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Typhoid fever

Introduction
Typically transmitted through tainted food and water, typhoid fever is a bacterial infection caused by Salmonella Typhi. Millions of cases are recorded every year, making it a serious public health issue in underdeveloped nations.

Epidemiology
Around the world, typhoid disease is endemic, especially in places with inadequate hygienic conditions. The World Health Organization (WHO) estimates that there are about 21 million cases and 200,000 fatalities per year.

Causative Agent
The causative agent of typhoid fever is Salmonella Typhi (S. Typhi), a gram-negative bacterium.

Incubation Period
Typhoid fever normally incubates for 10–14 days, though it can take anywhere from 3–21 days.

Reservoir
Humans are the natural reservoir of S. Typhi.

Reservoir Infection
The reservoir of infection is usually a person who is a chronic carrier of the bacteria, often with no symptoms.

Mode of Transmission
Typhoid fever is transmitted through the fecal-oral route,

  • Consuming contaminated food and water
  • Direct contact with an infected person
  • Raw fruits and vegetables washed in contaminated water

Period of Communicability
A person with typhoid fever can transmit the infection from 1-2 weeks before symptoms appear to 3-4 weeks after.

Susceptibility and Resistance
Anyone can get typhoid fever, but those with weakened immune systems are more susceptible. Antibiotics are effective against S. Typhi, but resistance is increasing.

Standard Case Definition
A suspected case is defined as a person with a fever > 38°C (100.4°F) and one or more of the following:

  • Headache
  • Muscle aches
  • Diarrhea or constipation
  • Abdominal pain

A confirmed case is defined as a suspected case with a positive culture or serology for S. Typhi.

Susceptibility Case
A susceptibility case is a person who has been exposed to S. Typhi and is at risk of developing the infection.

Confirmed Case
A confirmed case is a person with a laboratory-confirmed infection with S. Typhi.

Clinical Manifestation

  • Fever
  • Headache
  • Muscle aches
  • Diarrhea or constipation
  • Abdominal pain
  • Rash

Control

  • Improving sanitation and hygiene
  • Vaccination
  • Water treatment
  • Food handling and preparation guidelines

Prevention

  • Drinking safe water
  • Eating properly cooked food
  • Avoiding raw fruits and vegetables
  • Washing hands regularly

Treatment
Treatment includes antibiotics, usually ceftriaxone or ciprofloxacin, and supportive care, such as fluids and rest.

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