Understanding and Treating Typhoid

Understanding and Treating Typhoid

Healt Vault with ASP Chidera.


  • According to World Health Organization, an estimate of 11-20 million people get infected with typhoid; and between 128,000 and 161,000 people die from it yearly.


  • Two vaccines have been used for many years to prevent typhoid; Ty21a vaccine (oral) and polysaccharide vaccine (injectable).
  • There is a higher risk of typhoid infection in areas/communities that lack access to clean and safe water and adequate sanitation.
  • Poor communities and children are at the highest risk for typhoid infection.
  • Complicated typhoid fever, seen after the late second of third week can cause organ infections by bacterial seeding.
  • Typhoid Mary: Mary Mallon (1869-1938) was the first person identified as an asymptomatic typhoid carrier, who infected about 53 people with three confirmed deaths, without having any symptoms of the disease herself.
  • In 1922, a New Yorker, Tony Labella, a food worker reportedly caused two outbreaks that combined for more than 100 cases and five deaths; he was considered that most lethal carrier of typhoid.

Typhoid fever is a disease caused by Salmonella Typhi  bacteria, and can only be passed from human to human. The disease is more prevalent in developing countries and a serious health threat, especially to children.

In the 1930s, typhoid was sometimes confused with other diseases like malaria and yellow fever; this made diagnosing the disease very difficult.

The history of typhoid dates back 430BC in Athens where it was believed that typhoid fever was responsible for the widespread plague at the time, which proved fatal for one-third of the population. Similarly, in Jamestown, an English colony in Virginia, was believed to have been wiped out as a result of typhoid, which proved fatal for about 6,000 settler between 1607 and 1624, eliminating the entire colony.

History also has it that about 80,000 soldiers died as a result of typhoid during the American civil war. Generally, military and war environment are usually subjected to the presence of typhoid fever.

The history of typhoid cannot be without the most notorious typhoid carrier; Mary Mallon ‘Typhoid Mary’ (September 23, 1869 – November 11, 1938) emigrated to the United States of America from Ireland, and was identified as the first asymptomatic typhoid carrier, who infected about 53 people with three deaths without having any symptoms herself. She worked as a cook to many wealthy Americans and transmitted the disease through that means. She was isolated for about 26 years of her life, first that she was born with for three years and later 23 years, she however died in isolation from stroke. It was presumed that she was born with typhoid, because her mother was infected during pregnancy.

Typhoid fever is caused by Salmonella Typhi bacterium.


Typhoid is transmitted via any of the following means;

  • Through oral-fecal route
  • Through the ingestion of contaminated food or water.
  • By eating unwashed or raw fruits and vegetables fertilized by human excreta and also through the consumption of contaminated milk and milk products.


  • Poor sanitation
  • Contact with infected persons
  • Crowded places
  • Working in the health sector
  • Travel to developing/endemic places
  • Poor hygiene
  • Proximity to insects that feed on fecal matter
  • Children are the highest risked


The symptoms of typhoid vary from mild to severe and usually begin between 6 to 30 days of exposure. These symptoms may include;

  • Prolonged/high fever
  • Nausea
  • Headaches
  • Vomiting
  • Abdominal pain
  • Rashes
  • Diarrhea
  • Loss of appetite
  • Weight loss
  • Fatigue
  • Muscle aches
  • Sweating
  • Dry cough
  • Swollen stomach
  • Difficulty in breathing
  • Pale skin

In a case of severity, an infected person may become delirious.


Typhoid if left untreated for a prolonged period of time, may result to the following complications;

  • Delirium
  • Endocarditis
  • Intestinal Bleeding
  • Pneumonia
  • Inflammation of heart muscles
  • Kidney or bladder infections
  • Bronchitis
  • Encephalitis
  • Hemorrhage
  • Peritonitis
  • Death (if left untreated, the risk of death is about 20%)


If diagnosed with typhoid fever, it is advisable to visit a licensed healthcare provider for proper medication, nutrition and care. However, antibiotic therapy has proven to be effective for the treatment of typhoid; commonly used antibiotics as prescribed by a medical professional includes;

  • Ciprofloxacin
  • Azithromycin
  • Ceftriaxone

In the case of prolonged typhoid fever, drinking of fluids or the use of intravenous fluids and surgery in the case of intestinal perforation.


  • Drink safe and clean water
  • Maintain adequate sanitation and proper hygiene
  • Avoid eating food outside
  • Increase your fruit intake
  • Wash thoroughly fruits and vegetables before consumption
  • Always wash your hands
  • Get typhoid vaccination (the two typhoid vaccines licensed for use for the prevention of typhoid are (a) the live, oral Ty21a and (b) the injectable typhoid polysaccharide vaccine).


  • In times of war, soldiers however sensible, care a great deal more on some occasions about slaking their thirst than about the danger of enteric fever. Better known as typhoid, the disease is often spread by drinking contaminated water.

Winston Churchill

  • Typhoid and swans – it all comes from the same place.

                                                                                       Thomas Harris


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