How to avoid getting typhoid fever and what to do if it happens

Typhoid fever is a disease from the group of so-called intestinal infections (they also have a fecal-oral transmission mechanism). The disease is characterized by penetration of the pathogen into the blood (bacteremia), prolonged temperature reaction, general intoxication syndrome, specific ulcerative lesions of the small intestine, and disruption of the central and peripheral nervous system.

In practical healthcare, at the stage of preliminary diagnosis, that is, before receiving the results of a specific examination, the diagnosis of “typhoid fever” is usually replaced by the complex concept of “typhoid-paratyphoid disease”. Based on clinical symptoms and epidemiological features, it is almost impossible to distinguish between typhus itself and paratyphoid A, B, C. From the point of view of laboratory and instrumental examination, as well as treatment tactics of a particular patient, there are no special differences, therefore it is quite possible to make a specific diagnosis after a long time from the onset of the disease.

Typhoid fever was described as an independent disease only at the end of the 19th century by the Russian doctor S.P. Botkin, almost at the same time, isolated a pure culture and the causative agent of typhoid fever, which was named after the name of its discoverer - Ebert's bacillus.

How does infection occur?

The lice bite itself does not lead to infection. It occurs at the moment of scratching the skin, when the secretions left by lice are rubbed into the body. Typhoid is a disease with an incubation period of up to two weeks. Laboratory tests become positive only 7 days after infection.

The disease begins with chills, fever, severe headache and back pain. After a few days, a pink, spotted rash appears in the abdomen. The patient's consciousness begins to fog, speech becomes incoherent and hasty. Some people even sometimes fall into a coma. The temperature constantly remains at 40 degrees and drops sharply after 14 days. When typhoid epidemics occur, almost 50% of patients die.

Ways of transmission of the disease

Typhoid fever is an anthroponotic disease. A person can be a carrier of dangerous bacteria for a long time without having symptoms. There are three main routes of transmission of typhoid fever.

Methods of entry:

• Through contaminated water.
• When consuming contaminated products.
• From person to person.

In children, typhoid fever often occurs as a result of communicating with a sick child or when sharing toys and household items. Infection also occurs through contact with the same dishes, bedding, and household items. Typhoid fever is often transmitted by airborne droplets.

Water poisoning occurs when swimming in natural bodies of water. Often various waste and sewage waters are drained into them.

Raw milk can provoke the disease. In such a product, bacteria multiply quickly, and once they enter the body they disrupt the functioning of internal organs. It is recommended to remember that milk must undergo heat treatment, only after which it can be used for preparing other dishes.

Typhoid fever can develop after eating poor quality food. Flies can carry dangerous bacteria on their legs. It is required to follow the rules for preparing and storing food to avoid intoxication.

Medical history

The disease “typhoid fever” was discovered and introduced into the medical dictionary by the ancient Greek physician Hippocrates. Much later, Russian scientists discovered typhoid bacillus in the intestines of the dead. After this, the disease began to spread throughout the population.

The main causative agent of typhoid fever is Salmonella bacillus. This bacterium multiplies and actively manifests its vital activity on almost any surface and in any conditions. When bacteria are destroyed, a large number of harmful, harmful enzymes are released.

The bacterium can live in human feces for approximately 25 days, in human underwear for about 2 weeks, and in food for approximately one week. At very high temperatures, in particular, when boiling, absolutely all bacteria die.

The carrier of the infection is an infected person. It excretes typhoid bacteria in stool, urine and sweat. This is surprising, but bacteria that are dangerous to human life and health are found in large quantities in breast milk.

About 5% of patients who have had typhoid fever are carriers of the disease throughout their lives. Those patients who are directly related to food products can be dangerous to society.

Brill's disease

This is a relapse, it is a little easier to tolerate, but has all the manifestations of typhus. The causative agent is Provacek's rickettsia, whose properties are completely similar to epidemic typhus bacteria. The disease is named after the person who first described it. It is not epidemic, but is transmitted through lice.

It may reappear after the first disease decades later. Main symptoms: severe headache, hyperesthesia of feelings, clouding of mind. There is facial hyperemia, but weaker than with typhus. In some patients, doctors additionally find Rosenberg enanthema. This is a very profuse rash, but sometimes the disease occurs without it.

Typhoid classification

The disease in adults and children occurs in mild, moderate and severe forms. There are several forms of development of typhoid fever: the initial stage, the height of the disease, resolution and recovery. Several periods of the course of the disease are determined.

Periods:

1. Infection. During this period, the pathogen enters the human digestive system.
2. Primary regional reaction. At this stage, microorganisms penetrate into the lymph nodes and an inflammatory process develops.
3. Bacteremia. The pathogen enters the bloodstream, some die, releasing toxic substances.
4. Parenchymal dispersion of microbes. The functioning of internal organs is disrupted, and a characteristic rash appears on the skin.
5. Isolation of the pathogen. At this stage, pathogens are eliminated through natural waste.

In some cases, it is possible for the acute form of typhoid fever to become chronic. As a result, the recovered person continues to release dangerous bacteria into the environment.

What happens to the body?

What happens to an organism affected by typhoid fever? Bacteria initially penetrate the oral cavity, then into the intestines, where they begin to rapidly multiply. Further, as soon as there are a lot of bacteria, they pass into the patient’s bloodstream, provoking the occurrence of bacteremia.

As a result of the penetration of typhoid bacteria into the general bloodstream, a person begins to experience a pathological enlargement of the liver, lymph nodes, as well as the spleen and stomach.

On average, the incubation period ranges from several days to 3 weeks.

Epidemiological typhus

An infectious disease caused by Provacek's rickettsia. This is a classic transmissible anthroponosis. Infection occurs mainly from a person who suffers from typhus. Epidemic typhus is a type of typhus.

To treat this disease, tetracycline antibiotics are used, which should be taken up to 5 times a day. If the form of the disease is severe, chloramphenicol succinate is prescribed, taken 3 times a day. The causative agent of epidemic typhus is bacteria that infect body lice. Through them, infection occurs. Head lice are found in a smaller area than body lice, which is why the epidemic factor is limited.

Causes and symptoms of the disease

The main cause of typhoid fever is the penetration of dangerous bacteria into the body. The clinical picture consists of four stages. Each is characterized by the presence of certain symptoms.

initial stage

The incubation period of typhoid fever lasts up to two weeks, there are no symptoms, which poses a certain danger. After this period, some signs appear.

Signs:

• gradual increase in temperature to critical levels;
• chills;
• apathy, lethargy, lethargy;
• pale skin;
• low pressure;
• rare pulse;
• severe headaches;
• lack of appetite;
• gray coating on the tongue;
• swelling and redness of the throat;
• diarrhea;
• increased formation of gases.

The patient complains of pain in the abdomen. Within a week, the spleen and liver enlarge. If left untreated, the symptoms intensify and the disease moves to the next stage.

Peak infection stage

At this stage, typhoid fever reaches its peak. The symptoms become intense and the patient’s condition worsens. Immediate first aid and treatment of the disease is required. What is characteristic of the second phase of typhoid fever?

Symptoms:

• bloating, pain when pressing;
• brownish coating on the tongue, presence of teeth marks;
• intense diarrhea;
• heat;
• Strong headache;
• hallucinations and delusions;
• disturbance of consciousness;
• rash on the skin in the chest and abdomen;
• heart rhythm disturbance.

Often during the second phase, an inflammatory process occurs in the lungs. At this stage, the kidneys suffer and their functionality is impaired. The patient experiences a decrease in daily urine volume.

Resolution phase

At the third stage, there is a gradual decrease in temperature. The patient's general condition improves, unpleasant symptoms disappear. The victim's appetite is restored. The duration of this stage is a week.

Recovery phase

The human body gradually returns to normal, the pathogen is eliminated. The painful condition persists for some time, but after some time the patient fully recovers. With proper and timely treatment, the recovery process does not take long.

Relevance and geographical distribution

The highest level of annual incidence of typhoid fever is observed in regions with tropical and subtropical climates, as well as in countries with a low level of sanitary culture.

A significant reduction in the incidence of this infection on the territory of the USSR was achieved thanks to the strict implementation of all sanitary, hygienic and anti-epidemic measures. Currently, the incidence remains at a sporadic level (isolated cases of the disease among unrelated individuals); local outbreaks are extremely rarely recorded.

It should not be assumed that the world community is any closer to eliminating this infectious disease - in modern conditions this is impossible.

The following points contribute to the persistence of foci of typhoid infection and their periodic activation:

• lack of medical alertness - the diagnosis of typhoid infection is established at 3-4 weeks of illness;
• late request of the patient for qualified medical care;
• formation of resistance to traditional antibacterial agents (chloramphenicol and chloramphenicol succinate);
• untimely identification and not always adequate treatment of carriers (an active source of infection in typhoid fever);
• intensive migration of the population and high speed of movement from different parts of the planet (for example, a carrier of typhoid infection from India can end up in a European country within a few hours);
• the occurrence of natural and man-made disasters that lead to violation of sanitary and hygienic standards and activation of infectious agents.

Specific prevention of typhoid fever has been developed and applied, however, it is not a 100% effective means of protection against this infectious disease.

Symptoms and course of the disease

As mentioned above, the causative agent of epidemic typhus is Provacek's rickettsia. The disease begins very acutely. Within a few days the temperature rises to a critical level. The patient suffers from severe headaches, insomnia and incessant vomiting. Some may experience mental and neurological disorders, when consciousness darkens and even euphoria appears.

The skin of a sick person is hyperemic, and heart function is disrupted from the first days. Typhus often causes hypotension, tachycardia, and irregular heart rhythms. Upon examination, an enlarged spleen and liver are revealed. Sometimes there are problems with urination, liquid comes out drop by drop, with severe pain.

On the fifth day of illness, a rash appears on the body, mainly on the sides and limbs. With a more severe course of the disease, rashes can be observed on the face and neck. Sometimes there are complications in the form of meningitis. If you begin to treat epidemic typhus immediately, without wasting precious time, then it will completely disappear within two weeks.

Divided into several periods. Initially, in the first week, intoxication manifests itself progressively. Typhoid fever symptoms during this period are as follows: the skin turns pale, weakness appears, the headache intensifies, a significant or complete decrease in appetite occurs, and bradycardia begins. A pale coating is visible on the tongue, constipation or diarrhea is tormented.

The height of the disease occurs on the tenth day. The temperature is high and does not decrease, intoxication is pronounced. There is lethargy, irritability, and a pale pink rash appears in the form of roseolae protruding above the skin. It appears on the stomach, chest, side of the body, and on the bends of the limbs. The heart beats dullly, hypotension and bradycardia begin.

After the disease begins to recede, the temperature drops sharply. The recovering person has a good appetite, sleep is restored, weakness disappears, and overall health improves greatly.

The period of convalescence is dangerous with relapses, which can occur in 10% of patients. Precursors: the spleen and liver do not normalize, appetite weakens, weakness returns, and general malaise increases again. Clinical manifestations are the same as the course of the underlying disease, but shorter in duration.

Typhoid fever can be mild, moderate or severe. There are also two atypical ones - erased and abortive. They occur more often now, due to the use of antibiotics in treatment and the use of immunoprophylaxis. The fever lasts for a week, but can last three days. Often the onset of the disease is very acute, and serological reactions can be negative throughout the course of the disease.

Diagnostics [ edit | edit code ]

Laboratory diagnostics primarily consists of bacteriological examination of blood, feces, urine, and bile. The blood culture method can be used from the first days of the disease until the end of the febrile period, preferably before the start of treatment. To do this, 5-10 ml of blood from the cubital vein at the patient’s bedside is inoculated into 20% bile broth or Rapoport’s medium, meat-peptone broth with 1% glucose, or even into sterile distilled water. The volume of the medium is 50-100 ml. The ratio of material and medium should be 1:10. Feces, urine, duodenal contents are examined from the 2nd week from the onset of the disease, inoculating on Ploskirev, Levin, Muller, etc. media. The preliminary result of these studies is obtained after 2 days, the final result - after 4 days.

To detect typhoid bacillus in feces, urine, and duodenal contents, RIF with labeled sera to O- and Vi-antigens is used. A preliminary answer can be received within 1 hour, a final answer in 5-20 hours.

Serological methods include RA (Vidal) and RPHA with cysteine. The Widal reaction is performed with H- and O-antigens from the 7-9th day of the disease and repeated at the 3-4th week to determine the increase in titer (from 1:200 to 1:400-1:800-1:1600). The latter is important for excluding a positive reaction result, which may be due to previous immunization against typhoid fever. The answer can be obtained in 18-20 hours. When setting up RPGA, the results are taken into account after incubating the plates at 37 ° C for 1.5-2 hours and again after 24 hours at room temperature. A reaction with a titer of 1:40 or higher is considered positive.

How to detect typhus

It is very difficult to make a correct diagnosis in the first days of the disease, since the symptoms are similar to those of other diseases. For correct diagnosis, test results are needed to help determine the disease. Typhus may initially resemble syphilis, influenza, measles, pneumonia and a number of other ailments.

After 5-6 days, the diagnosis can be made more confidently, based on the nature of the rashes and the timing of their appearance, facial hyperemia, changes in the nervous system and a number of other indicators. Doctors also carefully study blood tests.

Laboratory tests are then carried out to identify typhoid bacteria. Serological tests detect the presence of parasites in the blood and confirm an accurate diagnosis. All this time, complex therapy is applied to the person, which helps relieve symptoms. Targeted drugs against typhus are prescribed only after doctors are sure that the patient has this particular disease.

What to do if you become infected with typhoid fever

If you suspect you have typhoid fever, contact your doctor immediately. The best thing is to call a doctor at home. The doctor will conduct an examination and clarify the symptoms. Don't forget to tell him if you've recently returned from a trip.

To confirm typhoid fever, they will take a blood, stool or urine test to look for Salmonella Typhi bacteria. If the diagnosis is confirmed, you will be hospitalized in an infectious diseases hospital.

Typhoid fever can be successfully treated with antibiotics. There are many options, the doctor will choose the one that will be most effective in your case. You will also likely be given an IV to help cope with dehydration, which will almost certainly occur due to prolonged fever and diarrhea.

If you seek help in time, you will feel better within a couple of days. However, you will not be discharged from the hospital earlier than after 21 days. Typhoid fever (infection caused by Salmonella Typhi) in adults. Clinical recommendations. after the temperature subsides. And only if several tests show that there are no more Salmonella Typhi bacteria in the body.

If the disease has gone far and caused complications, they will also need to be treated. How and for how long the therapy will take depends on which organs are affected.

Pathogen carrier

Recently cured patients are considered to be carriers of the bacilli. After recovery, a person remains infectious to others for a long time.

Vaccinated people are also carriers of the harmful microorganism.

In rare cases, the disease is hidden. The patient does not have severe symptoms. Treatment is carried out at home, without going to doctors and aggravating the general condition. As a result, family members and other people get sick. Most often, infection occurs through food and common household items.

Treatment

Treatment of all patients with typhoid fever is carried out in an inpatient hospital setting. First, a person must change his diet; food should be very soft and gentle. As a rule, all patients are prescribed diet No. 4. You need to drink plenty of liquid with your food.

You will need to stay in bed so that your abdominal muscles do not strain again. The diet and bed rest last for about a month.

Drug treatment consists of taking levomethicin as prescribed by a doctor and apyrexin. If the patient’s health is poor, then he is prescribed levomecithin-succinate.

Since typhoid bacilli become resistant to treatment with levomecithin, it is possible to prescribe azithromycin, ceftriaxone, ciprofloxacin. For gastric bleeding, a solution of aminocaproic acid is prescribed.

Prevention of epidemic typhus

Tetracycline antibiotics are considered the main drugs. If a person is intolerant to them, then the drug “Levomycetin” is used. The drug “Tetracycline” is prescribed more often. Taken orally 4 times a day. If the disease is severe, then for the first two days intravenous or intramuscular injections of chloramphenicol sodium succinate are given 3 times a day.

When the body temperature becomes normal, the medicine is taken in the usual dosage. Sometimes complications may arise due to the use of antibiotics. It occurs as a layering of a second disease, such as pneumonia. In this case, additional medications are prescribed.

Causal therapy usually gives a very rapid effect, and as a result, vaccine therapy and long-term oxygen therapy are not required. Vitamins are used as pathogenetic drugs. Mostly ascorbic acid and vasoconstrictor drugs are prescribed.

Typhoid is a disease that can cause serious complications. They are especially common in older people who have reduced immunity. They are additionally prescribed anticoagulants. They prevent the development of thrombohemorrhagic syndrome. Heparin is considered the most effective of these drugs. Elderly people need to take it as soon as an accurate diagnosis is established. The duration of taking such medications is from three to five days.

The causes of diseases lie in lice, so you need to start fighting them. It is advisable to prevent their appearance at all. Early diagnosis is also important. It is necessary to isolate the patient in time and, if possible, hospitalize. In the hospital, he must undergo thorough sanitary treatment. Clothes are disinfected.

For prophylaxis, a formaldehyde-inactivated typhoid vaccine containing dead Provacek's rickettsia is used. Now, thanks to timely and high-quality treatment and prevention of typhus, vaccination is no longer required on a large scale. The incidence has decreased significantly.

If a disease is detected, the patient is immediately hospitalized. Treatment is carried out in the infectious diseases department, isolating the patient from others. Antibacterial drugs active against salmonella are used for therapy. Sulfaniamides and cephalosporins are also used for treatment. Also includes other drugs.

Preparations:

1. chloramphenicol;
2. ibuprofen;
3. loperamide;
4. imodium;
5. paracetamol;
6. Ringer's solution;
7. saline solution and others.

Detoxification solutions are administered intravenously to cleanse the blood and lymph. If necessary, surgical intervention is performed.

During treatment, proper nutrition and bed rest are required. During the recovery process, vitamin complexes are selected. Treatment continues for at least four weeks.

Typhoid fever can be avoided by following preventive measures. It is recommended to maintain good hygiene and not drink contaminated water or spoiled food. Vaccination is recommended if necessary. Epidemiological surveillance is also important.

Typhoid fever is a dangerous infectious disease that is quickly transmitted from a sick person to a healthy person. Following the rules of prevention will help avoid infection. When the first signs appear, you need to contact a medical facility.

The contact route of transmission of infection is...

Contact transmission of infection is, as the name suggests, the spread of an infectious agent through direct contact. It can be carried out by several mechanisms:

• Contact with a sick person (natural smallpox, chickenpox, measles, scarlet fever, mumps, Botkin's disease, etc.). Therefore, it is prohibited to enter an apartment where there are sick people.
• Infection from bacilli carriers. The causative agents of some infectious diseases (typhoid fever, diphtheria, scarlet fever) continue to live in the body of a recovered person for a long time. Bacilli carriers can also be people who have not had this infectious disease, but carry its causative agent, for example, during a diphtheria epidemic, up to 7% of healthy schoolchildren have diphtheria bacilli in their throats or noses. Bacilli carriers are distributors of pathogens.

Diagnosis of the disease and complications

To select the most appropriate treatment, a thorough diagnosis is carried out. The medical worker talks with the patient and identifies complaints. In the future, specific examinations are prescribed.

Research:

1. General blood and urine tests.
2. Bacteriological blood culture for sterility.
3. Determination of the presence of antibodies to salmonella.

The abdomen is palpated to determine the condition of the liver and other organs. If necessary, the doctor will prescribe additional tests. It is necessary to differentiate typhoid fever from similar diseases (dysentery, salmonellosis). After all examinations, treatment is prescribed.

Irritation, a feeling of sand in the eyes, redness are only minor inconveniences with impaired vision. Scientists have proven that vision loss in 92% of cases ends in blindness. Crystal Eyes is the best way to restore vision at any age.

Typhoid fever is a dangerous disease that can lead to serious complications. In the absence of proper treatment, the functioning of internal organs is gradually disrupted. There are several of the most dangerous complications.

Consequences:

• toxic shock;
• perforation of the small intestine;
• bleeding in the intestines.

The latter complication is often asymptomatic and is detected only after specific examinations in a medical institution. Typhoid fever can cause death. Therefore, treatment must be started on time.

Exodus

Death from typhoid fever can be caused by a severe pathological process. This is especially true for intestinal perforation. If proper assistance is not provided, the outcome is unfavorable.

Recovery is possible. But subject to timely treatment. Much depends on the age of the patient. Children can develop lasting immunity.

The outcome also depends on compliance with bed rest. Patient care is also important. Since the outcome of the disease can be bedsores. Bedsores develop as a result of improper care.

Endemic typhus

An acute infectious disease caused by Muzer's rickettsia. The second type of bulk. Typhoid carriers are small rodents (rats, guinea pigs, etc.). That is why it has several other names:

• rat;
• classical;
• lousy;
• prison or ship fever.

Very common among small wild rodents. They are the natural reservoir for the virus. You can become infected not only through contact with them, but also by eating food that contains urine or feces of rat or mouse fleas. And also through scratching the skin, when their feces get into them. The disease can also be transmitted through tick bites on sick rodents.

How dangerous is typhoid fever?

If the disease is not treated, microbes multiply, and their waste products lead to serious intoxication of the body.

According to Typhoid WHO, every year there are 11–20 million cases of typhus worldwide. Up to 160 thousand infected people die.

The most common Typhoid fever complication of typhus is peritonitis. Due to bacterial damage, the intestinal walls become thinner, bleeding or through holes occur in them, through which the contents of the intestine enter the abdominal cavity. Peritonitis is a deadly condition that requires immediate medical attention.

If Salmonella Typhi leaves the intestines and enters the bloodstream, they attack other organs. Such complications are less common, but still possible and also dangerous:

• inflammation of the heart muscle (myocarditis);
• inflammation of the mucous membrane of the heart and heart valves (endocarditis);
• pneumonia;
• inflammation of the pancreas (pancreatitis);
• kidney or bladder infection;
• meningitis;
• psychiatric problems: clouding of consciousness, delusions, hallucinations, paranoid psychosis.

With timely initiation of treatment, almost all patients recover and there are no complications. Therefore, it is so important to recognize typhus in time.