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Typhoid fever

Alternative NamesEnteric fever

Causes

The bacteria that cause typhoid fever -- S. typhi -- spread through contaminated food,

drink, or water. If you eat or drink something that is contaminated, the bacteria enter your

body. They travel into your intestines, and then into your bloodstream, where they can

get to your lymph nodes, gallbladder, liver, spleen, and other parts of your body.

A few people can become carriers of S. typhi and continue to release the bacteria in their

stools for years, spreading the disease.

Typhoid fever is common in developing countries, but fewer than 4 cases are reported

in the !.S. each year. "ost cases in the !.S. are brought in from other countries where

typhoid fever is common.

Symptoms

#arly symptoms include fever, general ill-feeling, and abdominal pain. A high $typically

over %& degrees 'ahrenheit( fever and severe diarrhea occur as the disease gets worse.

Some people with typhoid fever develop a rash called )rose spots,) which are small red

spots on the abdomen and chest.

*ther symptoms that occur include+ Abdominal tenderness

Agitation

loody stools

hills

onfusion

ifficulty paying attention

$attention deficit(

elirium

'luctuating mood

/allucinations

0osebleeds

Severe fatigue

Slow, sluggish, lethargic feeling

1eakness

Exams and Tests

A complete blood count $( will show a high number of white blood cells.

A blood culture during the first week of the fever can show S. typhi bacteria.*ther tests that can help diagnose this condition include+

'luorescent antibody study to look for substances that are specific to Typhoid bacteria

Stool culture

Treatment

'luids and electrolytes may be given through a vein $intravenously(, or you may be asked

to drink uncontaminated water with electrolyte packets.

Appropriate antibiotics are given to kill the bacteria. There are increasing rates of

antibiotic resistance throughout the world, so your health care provider will check current

recommendations before choosing an antibiotic.

Prevention

Wash hands frequently2 It is important to wash your hands often with warm water and

soap, especially before eating and after using the bathroom.

3 Refrain from drinking untreated water 2 rinking contaminated water is one of theprimary causes linked to typhoid fever. It is advisable to boil water before drinking it.

Avoid swallowing contaminated water.2 Aside from drinking, contaminated water can be

ingested when brushing your teeth or taking a bath.

Avoid eating raw fruits and vegetables. 2 If there is a possibility that the water is

contaminated then it is advisable to avoid eating raw fruits and vegetables.

3 /eat food before eating. 2 It is not advisable to serve or eat food that has been stored at

room temperature.

Avoid eating street food. 2 efrain from buying food from street vendors.

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MalariaCause

"alaria is caused by 5lasmodium parasites.

There are four parasite species that cause malaria in humans+

5lasmodium falciparum

5lasmodium viva6

5lasmodium malariae

5lasmodium ovale.

5lasmodium falciparum and5lasmodium viva6 are the most

common. 5lasmodium

falciparum is the most deadly.

In recent years, some human

cases of malaria have also

occurred with 5lasmodiumknowlesi 2

Transmission

"alaria is transmitted e6clusively through the bites of Anopheles mos7uitoes.

Symptoms

"alaria is an acute febrile illness. In a non-immune individual, symptoms appear seven

days or more $usually %2%8 days( after the infective mos7uito bite. The first symptoms 2

fever, headache, chills and vomiting 2 may be mild and difficult to recogni9e as malaria.

If not treated within :4 hours, 5. falciparum malaria can progress to severe illness often

leading to death. hildren with severe malaria fre7uently develop one or more of the

following symptoms+ severe anaemia, respiratory distress in relation to metabolicacidosis, or cerebral malaria. In adults, multi-organ involvement is also fre7uent. In

malaria endemic areas, persons may develop partial immunity, allowing asymptomatic

infections to occur.

'or both 5. viva6 and 5. ovale, clinical relapses may occur weeks to months after the first

infection, even if the patient has left the malarious area. These new episodes arise fromdormant liver forms known as hypno9oites $absent in 5. falciparum and 5. malariae(;

special treatment 2 targeted at these liver stages 2 is re7uired for a complete cure.

Who is at risk?

young childrenin stable transmission areas who have not yet developed protective

immunity against the most severe forms of the disease;

non-immune pregnant womenas malaria causes high rates of miscarriage and can lead

to maternal death;

semi-immune pregnant womenin areas of high transmission. "alaria can result in

miscarriage and low birth weight, especially during first and second pregnancies;

semi-immune !"-in#ected pregnant womenin stable transmission areas, during all

pregnancies. 1omen with malaria infection of the placenta also have a higher risk ofpassing /I< infection to their newborns;

people with !"$%!&S;

international travellers #rom non-endemic areasbecause they lack immunity;

immigrants #rom endemic areas and their children

Diagnosis and treatment

The best available treatment, particularly for 5. falciparum malaria, is artemisinin-based

combination therapy $AT(.

Prevention