Typhoid fever is a sudden onset, or acute, febrile bacterial infection. It is transmitted through the ingestion of food or water that has been contaminated with the bacterium Salmonella typhi . Although common in the developing world, typhoid affects only 1 in 3,000 travellers to developing countries with the risk greatest for travellers to sub-Saharan Africa, India, Nepal, Indonesia and parts of Latin America. Without treatment the illness can be fatal, with perforation of the gut producing peritonitis or severe bleeding. With appropriate antibiotic therapy the fatality rate reduces to 1% (from 10 – 30 % in untreated cases.) Paratyphoid fever is a similar, but usually less severe, condition. Some people become chronic carriers and continue to shed the bacteria in the faeces without experiencing symptoms.
This is by ingesting food or water contaminated by the typhoid bacterium: contamination is most likely when cooked food is handled or left un-refrigerated. The bacteria enter the blood stream from the intestinal wall lining after ingestion of contaminated food or water.
7 to 14 days (range 3 to 60).
This is by laboratory tests to find the typhoid bacteria in the blood or faeces of an infected person. Illness is usually characterised by fever, loss of appetite, lethargy and change in bowel habit. Constipation is common in the initial stages of the disease but diarrhoea can also occur.
This is with antibiotics for 10 to 14 days.
Simple food and water precautions. Wash hands with soap and water after going to the toilet; avoid risky foods ( particularly raw fruit and vegetables ) and drinks.
Remember the adage:
COOK IT, BOIL IT, PEEL IT OR AVOID IT!!
Here Are 5 Top Tips that will help do this:
Drink bottled, purified or carbonated water for drinking and cleaning teeth. Make sure that bought bottled water is appropriately sealed; regular water ( at sea level ) should be brought to boiling point for one minute before it is safe to drink.
Avoid ice in drinks and remember that refreshing ice blocks and flavoured ices may be made with contaminated water.
Foods should be thoroughly cooked and served piping hot. Be very wary of food sold by street vendors!
Avoid raw seafood and shellfish; even though they may have been preserved with vinegar, lemon or lime juice.
Choose raw vegetables and fruits that you can peel yourself. Avoid salads unless they have been made by you! Do not forget to wash your hands with soap or hand cleanser first and do not eat the peelings!
The following are ‘High risk’ groups for developing Typhoid Fever:
travellers with individualistic lifestyle and those that are intending prolonged travel to areas where there is typhoid fever
former immigrants ( from developing countries ) visiting their parent countries
those with no acid ( or low concentrations of acid ) in their stomachs, such as post surgery or with the regular use of antacids and medication to reduce stomach acidity
those with severe or ongoing disease may need particular advice about Typhoid Fever and where the intended travel is to be
travellers to the Indian Subcontinent
medical personnel, foreign aid workers and military personnel assigned in developing countries
Travellers to endemic or epidemic area can reduce the chance of getting the disease by 70 – 90% with vaccines. Travellers should leave plenty of time for immunisation before they go. Typhoid vaccine (injectable or oral) is recommended for adults, and children over the age of two years, travelling in conditions of doubtful hygiene. The vaccination may not be expected to protect against 100% of susceptible bacteria. Breast-feeding is likely to protect infants. Children under 5 years of age may be more likely to have a mild illness of typhoid than older children.
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