Typhoid fever is a type of acute infectious illness associated with fever. It's most often caused by the bacteria known as Salmonella typhi. The faeces of the human bacteria carriers tend to contaminate the food or water. Then, the illnesses spread to other individuals in the area. Typhoid is more common in developing countries than in developed countries. 

Symptoms of typhoid fever 

Usually, the incubation period is one to two weeks. The illness duration is three to four weeks. The most common symptoms are: 

• Headaches 
• Poor appetite 
• Generalized aches and pains 
• Constant or high fever (can even reach 104 degrees Fahrenheit) 
• Lethargy 
• Constipation or diarrhea 
• Chest congestion 
• Discomfort and abdominal pain are both common. 

The ones without much complications show improvements in the third to fourth week. Nearly ten percent of people suffer recurrent symptoms after they feel better for at least a week or two. Actually, relapses are common in the ones under antibiotics.

Causes of typhoid fever 

People contract typhoid fever by eating or drinking the bacteria present in contaminated water or food. Those with acute illness tend to contaminate the surrounding water supplies through stool with a higher bacterial concentration. Now, the polluted water supply tends to affect the food supply. The bacteria tend to survive for weeks in dried sewage or water. 

Nearly three to five percent of people tend to become bacteria carriers after this acute illness. Others might suffer a mild illness that tends to go unrecognized. Some people have no evident symptoms but become long-term bacteria carriers. They remain the source of newer outbreaks for several years. 

Diagnosis of typhoid fever

There are two main ways to diagnose typhoid fever, and they are: 

• Travel and medical history

Your doctor will suspect typhoid fever based on your travel, medical history, and symptoms. Usually, the diagnosis is confirmed by identifying Salmonella typhi present in your blood culture or other tissues or body fluid. 

• Tissue or body fluid culture

For the body fluid culture, a sample of your urine, bone marrow, stool, or blood is put on a special medium that aids in bacterial growth. Then, the culture is put under a microscope to notice the presence of Salmonella typhi. Typically, the most sensitive test for Salmonella Typhi is a bone marrow culture. 

Though performing culture tests are the most common diagnosis, other tests might also help confirm a possible typhoid infection. Doctors might order tests to detect antibodies related to the bacteria in your body or check the typhoid DNA present in the blood. 

Treatment for typhoid fever 

Antibiotic therapy is an effective treatment for typhoid. Commonly prescribed antibiotics are 

Azithromycin (Zithromax): It is useful for ciprofloxacin-resistant bacteria or patients resistant to ciprofloxacin. 

Ceftriaxone: Ceftriaxone is an injectable antibiotic that is good for serious or more-complicated infections. It is also used for patients who aren't suitable for ciprofloxacin (like children). 

Vaccine against typhoid fever 

Vaccines can help in preventing typhoid. There are two types of vaccines used in this case: 

• Inactivated vaccine to be taken as a shot 
• Attenuated, live vaccine to be taken orally 

Who needs to get the typhoid vaccine? 

Routine vaccination for typhoid is not recommended in many countries, but the vaccine is highly recommended for: 

• The travelers to those cities where typhoid is common 
• The ones in close contact with a carrier of typhoid 
• Laboratory staff working closely with the Salmonella Typhi bacteria 

Inactivated typhoid vaccination through shots: 

A single dose offers protection. It needs to be administered at least two weeks before traveling to give time for the vaccine to work. The at-risk population needs a booster dose every two years. 

Live typhoid vaccine that is taken orally: 

• It involves four doses, whereby you need to take a capsule on alternate days of the week (for instance, Monday, Wednesday, Friday, and Sunday). The last dose is given a week before traveling so that the vaccine has time to work. 
• Each dose should be swallowed an hour before the meal with a lukewarm or cold drink. The capsule isn't supposed to be chewed. 
• A booster dose is required every five years for those at risk.  

Both types of vaccines can be safely administered simultaneously as the other vaccines. It is important to remember that the typhoid vaccine isn't 100 percent effective and isn't a substitute for remaining careful about what you drink or eat. Also, in case of fever, make sure to see a doctor if you have a constant high fever.