Typhoid Fever

By: Megan Uden

Introduction:

Did you know that if you travel outside of the United States to other undeveloped regions, you may be at risk to get Typhoid Fever? Typhoid Fever is an infectious disease that can be spread by contaminated food or water. It has caused 200,000 deaths worldwide each year.

Causes:

Typhoid Fever is caused by Salmonella Typhi bacteria.
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Spreads by:

Typhoid Fever is spread by contaminated food or water, close contact with someone who has it, or contact with infected feces. Flies can also pass the germs into food. Once the contaminated food or water is ingested, the bacteria enters the bloodstream and multiplies. Shortly after that, symptoms begin to appear.

Infected Organs:

Typhoid Fever can damage your stomach, gallbladder, spleen, or your intestines. If the disease isn't treated right away, it may eventually affect all of your major organs. Once the bacteria enters the intestines, tissue damage occurs. The bacteria then enters the bloodstream and begins to cause fatty liver cells, inflammation of the gall bladder, and enlarges the spleen. It can also enlarge lymph glands, swell the kidney tissue, and cause rashes. In the later stages, the lungs become inflamed, the heart enlarges, and blood clots can form. Hallucinations and psychosis can also occur,
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Symptoms:

Symptoms will begin to appear 6-72 hours after the bacteria is ingested. The first symptoms of Typhoid Fever include: a high fever that increases (can go up to 104 degrees), headache, dry cough, lack of appetite, rash, diarrhea, constipation, malaise (not feeling good), and abdominal pain. The second week the high fever continues, the heart rate slows down, and the stomach gets distended (bigger). The third week, the Typhoid state occurs (lie motionless with eyes half-closed, start to breath fast, HUGE weight loss, thready pulse, liquid-green diarrhea, confusion, hallucination). This stage of the disease is considered life-threatening.

Treatment:

Typhoid Fever is treated with antibiotics and fluids. Ciprofloxacin (Cipro), Ceftriaxone (Rocephin), and Zithromax are the best antibiotics for this disease. Resistance to some of these antibiotics can complicate treatment. If a person is resistant or doesn't respond to one antibiotic, another antibiotic will be tried.
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Prevention:

Typhoid Fever can be prevented in many ways. If a person is traveling out of the country, the typhoid vaccine should be given before leaving. The vaccine does not guarantee the disease will be prevented; therefore, washing hands before handling foods and after going to the bathroom is important. Drinking bottled water is encouraged, as well as wiping off the outside of cups. While showering, don't swallow the water. Eating cooked foods rather than raw is also helpful. Fresh foods need to be washed with clean water before eating.


Carriers of the disease need to be extra careful. While they are not sick anymore, the disease can still be spread in their feces for years after it was treated. It is important for them not to infect other people. Keeping hands clean, cleaning furniture often, and not touching others' food is best if you have had the disease. Therefore, if a person is a carrier, they shouldn't be a cook or serve food to others.

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Statistics:

There are about 5,700 cases reported in the U.S. annually, and about 200,000 deaths world-wide a year. There are more than 2,400 different types of Typhoid Fever. 75% of people get Typhoid Fever when traveling outside the U.S. About 30% of the people that are infected become carriers of this disease. Deaths from Typhoid Fever have decreased significantly since the early 1900s.
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Locations:

Typhoid Fever is most commonly found in Asia, Africa, and Latin America. It is rare in developed countries like the United States, Canada, Western Europe, and Japan because these countries have cleaner water and more sanitary conditions.
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Similar diseases:

Some similar diseases to Typhoid Fever are:
  • Abdominal Abscess
  • Amebic Hepatic Abscesses
  • Appendicitis
  • Brucellosis
  • Dengue Fever
  • Influenza
  • Leishmaniasis
  • Malaria
  • Rickettsial diseases
  • Toxoplasmosis
  • Tuberculosis
  • Tularemia
  • Typhus

Typhoid Mary

Mary Mallon, known as "Typhoid Mary," was born in Ireland in 1869. She emigrated to the United States at age 15, and became a cook in New York City. Mary Mallon lived with her aunt and uncle for a while. Then Mary worked for several families. In 1900, Mary worked for a family in New York, but after two weeks they developed Typhoid Fever. Then Mary decided to move to Manhattan. She worked as a cook and everyone suddenly developed diarrhea and fevers, and the laundress died. Mary then worked for a lawyer, but soon 7 of 8 people in that house became sick. Typhoid Mary was taken to jail because people thought she had been causing the illnesses. She was tested, even though she did not believe she was the cause of multiple cases of Typhoid Fever.

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Once Mary was released from jail in 1910, she worked as a laundress. She eventually changed her name to Mary Brown and worked as a hospital cook. Then, while she was working at the hospital, there was a Typhoid Fever outbreak. 25 people were infected, while 2 died. The police figured out who Mary Brown was and she was taken back to jail. When policemen found her, she came out swearing at them and telling them she believed that she didn't have Typhoid Fever. A policeman had to sit on Mary to keep her from getting away. Mary spent the rest of her life in jail, and 11 years before she died she had a stroke. Typhoid Mary died in 1938. In all, Typhoid Mary was thought to be responsible for 47 cases of Typhoid Fever, and 3 deaths.

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