Symptoms
After an incubation period of 7-14 (up to 60) days, the following symptoms appear, initially resembling influenza:
- Fever
- Headache
- Irritative cough
- Feeling sick, tiredness
- Muscle pain
- Abdominal pain, diarrhea in adults, constipation in children.
- Rash on the abdomen and chest.
- Swelling of the spleen and liver
- Slow pulse
There are numerous known possible complications. Among the most important are bleeding in the digestive tract (up to 10%), dangerous intestinal perforation and encephalopathy. A milder relapse often occurs 2-3 weeks after healing. In the indigenous population, typhoid fever occurs mostly in children and young adults who are not yet immune. The disease is a health problem in many developing countries and causes deaths worldwide. Most cases are reported in India (South Asia) and Southeast Asia. In Europe, typhoid fever has become rare due to good hygienic conditions and is mainly relevant for travel medicine.
Causes
The disease is caused by the gram-negative bacterium serotype, a highly virulent and invasive pathogen of the enterobacteria family. Humans represent the only reservoir. The bacteria are ingested orally and first enter the intestine, where they penetrate the mucosa. From the intestine, they spread to various organs and can colonize the liver, spleen, bone marrow, gallbladder, and terminal small intestine, among other organs.
Transmission
The bacteria are most commonly transmitted through fecal or urine-contaminated food and water. Infected individuals excrete the bacterium, and asymptomatic carriers can carry it for months to more than a year, spreading it further (Typhoid Mary). The infectious dose is 1000 to 1 million germs.
Diagnosis
Diagnosis is made by laboratory methods. Diagnosis based on nonspecific symptoms is difficult because numerous other diseases cause similar clinical pictures. For example, possible differential diagnoses include malaria, dengue, a cold, or influenza.
Treatment
Typhoid fever is treated with antibiotics, bed rest, and symptomatic treatment. One problem is the large number of travelers. The former standard drugs such as chloramphenicol, trimethoprim, sulfamethoxazole, and amoxicillin (ampicillin) are now often ineffective. Currently, quinolones, 3rd generation cephalosporins such as cefixime or ceftriaxone, and azithromycin are used.
Prevention
For prevention, a vaccine is available see Typhoid vaccination.
- Careful handling of water and food: “boil it, peel it, or forget it”.
- Boil water
- Boil food well
- Wash hands well on a regular basis