By Penelope A. Domogo, MD
The rainy or monsoon season is here and as expected, we are now seeing patients with the diseases of the season like typhoid fever.
Typhoid fever is an infection caused by a bacteria called Salmonella typhi. It is transmitted through food and drink that are contaminated with the bacteria thus we also categorize typhoid fever as a food-and-water-borne disease. How does the bacteria get into food and water? The feces of an infected person could get into food or drink in many ways. For example, if a person does not wash hands properly after defecating and then handles food. Another example is when an infected person defecates in the open and flies transfer the bacteria from the feces to the food. A water source can be contaminated when an infected person defecates near or above the water source and when the rains come, the bacteria flows and contaminates the water source. Thus typhoid fever is more common in places with poor water supply and sanitation conditions. It is also more common in the tropics like Asia because of the warm and humid weather which favors the growth and multiplication of bacteria.
When the contaminated food and/or drink is ingested and gets past the defense system of the digestive system, it is then absorbed into the blood. And if it has enough food in the blood and the immune system is weak, then these typhoid bacteria will reproduce and overwhelms the defense system and after about 1-2 weeks, the patient experiences symptoms. So incubation period of typhoid fever is 1-2weeks.
Symptoms of typhoid fever are non-specific and can be mistaken for flu or even covid. These are fever, headache, general body pains or discomfort, stomach pain or discomfort, poor appetite, weakness, constipation or diarrhea. These symptoms could last for 3-4 weeks. However, with antibiotics, the person can get well in a week.
Since these symptoms can mimic other diseases, the diagnosis of typhoid fever rests on the blood test to measure antibody levels. A culture of the bacteria may also be done of the blood, urine and feces but this test is available only in big health facilities.
Since the S. typhi is a bacteria, not a virus, it can be killed by an antibiotic. The drug of choice is chloramphenicol but can only be availed of with prescription. Of course, because one needs to consult the doctor first before taking antibiotics.
Even with treatment, a few patients will get well but still shed the bacteria in their feces- meaning they become carriers. Some people also may be asymptomatic. These people can transmit the bacteria. Thus it is important to use sanitary toiles and practice proper hygiene. In instances when you don’t have water to wash your hands, you use the spoon when eating. The secret is not to contaminate the food and drink with your unwashed hands.
Aside from these precautions, think of two major preventive measures. 1) One needs to make the immune system strong. So that even if the typhoid bacteria get into your food and drink, they won’t be able to get past your inner defense army. 2) Don’t feed them. Just like all germs, the typhoid bacteria like sugar and animal products like meat, eggs and dairy. Minimize all these extreme foods and limit them to occasions. Cheers to a healthy rainy season!***
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“Give thanks into the Lord, for he is good; his love endures forever.” 1 Chronicles 16:34
