Typhoid Fever
INTRODUCTION
Typ
hoid
Fever,
acute infectious disease caused by the typhoid bacillus Salmonella typhi.
The bacillus is transmitted by milk, water, or solid food contaminated by faeces
of typhoid victims or of carriers, that is, healthy people who harbour typhoid
bacilli without presenting symptoms.
SYMPTOMS AND
TREATMENT
The incubation
period of typhoid fever lasts one to three weeks. The bacteria collect in the
small intestine, from which they enter the bloodstream. This induces the first
symptoms, chills followed by high fever and prostration. Victims may also
experience headache, cough, vomiting, and diarrhoea. The disease spontaneously
subsides after several weeks in most instances, but in about 20 per cent of
untreated cases the disease progresses to pneumonia, intestinal haemorrhage, and
even death. Deaths from typhoid fever were greatly reduced by the isolation of
the first antibiotic effective against the typhoid bacillus, chloromycetin, or
chloramphenicol, derived from a South American mould in the late 1940s. This
drug, which is now made synthetically, is still the preferred treatment in most
cases. For infection with typhoid bacilli resistant to chloramphenicol or for
treatment of carriers, ampicillin is recommended.
CONTROL
Compulsory
inspection of milk and water supplies, and the pasteurization of milk in
particular, have greatly reduced the incidence of the typhoid bacilli. Of equal
importance in the control of typhoid fever has been the recognition of carriers
(who can then be prevented from handling food), and improvement of sewerage
facilities.
Another important
factor in the control of typhoid fever is typhoid inoculation of people exposed
to the disease, such as hospital employees and travellers to areas with poor
sanitary facilities.