Typhoid
Typhoid fever is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person. Typhoid does not affect animals and therefore transmission is only from human to human. The bacteria which causes typhoid fever may be spread through poor hygiene habits and public sanitation conditions, and sometimes also by flying insects feeding on feces. Therefore sanitation, hygiene and careful food preparation are critical measures that can be taken to prevent typhoid.
Generally the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week. In the first week, there is a slowly rising temperature with relative slow heart rate, malaise, headache, and cough. In the second week of the infection, the patient will have a high fever in plateau around 40 °C, slowed heart rate, delirium, diarrhea or constipation, and enlarged spleen and liver. In the third week in addition to the efever a number of complications can occur including intestinal hemorrhage, intestinal perforation (which is frequently fatal), encephalitis, neuropsychiatric symptoms including dilirium and hullucinations, metastatic abscesses, cholecystitis, endocarditis and osteitis. By the end of third week the fever has started reducing and will continue to into the fourth week. However a person may be or become an asymptomatic carrier of typhoid fever, suffering no symptoms, but capable of infecting others.
There are two vaccines licensed for use for the prevention of typhoid: the live, oral Ty21a vaccine and the injectable Typhoid polysaccharide vaccine. Both are recommended for travellers to areas where typhoid is endemic. Boosters are also recommended to maintain immunity - every five years for the oral vaccine and every two years for the injectable vaccine.
