Typhoid fever is one of the great plagues throughout history and still is a major problem throughout the world -- especially in the Indian continent, Sub-Saharan Africa, and South America.
One of the problems in dealing with typhoid is that it develops slowly and the symptoms change over time. It begins with symptoms similar to influenza, so the temptation is to ride it out until symptoms subside. Unfortunately, it then progresses to a serious and potentially fatal disease.
Typhoid is derived from food contaminated by Salmonella typhi, a bacterium that spreads throughout the body and produces damaging toxins.
Once unsanitary food is eaten or water is drunk, incubation is about 10 days – but can be less or more.
The first symptom may be loose stools. Within a week or so, constipation may be more common, followed later by diarrhea. Sore throat with characteristic spots happens. Fever comes at this stage and is accompanied by severe headache and aching of muscles and bones. This is the stage which can be confused with influenza.
By two weeks, however, abdominal pain develops and can be severe. Pains can mimic appendicitis. Liver and spleen enlarge and become tender as the bacteria spread.Sometimes an abdominal rash occurs at this stage.
By the third week, severe diarrhea occurs with debilitating weakness. Mental effects include confusion, disorientation, and a classic typhoid muttering delirium. The headache is very severe, especially focused in the neck – resembling encephalitis. Inflammation in intestines lead to bloody stools and can result in perforation of the bowel and fatal infection. The delirium may result in seizures and actual coma.
If you survive all these sufferings, the body does get over the infection after four weeks or more. Many people do have one episode in young age, and then seem free of it for the rest of their life.
If left untreated, the death rate from typhoid is between 10 and 30%. This is even worse in children because of severe dehydration and collapse. It is this outcome that is seen in the world’s literature going back to ancient Greece, Rome, Egypt, and Europe during the Dark Ages.
Typhoid is a very serious ailment, and there are many serious complications. In late stages, brain inflammation (encephalitis) can damage brain function. Pneumonia is fairly common. Also, inflammation of the lining of the heart (myocarditis) can compromise heart function. Thus, typhoid can affect all the really vital organs.
In addition, abscesses may form in liver, spleen, and gallbladder. Acute arthritis and even inflammation of bone itself can happen.
Making a diagnosis is not easy but can be important in preventing dire consequences.
Stool culture usually fails in early stages. Once symptoms become more severe, blood cultures often become positive as the organism spreads through the body.
Bone marrow culture is the most reliable, but of course this is a painful procedure.
There are DNA tests that can detect Salmonella. And there is an old standard Widal test for detecting antigen; however this takes awhile to give a result.
Standard treatment involves antibiotics; after all, this is a bacterial infection. However, antibiotic resistance has spread throughout the world. Amoxicillin and Ampicillin are no longer useful. Azithromycin (Zithromycin) and ciprofloxacin (Cipro) are commonly used. Chloramphenicol can be a last resort, although this is a fairly toxic antibiotic.
As symptoms progress, intravenous and oral rehydration support are critical, especially in children. There are proprietary formulas on the market. You can make your own: ½ tsp salt and 1 tsp sugar in a large glass of water is the recipe.
An eRemedy from eremedyonline.com/module/16/typhoid/ can provide rapid relief based on the unique picture of symptoms occurring in the moment. If the first attempt fails, it is worth another try as the symptom picture changes over time.
When available, herbs can be helpful in mitigating some symptoms. Eucalyptus tincture and Echinacea tincture, taken 3 or 4 times a day, are the main ones to use.
Unfortunately, 3 to 5% of people who have either had typhoid or been exposed without getting a serious disease end up being carriers of the disease without having symptoms themselves. Because cultures are difficult to obtain, it can be hard to detect carriers.
Especially for travelers who have no immunity, there is a vaccine available in a two-shot protocol. It is 50-80% effective.
Chlorination of water has a powerful benefit in preventing water-borne transmission.
Food transmission is extremely common. The famous Typhoid Mary story involved a carrier who was a food handler. So frequent hand-washing is crucial, especially in food processing an restaurant settings.