Patna, Aug 17 (IANS) Four persons including 3 minors died in Bihar's Nawada district on Monday night. They were suffering from anaemia and also had symptoms of typhoid.This was the second such incident in the last one week. Earlier, three children died in the same district.The deceased were identified as Rinki Kumari, Karisma Kumari, Lado Kumari and their aunt Sonam Devi. All of them were residents of Baratandi village. Another minor girl named Vibha Kumari is battling for her life in RIMS Pawapuri."As soon as we learnt about the incident, a medical team was rushed to the village. I also visited the place and directed the medical team to give corona vaccine to every villager," said Yashpal Meena, district magistrate of Nawada."Preliminary medical reports revealed that the patients were suffering from anaemia. Their haemoglobin was low and it resulted in typhoid. The victims were admitted in Sadar hospital Nawada. As their condition was not improving, the doctors referred them to PMCH for better treatment. The family members of the victims refused to go there for treatment," said a senior officer of the medical team.--IANS ajk/bg
टाइफाइड, एक प्रकार की संक्रामक बीमारी है जो साल्मोनेला टाइफी नामक बैक्टीरिया की वजह से होती है। यह बीमारी मुख्य रूप से बरसात के दिनों में ज़्यादा देखने को मिलती है। भूख न लगना और तेज बुखार आना इस बीमारी के मुख्य लक्षण है। यह एक ऐसे बीमारी है जिससे विकासशील देशो जैसे भारत आदि में लगभग १० लाख लोग , उनमे भी बच्चे ज़्यादा पीड़ित होते है जबकि विकसित देशों में यह कम देखने को मिलता है।
आयुर्वेद में टाइफाइड - Typhoid in Ayurveda in Hindi
वैसे तो आयुर्वेद की अपनी व्याधियाँ है जो वातादि दोषों में असंतुलन की वजह से होती है। फिर भी यदि मोटे मोटे तौर पर देखा जाये तो टाइफॉइड के लक्षण आयुर्वेद में वर्णित कफ प्रधान सन्निपातज संतत ज्वर के लक्षणों से समानता रखते है। यह संतत ज्वर दोषो के बल अबल के आधार पर सात , दस तथा बारह दिनों में या तो सही हो जाता है या फिर कभी कभी दोषो के अत्यधिक कुपित हो जाने रोगी की मृत्यु तक का कारण बन जाता है। इस ज्वर का मुख्य लक्षण यह होता है की यह दिन रात में दो बार आता है।
टाइफाइड के लक्षण - Symptoms of Typhoid in Hindi
बुखार
सर दर्द
भूख न लगना
शरीर में लाल रंग के चक्कत्ते हो जाना
उल्टी तथा दस्त होना
पेट में दर्द होना
शरीर में कमजोरी और दर्द होना
टाइफाइड के कारण - Cause of Typhoid in Hindi
साल्मोनेला टाइफी बैक्टीरिया का संक्रमण
टाइफॉइड संक्रमित व्यक्ति के संपर्क में आना
टाइफाइड से बचाव - Prevention of Typhoid in Hindi
वैसे तो टाइफॉइड के लिए वैक्सीन उपलब्ध है लेकिन कभी कभी वैक्सीन के बाद भी टाइफॉइड हो जाता है इसलिए साफ सफाई का ध्यान रख कर और कुछ छोटी छोटी बातो ध्यान रख कर टाइफॉइड से बचा जा सकते है। टाइफॉइड से बचाव हेतु निम्न बातो का ध्यान रखना चाहिए -
नियमित रूप अर्थात खाना खाने से पहले , टॉयलेट का प्रयोग करने के बाद हाथो को पानी तथा साबुन से धोये ; पानी या साबुन उपलब्ध न होने पर एल्कोहल युक्त सैनिटाइज़र का प्रयोग करे।
पानी को उबालकर पिए।
कच्चे फल तथा सब्जियों का सेवन न करे।
टाइफाइड फीवर डायग्नोसिस - Typhoid Fever Diagnosis in Hindi
सी.बी. सी ( कम्पलीट ब्लड सेल काउंट )
विडाल टेस्ट
स्टूल कल्चर
टाइफी डॉट आई जी एम
टाइफाइड से बचाव के लिए घरेलु उपचार - Home Remedies to Prevent Typhoid in Hindi
बुखार को कम करने के लिए सर पर ठन्डे पानी की पट्टियों का प्रयोग करे।
पानी की कमी को दूर करने के लिए एक लीटर पानी को उबालकर उसमे नमक और चीनी मिलाकर पीते रहे।
तुलसी (जिसमे की एंटीबायोटिक गुण पाए जाते है ) को पानी में उबालकर उसका काढ़ा प्रयोग करे।
षडङ्गपानी अर्थात मोथा , पित्तपापड़ा , खस , रक्त चन्दन , सुगंदबाला और सौंठ से सिद्ध किया हुआ पानी पिए।
क्या करे? - What to Do in Hindi
पानी को उबालकर प्रयोग करे।
ताज़ा तथा गर्म भोजन का सेवन करे।
पचने में हलके भोजन का सेवन करे जैसे पतली दाल , पतली सब्जी , खिचड़ी आदि।
क्या न करे? - What Not to Do in Hindi
पचने में भारी चीजों जैसे दूध , पनीर आदि का सेवन न करे।
अल्कोहल का सेवन न करे।
दही का सेवन न करे।
खुले में मिलने वाले भोज्य पदार्थो जैसे खुले में मिलने वाले समोसे , कचौड़ी , चाट आदि का सेवन न करे।
प्रश्न उत्तर - Question & Answer in Hindi
प्रश्न- टाइफॉइड होने पर तुरंत हो लैब इन्वेस्टीगेशन करा लेनी चाहिए ?
उत्तर- वैसे तो चिकित्सक लक्षण देख कर ही लैब इन्वेस्टीगेशन कराता है फिर भी यदि आप खुद से बिना चिकित्सक को दिखाए टाइफॉइड का अंदेशा होने पर खुद से लैब इन्वेस्टीगेशन कराना चाहे तो तुरंत न करा कर के कुछ दिन व्यतीत हो जाने पर करानी चाहिए क्योकि इसका इन्क्यूबेशन पीरियड् तीन दिन से लेकर १०- १४ दिन का होता है यदि तुरंत ही लैब इन्वेस्टीगेशन करा ली जाये तो रिपोर्ट सटीक नहीं आ पाती है।
प्रश्न- टाइफॉइड मुख्य रूप से किन लोगो को होने की सम्भावना होती है ?
उत्तर- टाइफॉइड वैसे तो किसी को भी सकता है लेकिन बच्चों और ऐसे लोग जिनका पाचन तंत्र कमजोर होता है उनको टाइफॉइड होने की ज्यादा सम्भावना होती है।
प्रश्न- टाइफॉइड या अन्य कोई व्याधि होने पर खुद से ही आयुर्वेदिक दवा ले लेना कितना सही है?
उत्तर- आधुनिक डायग्नोसिस के आधार पर तथा बिना ये जाने की रोगी व्यक्ति के शरीर में कौन से दोष का असंतुलन हुआ है , चिकित्सा करने पर या रोगी द्वारा खुद ही सोशल मीडिया में देख कर किसी भी आयुर्वेदिक दवा का सेवन करना बिल्कुल भी सही नहीं है खुद से दवा लेने के कई दुष्परिणाम हो सकते है इसलिए टाइफॉइड हो या अन्य कोई व्याधि शरीर में व्याधि के लक्षण दिखाई देने पर किसी आयुर्वेदिक चिकित्सक की सलाह पर ही आयुर्वेदिक दवाई का सेवन करे।
प्रश्न- यदि टाइफॉइड के लिए उपचार न लिया जाये तो क्या क्या कॉम्प्लीकेशन्स हो सकते है ?
उत्तर- टाइफॉइड होने पर इलाज न करने या देरी से इलाज करने पर मुख्य रूप से जो कॉम्प्लीकेशन्स हो सकते है वो है -
पाचन तंत्र के किसी भाग से आंतरिक रक्तस्राव होना।
पाचन तंत्र के किसी हिस्से में परफोरेशन हो जाना तथा परफोरेशन की वजह से इन्फेक्शन का आस पास के हिस्सों में भी फ़ैल जाना।
प्रश्न- आयुर्वेद में टाइफॉइड के लिए क्या उपचार उपलब्ध है ?
उत्तर- टाइफॉइड के लक्षण आयुर्वेद में वर्णित सन्निपातज प्रधान कफज संतत ज्वर से मिलते है तथा इसकी चिकित्सा में दोष , दुष्य , काल , प्रकृति आदि को देखते हुए अपतर्पण अर्थात लंघन चिकित्सा कराने का वर्णन मिलता है।
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
Headache
Malaise
High fever with relative bradycardia
Cough
Constipation
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
Beverages
Junk foods
Alcohol/ Smoking
Excessive exercise
Stress
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
Shadangapaniya
Proper fluid intake to avoid dehydration
Banana
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:-
1st week
Hyperpyrexia (103 degree F - 104 degree F)
Splenomegaly
Tongue coated and reddish.
Flatulence.
Constipation.
Red spots on neck/ abdomen/ chest area
2nd week
Hyperpyrexia
Delirium
Drowsiness
Cough
Furrowed tongue/ dry with reddish coloration
Weakness
Dryness of mouth
Restlessness
Flatulence
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,
c) Immunization.
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.
References
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
Hyderabad, Dec 11 (IANS) Biological E. Limited (BE), a Hyderabad-based vaccines and pharmaceutical company, on Friday announced that its Typhoid Conjugate Vaccine (TCV) has been pre-qualified by the World Health Organisation (WHO).With this pre-qualification, BE became one of two pre-qualified suppliers of TCV to the UN agencies.BE's TCV is a single-dose injectable vaccine, which can be administered to children from six months of age to adults up to the age of 45 and it is formulated with Vi polysaccharide conjugated to a carrier protein (CRM197).The Vi polysaccharide antigen used in BE's TCV is derived from C. freundii, which is a non-pathogenic source (BSL 1 organism), compared to virulent Salmonella Typhi used by other manufacturers, and the carrier protein used for conjugation is a non-toxic CRM197 protein locally developed by BE through in-house R&D effort, the company said.Clinical studies conducted in India have shown that the safety and immunogenicity profiles of this vaccine are comparable with those of the other WHO pre-qualified TCV. BE offers this vaccine as single-dose and multi-dose vials for ease of administration.The vaccine was developed in collaboration with the GSK Vaccines Institute for Global Health (GVGH), based in Siena, Italy, which first developed the vaccine strain and transferred the technology to BE in 2013. BE has further developed the vaccine, including manufacturing process optimization and scale up, pre-clinical studies and comprehensive clinical trials for Phase I, II/III in India. This vaccine is being manufactured in BE's GMP manufacturing facilities in Hyderabad."This is a remarkable accomplishment and a significant milestone in the journey of our vaccines. I am delighted that we have been able to produce a new WHO pre-qualified vaccine. We believe that every year this vaccine would save about 1.5 Lakh people worldwide," said Mahima Datla, Managing Director, Biological E. Limited."GSK, through its R&D efforts at GVGH, is proud to have played an essential role in providing technologies to Biological E for their Typhoid Conjugate Vaccine (TCV)," said Francesco Berlanda-Scorza, GVGH Director.--IANSms/rt
The hospitals have reported at least 50 per cent fewer cases of these two seasonal illnesses, the doctors said.
Aakash Healthcare Super-Speciality Hospital in Dwarka said that they received only 50 patients so far who had Typhoid and Influenza in the last two months. The hospital stated that the count usually went up to 100 to 150 in previous monsoon seasons.
"We are not receiving the cases of Typhoid that usually comes in this season," informed Vikramjeet Singh, senior consultant, department of internal medicine at the hospital.
Max Super Speciality Hospital, Shalimar Bagh, also witnessed around 50 per cent fall in the cases related to Typhoid. However, the same situation was not reported in the cases of Influenza. "There has been a surge in flu (Influenza) cases recently, but again, the surge is expected during this season so not much variation from the routine," said Parul Kakkar, consultant, internal medicine, at the hospital.
BLK Hospital in Rajendra Place, which also saw a notable decrease in Typhoid and Influenza cases, said that cases of Typhoid and Influenza decrease with the end of monsoon. However, they did not reach their peak this year.
"During the monsoon season, normally the typhoid cases increase every year, which usually decreases by the end of this season. However, this was not the case this year," Rajinder Kumar Singal, senior director & head of the department of internal medicine at BLK.
The doctors attributed two scenarios behind the fall in the cases of Typhoid and influenza. One is a newfound change in the lifestyle enforced by the Covid-19 pandemic where eating home-cooked food and maintaining an optimum level of hygiene have become an integral part of life.
"During the current pandemic, everything around us is undergoing a change, including our lifestyle, eating habits and socialising etiquettes. Thankfully not every change is for the worse! The number of typhoid and hepatitis cases this year has decreased, and the full credit goes to our renewed respect and regard for the home-cooked "safe and healthy food ". Besides, the frequent hand washing that the public is now following also helped," said Kakkar.
"People are avoiding outside food and have not been going to eateries. Also, school and colleges are closed too. Elderly people are avoiding the parks and outdoor activities," reasoned Pankaj Solanki who runs Dharmaveer Solanki Multi-Speciality Hospital in Rohini.
Another reason behind the recorded fall in Typhoid and influenza cases is the less reporting due to fear induced by the Covid-19 outbreak. Doctors said people wish to avoid coming to hospitals. Also they relate the symptoms of the two seasonal illnesses with the COVID-19 disease.
"They are worried that they will have to follow isolation or hospital admission if they are confirmed with the Covid-19. This fear is making them not report the cases of Typhoid and Influenza," said Singh.
Solanki also said that people tend not to report the case as they relate the symptoms of the two viral illnesses, especially Influenza with the Covid-19 disease. "Most of the people who had symptoms did not come forward due to the fear of Covid-19 testing and mandatory isolation that follows. People are not reporting it as they are afraid of coming to the hospital as they assume the fever and other symptoms of Typhoid and Influenza are due to the Covid-19. So they are treating themselves at home," he added.
The symptoms of Covid-19 are almost similar to the Typhoid and Influenza, particularly. In the Typhoid, people usually have a sustained fever (one that doesn't come and go) that can be as high as 103-104 degrees fahrenheit (39-40 degrees Celsius). Some people with typhoid fever or paratyphoid fever develop rash or rose-coloured spots. Cough and sore throat are also symptoms.
Just like the SARS-CoV-2, which causes the Covid-19, Influenza also attacks the respiratory system -- nose, throat and lungs. Its symptoms include fever, runny or stuffy nose, sore throat, aching muscles and shortness of breath. (Agency)
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