Typhoid and Paratyphoid Fever: Causes, Symptoms, and Treatment

 

They are called “Salmonella typhi” and “Salmonella enteritidis” and are always at the top of the usual suspects when a disease occurs. Because the pathogens of abdominal typhus and the weakened form of paratyphoid prefer to frolic in the faeces – where the hygienic conditions leave something to be desired, typhoid and paratyphoid can then spread. The disease is transmitted through food and drink contaminated with faeces, so regular hand washing with clean water is the best way to avoid contagion.

Typhoid: Illnesses are becoming rarer

Around 17 million people contract typhus every year, and around 600,000 of them die. In the industrialized nations, typhoid has become relatively rare. Only a few of the long-term excretory who acquired their disease during the typhoid outbreaks immediately after World War II and in the 1950s are still alive. Typhus infections are reported more frequently and repeatedly, especially in countries with poor hygienic and sanitary conditions.

 

Be careful when travelling abroad.

According to estimates by travel physicians, 80 to 90 per cent of all typhoid and paratyphoid cases in Germany are now imported from travel regions with inadequate hygiene standards. These include Pakistan, India, Thailand, Indonesia, Egypt, Turkey and Morocco. It is estimated that one in 30,000 long-distance travellers imports typhoid fever. The increasing antibiotic resistance of the pathogens makes successful treatment difficult and problematic.

Symptoms and course of typhus

Typhoid (Greek typos haze, fog, dizziness ) and paratyphoid are bacterial infectious diseases caused by Salmonella. It is a severe general infection with a high fever of around 40 degrees Celsius, lasting about three weeks. However, the fever can last longer. Typical initial symptoms include fever and a severe headache. There is also diarrhoea, drowsiness and a swollen spleen or liver.

Because the symptoms of the disease are relatively unspecific, typhus is often recognized late. With complications such as intestinal bleeding or pulmonary typhoid, the disease can also be fatal. About two to five per cent of typhoid and paratyphoid patients become so-called “permanent excretory” after they have had the disease, which means they excrete the pathogens in the stool for weeks after the disease and can remain contagious for the rest of their lives.

However, not everyone who ingests typhoid bacteria also becomes ill. The onset of the disease depends on the infectious dose and the patient’s general health. This constellation also applies to other salmonella diseases, which can often be observed in the summer months as epidemic-like diarrheal diseases, especially in facilities with canteen kitchens.

 

treatment of typhoid

In the first and often also in the second week of illness, the pathogens can be detected in the blood. However, the results of the blood cultures are available after 48 hours at the earliest, so patients suspected of having typhoid or paratyphoid must be isolated immediately because the pathogens can already be excreted during this phase. From the second week of illness, the pathogens can also be detected in the stool, and as the disease progresses, high antibody levels can be detected in the patient’s serum.

Typhoid: Vaccination for prevention

Typhoid and paratyphoid can be treated with antibiotics, and the high fluid and electrolyte losses caused by diarrhoea and vomiting must be compensated for. Without treatment with antibiotics, about 10 to 15 per cent of those infected die; with treatment, about one to two per cent. Anyone planning a long-distance trip should be vaccinated against typhus. This does not only apply to trekking or adventure vacationers: package tourists can also become infected with the pathogen through contaminated food in the hotel.

The vaccine can be given as an oral vaccine or as an injection. Both vaccines can be used for both adults and children over the age of two. The typhoid vaccination can be done at the same time as other vaccinations. The oral vaccines contain rendered harmless, live typhoid bacteria.

For the vaccination to be fully effective, malaria prevention, laxatives or antibiotics should only be taken three days after completion of the complete typhoid immunization. Since three capsules are taken at intervals of two days for the oral vaccination, vaccination planning should be done in good time and with the foresight not to jeopardize the success of this and other vaccinations.

Do not vaccinate Pregnant women and children under the age of two.

Booster vaccinations are recommended after three years if you stay in a danger zone for a long time, possibly more often after consultation with the doctor. Anyone suffering from an acute infection should postpone the vaccination until the infection has subsided. Children under two and pregnant women should avoid vaccination and travel. An oral vaccine can be given while breastfeeding because Salmonella does not pass into breast milk.