TYPHOID FEVER

Typhoid fever facts

• Typhoid fever usually is caused by Salmonellae typhi bacteria.
• Typhoid fever is contracted by the ingestion of contaminated food or water.
• Diagnosis of typhoid fever is made when the Salmonella bacteria is detected with a stool culture.
• Typhoid fever is treated with antibiotics.
• Typhoid fever symptoms are poor appetite, headaches, generalized aches and pains, fever, and lethargy.
• Approximately 3%-5% of patients become carriers of the bacteria after the acute illness.

What is typhoid fever? What is the history of typhoid fever?

Typhoid fever is an acute illness associated with fever that is most often caused by the Salmonella typhi bacteria. It can also be caused by Salmonella paratyphi, a related bacterium that usually leads to a less severe illness. The bacteria are deposited in water or food by a human carrier and are then spread to other people in the area. Typhoid fever is rare in industrial countries but continues to be a significant public-health issue in developing countries.
The incidence of typhoid fever in the United States has markedly decreased since the early 1900s. Today, approximately 400 cases are reported annually in the United States, mostly in people who recently have traveled to endemic areas. This is in comparison to the 1920s, when over 35,000 cases were reported in the U.S. This improvement is the result of improved environmental sanitation. Mexico and South America are the most common areas for U.S. citizens to contract typhoid fever. India, Pakistan, and Egypt are also known high-risk areas for developing this disease. Worldwide, typhoid fever affects more than 13 million people annually, with over 500,000 patients dying of the disease.
If traveling to endemic areas, you should consult with your health-care professional and discuss if you should receive vaccination for typhoid fever

How do patients get typhoid fever?

Typhoid fever is contracted by the ingestion of the bacteria in contaminated food or water. Patients with acute illness can contaminate the surrounding water supply through stool, which contains a high concentration of the bacteria. Contamination of the water supply can, in turn, taint the food supply. About 3%-5% of patients become carriers of the bacteria after the acute illness. Some patients suffer a very mild illness that goes unrecognized. These patients can become long-term carriers of the bacteria. The bacteria multiplies in the gallbladder, bile ducts, or liver and passes into the bowel. The bacteria can survive for weeks in water or dried sewage. These chronic carriers may have no symptoms and can be the source of new outbreaks of typhoid fever for many years.

How does the bacteria cause disease, and how is it diagnosed?

After the ingestion of contaminated food or water, the Salmonella bacteria invade the small intestine and enter the bloodstream temporarily. The bacteria are carried by white blood cells in the liver, spleen, and bone marrow. The bacteria then multiply in the cells of these organs and reenter the bloodstream. Patients develop symptoms, including fever, when the organism reenters the bloodstream. Bacteria invade the gallbladder, biliary system, and the lymphatic tissue of the bowel. Here, they multiply in high numbers. The bacteria pass into the intestinal tract and can be identified for diagnosis in cultures from the stool tested in the laboratory. Stool cultures are sensitive in the early and late stages of the disease but often must be supplemented with blood cultures to make the definite diagnosis.

What are the symptoms of typhoid fever?

The incubation period is usually one to two weeks, and the duration of the illness is about four to six weeks. The patient experiences

• poor appetite;
• abdominal pain;
• headaches;
• generalized aches and pains;
• fever, often up to 104 F;
• lethargy (usually only if untreated);
• intestinal bleeding or perforation (after two to three weeks of the disease);
• diarrhea or constipation.

People with typhoid fever usually have a sustained fever as high as 103 F-104 F (39 C-40 C).
Chest congestion develops in many patients, and abdominal pain and discomfort are common. The fever becomes constant. Improvement occurs in the third and fourth week in those without complications. About 10% of patients have recurrent symptoms (relapse) after feeling better for one to two weeks. Relapses are actually more common in individuals treated with antibiotics

What is the treatment for typhoid fever, and what is the prognosis?

Typhoid fever is treated with antibiotics that kill the Salmonella bacteria. Prior to the use of antibiotics, the fatality rate was 20%. Death occurred from overwhelming infection, pneumonia, intestinal bleeding, or intestinal perforation. With antibiotics and supportive care, mortality has been reduced to 1%-2%. With appropriate antibiotic therapy, there is usually improvement within one to two days and recovery within seven to 10 days.
Several antibiotics are effective for the treatment of typhoid fever. Chloramphenicol was the original drug of choice for many years. Because of rare serious side effects, chloramphenicol has been replaced by other effective antibiotics. The choice of antibiotics needs to be guided by identifying the geographic region where the organism was acquired and the results of cultures once available. (Certain strains from South America show a significant resistance to some antibiotics.) Ciprofloxacin (Cipro) is the most frequently used drug in the U.S. for nonpregnant patients. Ceftriaxone (Rocephin), an intramuscular injection medication, is an alternative for pregnant patients. Ampicillin (Omnipen, Polycillin, Principen) and trimethoprim-sulfamethoxazole (Bactrim, Septra) are frequently prescribed antibiotics although resistance has been reported in recent years. If relapses occur, patients are retreated with antibiotics.
The carrier state, which occurs in 3%-5% of those infected, can be treated with prolonged antibiotics. Often, removal of the gallbladder, the site of chronic infection, will cure the carrier state

Can typhoid fever be prevented?

For those traveling to high-risk areas, vaccines are now available. The vaccine is usually not recommended in the U.S. There are two forms of the vaccine available an oral and an injectable form. The vaccination needs to be completed at least one week prior to travel and, depending on the type of vaccine, only protects from two to five years. The oral vaccine is contraindicated in patients with depressed immune systems. Details of the vaccination and the vaccine you chose should be discussed with your health-care provider.
SOURCE:medicinenet.com

Typhoid Fever - Treatment and Symptoms

Ayurvedic Name: Aantrik Jwara

What is Typhoid Fever?

Typhoid fever is also called enteric fever. It happens due to the involvement of the intestines and may become very serious if treatment is not provided to the patient at the right time. Typhoid fever has a tendency to relapse the patient. It is sometimes accompanied by hoarse cough and constipation or diarrhoea. Typhoid fever is mainly transmitted by ingestion of food or contaminated water from an infected person. Typhoid fever is still common in many developing countries like india, where it affects about 21.5 million persons each year.
Now vaccines for typhoid fever are also available, but these vaccines are not effective so much and are just partially effective and are usually reserved for people who may be exposed to the disease or are traveling to areas where typhoid fever is endemic. No vaccine has been discovered till date for paratyphoid fever.

How does typhoid fever spread?

Typhoid fever appears to have affected thousands of human beings from last so many years, but the cause of the illness is a poisonous and interruptive bacterium called Salmonella typhi . Typhoid fever mainly spreads when people eat food or drink water which is already been infected with Salmonella typhi. This bacteria lives only in humans. Persons with typhoid fever carry the bacteria in their bloodstream and intestinal tract. Therefore, typhoid fever is more common in unhygienic areas of the world where hand washing is less frequent and water is likely to be contaminated with germs. It also spreads through direct contact with a person who is already infected with this disease.
A different pathogen, Salmonella paratyphi , causes paratyphoid fever. Although they're related, these aren't the same bacteria responsible for salmonellosis, another serious intestinal infection.
After treatment, some people who recover from typhoid fever, even then continue to harbor the bacteria in their intestinal tract or gallbladder, for some years. These people are called chronic carriers, usually shed the bacteria in their feces and are capable of infecting others, although they no longer have signs or symptoms of the disease themselves.

What are the symptoms of typhoid fever?

If you have typhoid fever you may have the following symptoms:

• Typhoid fever is usually recognized by the sudden onset of sustained fever.
• During typhoid fever you may also suffer from severe headaches.
• Nausea is an another symptom for typhoid fever.
• Some times Stomach Pain is also accounted.
• Sometimes the person also suffers from severe loss of appetite.
• Typhoid fever accompanied by insomnia and feverishness, particularly at night.
• In the beginning the temperature of the body is slightly high in morning, then it gradually becomes normal in the afternoon and then again rises in the evening. The temperature of sustained fever may go up to as high as 103° to 104° F (39° to 40° C ).

Some other symptoms of typhoid fever are:

• Sore throat.
• Myalgia.
• Mild vomiting.
• Lassitude and discomfort.

What you should do if you think you have typhoid fever?

You may go to doctor immediately, if you suspect you have typhoid fever . The patient may be given an antibiotic for the treatment of the typhoid fever. Persons given antibiotics usually begin to feel better after 2 days and chances of deaths rarely occur. Persons who do not get treatment may continue to have fever for weeks or months, and as many as 20% may die from complications of the infection.

Ayurvedic Treatment for Typhoid fever

Given below course you may follow for general treatment of typhoid fever, it depends on subjective or objective symptoms of the patient.
In first week: You may take 125 mg each of Muktashukti Bhasma and Mrigshringa Bhasma, at least three times daily which should be mixed with honey. A decoction of 12 gm of Khub Kalan and 10 gm of dried grapes with one litre of water, boiled down to about one-third, can be given along with the above medicines.
In second week: You may take a dose of Muktashukti Bhasma (10-12mg) & a dose of Kasturibhairava Rasa (120-125mg) with honey thrice daily. You may also take a mixture of Saubhagya Vati (240 mg) and Jwararyabhra (120 mg) three times in a day with juice of fresh ginger.
In third week: Mix 120 mg of Pravala Bhasma and 120 mg of Vasantmalati Ras with atleast 120 mg Amritsattva, to be taken with honey at least two times in a day. After at least three hours of serving the above medication give a dose of 240 mg of Powder of Pippali & also 240 mg of sarvajwaralauha with honey atleast two times in a day.
That is first, second & third, second should be taken alternatively.
In fourth week:You may take a mixture of Navayasa Choorna (Powder) - 2.5 mg & Vasantmalati Ras 125 mg & Sitopladi Choorna - 1.5 gm (Two Doses) to be taken with honey at least two times in a day. After meals, take a liquid compound prepared from- 10ml of Amritarishta & 5ml of Vishmushtayasava with 10ml of Lauhasava (one dose to be taken for each with equal quantity of water after lunch & dinner meals).
If whole body is massaged with oil, preferably Mahalakhshadi Tail daily, it will provide much desired relief to the patient and also help in quicker recovery. Some people suggest massage with olive oil or Johnson's Body oil but, then, it is simply a matter of individual response and suitability, availability and choice.

Some Prevention Tips for Typhoid Fever

You may follow following three actions to protect from typhoid fever:

• Avoid foods and drinks that you may think may be contaminated. Also avoid eating things that have been kept in the open for long time.
• Most important thing - Get vaccinated against typhoid fever.
• Avoiding risky foods will also help protect you from other illnesses, including travelers diarrhea, cholera, dysentery and hepatitis A.
• Source:ayurvedic-medicines.org