were in children less than 5 years of age and 27% less than 2 years. (23) This has significant implications for vaccination policies.
It is recommended that treatment of typhoid fever begin on the basis of clinical findings prior to definitive diagnosis. Sadly in endemic regions, facilities for definitive diagnosis, based on blood or bone marrow culture or serologic tests may be entirely lacking. Supportive measures such as oral or intravenous rehydration, antipyretics, appropriate nutrition and blood transfusion are important.

Answer 3

typhoid fever:

Noun
An acute, highly infectious disease caused by a bacillus (Salmonella typhi) transmitted chiefly by contaminated food or water and characterized by high fever, headache, coughing, intestinal hemorrhaging, and rose-colored spots on the skin. Also called enteric fever.