It is also known as Enteric Fever, it is a systemic infection caused by Salmonella Typhi, usually through ingestion of contaminated food/ water. It is transmitted by the fecal-oral route. The causative organisms are Salmonella typhi and S.paratyphi A and B.
The incubation period of typhoid fever is around 10-14 days., and the onset may be insidious. Typhoid fevers are an important cause of fever in India, sub-Saharan Africa, and Latin America.
According to Ayurveda, typhoid fever is described as Manthana Jwar and signs and symptoms of typhoid fever are also similar to santata jwara.
Symptoms of Typhoid Disease
- Persistent fever
- High fever with relative bradycardia
- CNS signs such as coma/ delirium/ meningism/ cerebellar signs/ fits)
- Diarrhea ( more common after 1st week )
- Bloody stools
- Slow/sluggish/ lethargic feeling
- Rose spots ( trunk region )
- Epistaxis/ bruising/ abdominal pain/ splenomegaly may occur
- The temperature rises in a stepladder fashion for 4-5 days + malaise/increasing headache/ drowsiness/ and aching in the limbs.
- In Children= diarrhea and vomiting may be prominent early in typhoid.
- Diffuse abdominal pain.
- Rashes/ abdominal distension/ tenderness.
When to See Your Doctor for Typhoid Disease
When the above signs and symptoms appear consistently and with that fatigueness/ weakness/ intense abdominal pain occur then you should consult the doctor for the proper diagnosis.
Causes of Typhoid Disease
The main cause of typhoid fever is Bacterial infection( agantuj karana). S.Typhi is spread through contaminated food/drink/water that contains bacteria in it. Bacteria after entering in body travel into the intestines and then into the blood. From blood, it travels to lymph nodes, gall bladder, liver, spleen, and other parts of the body.
Diagnosis of Typhoid Disease
- CBC ( Complete Blood Count ) = it will show leucopenia associated with neutropenia.
- Typhi Dot IgM
- Widal test
- ELISA urine test
- Fluorescent antibody study
- Platelet count
- Stool culture
Clinical features like relative bradycardia/ step ladder pattern of fever/ coated tongue with periphery redness may be present.
- General Tips/ Prevention
- Use boiled and cooked food.
- Use purified water.
- Wash your hands properly with an antiseptic solution.
- Avoid Raw fruits/ vegetables.
- Avoid drinking untreated/impure water.
- Stay hydrated by increasing fluid intake.
- Use cold compresses in case of high fever.
- Drink ORS= Oral Rehydration Solution.
- Basil use = add basil to boiled water and drink 3-4 cups daily.
- 4/5 basil/tulsi leaves (paste)+ pepper powder + few strands of saffron/Kesar + mix all these and divide into 3-4 parts and use after every meal.
- Garlic use/pomegranates use.
- Banana = it helps the intestine to absorb fluids, thus curing diarrhea.
- Triphala Churna
- Boil water + cloves = strain in a cup ( two cups daily)
- Avoid sweetened beverages and coffee.
What to Avoid?
- Heavy / spicy/ sour substances.
- Fast food
- Fried items
- Oily substances
- Unpacked food
- Street foods/ Roadside foods
- Junk foods
- Alcohol/ Smoking
- Excessive exercise
- Excessive intake of street foods
- Artificial sweeteners
- Excessive coffee consumption
What to Eat?
- Purified water
- Seasonal fruits
- Cow’s milk
- Peya vilepi langana
- Orange/ Pomegranate/ Grapes/ Munakka
- Proper fluid intake to avoid dehydration
- Proper boiled/cooked food
Questions and Answers
Q.1) In which part of the body, typhoid fever mainly attacks?
Ans. The GIT ( Gastrointestinal ) tract of our body is more severely affected. After getting infected by bacteria, the blood of our body becomes infected which reaches various organs like the liver, spleen/ muscles/ gallbladder/ lungs/ kidneys.
Q.2) What are the modes of transmission of Typhoid fever?
Ans. The following are the modes of transmission: oral transmission via food/beverages handled by an often asymptomatic individual- a carrier - who chronically sheds the bacteria through stool/ urine. Hand to mouth transmission after using a contaminated toilet/neglecting hand hygiene. Oral transmission via sewage-contaminated water/ shellfish (developing world)
Q.3) What is the incubation period of Typhoid fever?
Ans. Typhoid incubation period usually lasts for 10-14 days. But, it may be as short as 3 days /long as three weeks depending upon the dose of the bacilli ingested and how it affects the system of the body.
Q.4) In which age usually Typhoid fever mainly affects?
Ans. It can occur at any age. The highest incidence of this disease = 5-19 years of age group. Prospective population-based surveillance in some Asian urban slum areas has shown that in the age group 5-15 years, the annual incidence of blood culture-confirmed typhoid fever may reach 180-494 per 100,000. In some of these areas, pre-school age children less than 5 years, show incidence rates similar to those of school-age children. After the age of 20 years, the incidence falls probably due to acquisition of immunity from clinical/ subclinical infection. Children of slum areas are more prone to these typhoid infections.
Q.5) According to Ayurveda, in which classification does Typhoid fever comes?
Ans. According to Ayurveda, Typhoid fever usually termed as Manthana Jwara and due to most oftenly Gastrointestinal infection occurs, it is also considered in aantrika jwara. Due to intake of causing elements, bacillus typhosus infection in intestines occur. After the infection, rasa, rakta, and doshas will get affected. If Typhoid fever is not well treated timely, then it may leads to perforation of the intestine which may be incurable.
Q.6) What are the major complications of Typhoid fever?
Ans. Major complications are- intestinal tuberculosis, toxaemia, haemorrhage, peritonitis, intestinal perforation, nephritis.
Q.7) Are signs and symptoms of Typhoid fever are different in weeks after getting infected, if yes then what are those signs and symptoms?
Ans. Yes, signs and symptoms of Typhoid fever are differ in weeks. According to 1st week and 2nd week, signs and symptoms are:-
- Hyperpyrexia (103 degree F - 104 degree F)
- Tongue coated and reddish.
- Red spots on neck/ abdomen/ chest area
- Furrowed tongue/ dry with reddish coloration
- Dryness of mouth
- Dicrotic pulse
- Blood mixed stool.
In 3rd week, fever can be stop but due to intake of causing factors/ not following preventive measures properly, it may lead to further complications.
Q.8) What is Widal Test ? How typhoid is diagnosed by Widal Test?
Ans. Widal test is a serological method to diagnose enteric/typhoid fever that is cause by the infection with pathogenic microorganisms like Salmonella typhi, Salmonella paratyphi a,b and c. The tests measure agglutinating antibodies directed against a Salmonella O somatic surface antigen/ Salmonella H flagella antigen of the suspected organism. The Widal tests detects antibodies against O and H antigens.
Q.9) How Typhoid Fever can be controlled?
Ans. There are generally 3 lines of defence against typhoid fever :
a) Control of reservoir,
b) Control of sanitation,
Q.10) What are the principles of treatment for Typhoid Fever?
Ans. In Ayurveda, Typhoid fever is described as Manthana Jwara. Firstly, langana preferred for dosha pachana, Treatment of santata jwara should be started. And, in case of symptoms of sannipataja jwara are found then treat kapha first followed by Pitta and Vata.
1) Park’s textbook of preventive and social medicine by K.PARK, 24TH EDITION (2017)
2) Kayachikitsa Volume-2 by Prof. Ajay Kumar Sharma (2017)
3) Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition.
4) Harsh Mohan Textbook of Pathology by Ivan Damjanov ( 7th edition).
5) J.Alastair Innes, Davidson’s Essential of Medicine 2nd edition