By Adaobi Rhema Oguejiofor
1Typhoid fever is caused by a bacterial infection from the Salmonella Typhi bacterium; a simple glass of water or a bite of food can lead to a very life-threatening situation. This bacterium, which can spread throughout the body and affect many organs, is related to the bacteria that cause salmonella food poisoning. Without immediate treatment, typhoid fever can eventually lead to serious complications as well as fatality.
Typhoid fever is highly contagious. An infected person can pass the bacteria out of their body through their faeces or, less commonly, through pee. If they do not wash their hands properly after the discharge, they can contaminate any food they touch. So, if someone else eats food or drinks water that has been contaminated with a small number of infected faeces or pee, they can become infected with the bacteria and develop typhoid fever.
The bacteria, once ingested travels into the intestines and then into the blood. It further spreads into the lymph nodes, gallbladder, liver, spleen, and other parts of the body. Some people become carriers of S. typhi and continue to release the bacteria in their stools, sometimes for years, spreading the disease.
Available data by the World Health Organization (WHO) revealed that the parts of the world where this disease is most common are places that have poor sanitation and limited access to clean water, like Africa and South Asia. Also, on a global scale, children are thought to be the most at risk of developing typhoid fever. This is because their immune system, which is the body’s natural defence against infection and illness, is still developing. However, children with typhoid fever tend to have milder symptoms than adults with the disease.
Symptoms of Typhoid Fever
Early symptoms of the disease include fever, general ill-feeling, and abdominal pain. A high fever of about 103°F, or 39.5°C or higher and severe diarrhoea occur as the disease gets worse. Other symptoms include severe fatigue, headache, nausea, loss of appetite, and cough. Some patients also experience red rashes, while in severe cases, serious complications and even death will occur.
Treatment
A medical doctor, Meredith Goodwin, noted that the most effective way to treat typhoid fever is with antibiotics. Commonly used antibiotics are ciprofloxacin (Cipro) for non-pregnant people. Other antibiotics that can be administered include chloramphenicol (Chloromycetin), ampicillin (Ampi, Omnipen, Penglobe, and Principen), and sulfamethoxazole/trimethoprim (Bactrim). Pregnant women are advised to avoid using chloramphenicol.
It is also very important to note that even when typhoid symptoms go away, people may still be carrying typhoid bacteria, which means that they can spread it to others, through the shedding of bacteria in their faeces.
When undergoing treatment for the disease, patients are to ensure that they take prescribed antibiotics for as long as the doctor has prescribed. It is also essential to wash hands with soap and water after using the bathroom and avoid preparing or serving food for other people as this will lower the chance of passing the infection on to someone else. Also, such patients should have themselves tested after treatment to ensure that no Salmonella Typhi bacteria remain in their bodies.
Prevention
Typhoid fever can be prevented by practising safe eating and drinking habits when in places with poor sanitation and clean water.
The practice of washing hands thoroughly with soap and water, especially after using the bathroom and before preparing food or eating is also essential to the disease’s prevention. Hand sanitisers with at least 60% alcohol can be used if soap and water are not available.
Another important way to prevent typhoid fever is to drink bottled and canned carbonated water. In cases where this is not available, water can be boiled for at least 1 minute before using it.
People should also consume only well-cooked foods that are still hot and steaming. Avoiding raw vegetables and fruits that cannot be peeled is vital as vegetables like lettuce and other greens can stay contaminated even after washing. Food and drinks from street vendors unless they are steaming hot should also be avoided.
Typhoid Vaccination
Typhoid fever can also be prevented through vaccination. Typhoid vaccines are safe and effective, and they can significantly reduce a person’s risk of contracting the disease. There are two major types of these vaccines.
Live Attenuated Vaccine: This vaccine type contains a weakened form of the typhoid bacteria and it is administered orally in four doses over a period of two weeks. It is highly effective and can prevent the disease for up to three years.
Inactivated vaccine: This type contains killed typhoid bacteria administered intramuscularly in a single dose. It is moderately effective and can prevent the disease for up to two years.
Individuals like travellers, healthcare workers and those with weakened immune systems are recommended to get vaccinated against typhoid fever.
In Nigeria, typhoid fever is a common disease and a significant public health challenge, affecting millions of people yearly. To address the burden, a multifaceted approach is required. These approaches include:
– Improving sanitation and water supply
– Promoting food safety and hygiene
– Expanding vaccination programs
– Strengthening healthcare systems
– Community engagement and awareness
By addressing these pressing issues and implementing effective prevention strategies, typhoid fever can significantly be reduced and the health and well-being of citizens improved.