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Typhoid fever, also known as typhoid,is a common worldwide bacterial disease, transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella typhi, serotype Typhi. The disease has received various names, such as gastric fever, abdominal typhus, infantile remittant fever, slow fever, nervous fever or pythogenic fever. The name "typhoid" means "resembling typhus" and comes from the neuropsychiatric symptoms common to typhoid and typhus.Despite this similarity of their names, typhoid fever and typhus are distinct diseases and are caused by different species of bacteria


Classically, the course of untreated typhoid fever is divided into four individual stages, each lasting approximately one week.

In the first week, the temperature rises slowly and fever fluctuations are

seen with relative bradycardia, malaise, headache, and cough. A bloody nose (epistaxis) is seen in a quarter of cases and abdominal pain is also possible. There is leukopenia, a decrease in the number of circulating white blood cells,a positive reaction and blood cultures are positive for Salmonella typhi or paratyphi. in plateau around 40 C (104 F) and bradycardia (sphygmothermic dissociation), classically with a dicrotic pulse wave. Delirium is frequent, frequently calm, but sometimes agitated. This delirium gives to typhoid the nickname of "nervous fever". Rose spots appear on the lower chest and abdomen in around a third of patients. There are rhonchi in lung bases. where borborygmi can be heard. Diarrhea can occur in this stage: six to eight stools in a day, green with a characteristic smell, comparable to pea soup. However, constipation is also frequent. The spleen and liver are enlarged (hepatosplenomegaly) and tender, and there is elevation of liver transaminases. The Widal test is strongly positive with antiO and antiH antibodies. Blood cultures are sometimes still positive at this stage. (The major symptom of this fever is that the fever usually rises in the afternoon up to the first and second week.)

In the second week of the infection, the patient lies prostrate with high fever

The abdomen is distended and painful in the right lower quadrant

Symptoms include:

Sudden onset of fever Severe headache Nausea Abdominal pain Loss of appetite Constipation or diarrhoea

poor hygiene habits and public sanitation conditions, and sometimes also by flying insects feeding on feces. You can get typhoid fever if you eat food or drink beverages that have been handled by a person who is shedding Salmonella Typhi or if sewage contaminated with Salmonella Typhi bacteria gets into the water you use for drinking or washing food Public education campaigns encouraging people to wash their hands after defecating and before handling food are an important component in controlling spread of the disease.

Diagnosis is made by any blood, bone marrow or stool cultures and with the Widal test (demonstration of salmonella antibodies against antigens O-somatic and Hflagellar). In epidemics and less wealthy countries, after excluding malaria, dysentery or pneumonia, a therapeutic trial time with chloramphenicol is generally undertaken while awaiting the results of Widal test and cultures of the blood and stool.

The term "enteric fever" is a collective term that refers to typhoid and

Avoid risky foods and drinks. Get vaccinated against typhoid fever. Sanitation and hygiene are the critical measures that can be taken to prevent typhoid.


If you drink water, buy it bottled or bring it to a rolling boil for 1 minute before you drink it. Bottled carbonated water is safer than uncarbonated water. Ask for drinks without ice unless the ice is made from bottled or boiled water. Avoid popsicles and flavored ices that may have been made with contaminated water. Eat foods that have been thoroughly cooked and that are still hot and steaming. Avoid raw vegetables and fruits that cannot be peeled. Vegetables like lettuce are easily contaminated and are very hard to wash well. When you eat raw fruit or vegetables that can be peeled, peel them yourself. (Wash your hands with soap first.) Do not eat the peelings. Avoid foods and beverages from street vendors. It is difficult for food to be kept clean on the street, and many travelers get sick from food bought from street vendors.

Remember that you will need to complete your vaccination at least 1-2 weeks (dependent upon vaccine type) before you travel so that the vaccine has time to take effect. Typhoid vaccines lose effectiveness after several years; if you were vaccinated in the past, check with your doctor to see if it is time for a booster vaccination. Taking antibiotics will not prevent typhoid fever; they only help treat it.





Time immunization should be completed by (before possible exposure)

1 week

Minimum Age For Vaccinatio n

Ty21a (Vivotif Berna, Swiss Serum and Vaccine Institute) ViCPS (Typhim Vi, Pasteur Merieux)

1 capsule by mouth

2 days

6 years

5 years



2 weeks

2 years

2 years


oral rehydration therapy fluoroquinolone / ciprofloxacin . Antibiotics, such as ampicillin, chloramphenicol, trimethoprimsulfamethoxazole, amoxicillin and ciprofloxacin