Description of typhoid fever

Typhoid fever is a worldwide serious infectious disease, affecting only humans. In the distant past, it was often confused with other diseases in which also leads to drowsiness, which derives its title (Greek tyfos = fog, smoke).

Its author is a bacterium called Salmonella enterica typhi, which belongs to the group of major intestinal pathogenic (disease causing) bacteria in humans, as well as in wild and domestic animals.

Paratyphoid are three separate diseases The cause of which is also a bacterium of the genus Salmonella. For us, the most common paratyphoid type B, type A is only imported and paratyphoid type C is very rare in the world, for us it does not.

Risk factors for typhoid fever

The disease is among the “disease of dirty hands”, is transmitted so. Fecal-oral route. Is the most widespread in countries with a warm climate, which is a low standard of hygiene, particularly in South Asia, Africa, the Caribbean and Central and South America. Typhus used to be regular tours of situations in which there was a violation of basic hygiene rules (such as war or natural disaster). We held the latest typhus epidemic after World War II, in 1945, nearly 10,000 people had been infected with typhoid bacteria. Today, the incidence of typhoid fever in developed countries rarely, most often in relation to cases of typhoid deported by travelers or immigrants.

The source of infection is the only man – sick or germ carrier (which is a person who is infected, but in which the disease does not show, and that permanently eliminates bacteria in their secretions and secretions).

Water contaminated with feces of sick becomes a reservoir of infection and, while drinking leads to transmission of infection. Also fever can spread from undercooked foods that have been prepared from products of infected animals (which are also infected by drinking contaminated water) or were infected secondarily, ie in contact with contaminated water.

Part of the bacteria causing the disease is destroyed by penetrating acidic gastric juice, but those that survive to reach the small intestine, where they pierce the lining to the lymphoid tissue. There they multiply and subsequently lymphatic and blood borne drifting throughout the body.Subsequently, maintain and continue to proliferate primarily in lymph nodes, spleen and liver.

For paratyphoid risk factors are the same, but sometimes appear as an occupational disease for workers microbiological laboratories.

Prevention of typhoid fever

To prevent the disease is necessary to observe basic hygiene rules, especially in areas where the incidence of this disease. It is a strict adherence to personal hygiene, especially thorough hand washing after using the toilet and before eating. Tourists at-risk countries should drink only bottled or boiled water should not be used in drinks ice cubes. Also, eating in different establishments street travelers can induce the formation of typhus, so it is recommended to eat only in places that can guarantee high standards of hygiene.

In areas where typhoid broke out, it is necessary in addition to these rules also comply with basic infection control measures. It is mainly about securing safe drinking water for the separation and disposal of human excreta and Waste Disposers example zasypáváním with bleach. It is also necessary for isolation of the patient and must be carried out disinfection of all surfaces and objects with which it could come into contact with.

Before traveling to landscapes with poor sanitary conditions, and also for people who suffer from reduced production of gastric juice, or taking medications to reduce its acidity (antacids), it is recommended to vaccinate. It is recommended especially in those cases where the traveler will linger in the countryside or in the countryside, where they have to choose instead of eating, and also in areas with a long access to medical care.

Currently, there are two kinds of vaccines. One is taken in capsule form, which served a total of four days in the scheme 0-2-4-6. If necessary, it is possible to perform a booster after five years, again four capsules.

The second type of vaccine is administered by injection into a muscle. There must be made at least two weeks before departure and can be repeated every two years. This vaccine is currently recommended because it increases immunity against the disease for approximately three years.

Preventive vaccination is possible to perform well in members of families where there is a carrier of the bacteria.

Vaccination, however, provides only partial immunity to the disease, in any case not replace the enhanced hygiene and rigor in the selection of food and water!

Symptoms of typhoid fever

The incubation period (from infection to manifestation of the first symptoms) is in typhoid fever 7-21 days, usually 14. If untreated, the disease lasts for four weeks. Typhoid fever is starting to show sudden onset of high fever (39-40˚C) with chills, loss of appetite, nausea, cough, the patient gradually deteriorating. The patient may be feverish aggressive, trying to escape from the bed, or vice versa, it is seized and napping. The fever is added persistent headache (since it was too old Czech name for the disease – Hlavnička). When looking at the patient, we see that it has a dry pale skin, stale language coated brown coating which is purified from the apex of the V or W. Also on the gums and teeth of a patient mucus coating. As the bacteria multiply in the intestines of the patient’s abdomen is slightly distended, may be sensitive to touch, especially in the right lower abdomen. Approximately half of the patients also occurs to the liver and spleen enlargement, also due to the proliferation of bacteria. Some patients with the skin of the abdomen appears at the beginning of the second week of illness pink spots (typhus roseola). Diarrhea is not usually present, rather constipation, is also present in low frequency heart rate. In the fourth week of high fever decreases, the patient wakes up ,, “has a hunger and thirst and a new interest in the area.

In children, the disease progress rapidly, and older people is often complicated by the associated difficulties.

In some patients, it occurs after 30 days for disease recurrence, the same, but accelerated symptoms.

2-5% of patients, mostly middle-aged woman with previous bile problems, becomes a carrier of the disease. It means that they are free from symptoms appear, but in their gallbladder continue to live salmonella excreted in faeces and can be dangerous to your surroundings.

Paratyphoid A appears as lightly to moderately hard extending typhoid, and may also cause the same complications of this disease but tend to be less early. More frequent as the fever but often relapse, which occurs mainly in non-compliance with therapy.

Paratyphoid B can occur in two forms – or gastro-enteric typhoid. Typhoid form, like the typhoid fever manifested mainly, which has a greater daily fluctuation than typhoid fever. The symptoms are very similar to typhoid fever, it differs just by the presence of cold sores, as well as accelerated heartbeat frequency.

Gastroenteric mold was evident already after a few hours after infection watery, sometimes green colored diarrhea without admixture of mucus and blood.

Manifestations of paratyphoid fever dominates C and airway inflammation in this disease does to impairment of the digestive tract.

Treatment of typhoid fever

Typhoid and paratyphoid is proving culture examination (by growing the causative agent of the sample) feces, urine, blood, also joint fluid or pus. Also as so-called Widal reaction, where in the serum of the patient determines the presence of antibodies against antigens of bacteria.

Typhoid fever is treated with antibiotics, especially chloramphenicol. It is important to start treatment sooner if the patient is not yet exhausted by prolonged fever, thus preventing the development of complications.

The patient also serves as a supportive treatment – i.e. prevention of bedsores, sufficient hydration of the patient, and increased intake of vitamin C and the B group vitamins.

For chronic carrier but antibiotic treatment to cure often enough, usually require surgical removing of the gallbladder (cholecystectomy).

How can I help myself

Sick often isolated during treatment at the hospital isolation wards, mainly in order not to endanger the surroundings. He has ordered bed rest, and even in the time after his recovery he recommended to avoid excessive physical exertion – is at risk of rupture of an enlarged spleen.

For home care may be released only after proving that no germ carrier, which is investigating the presence of bacteria in urine and feces. The total duration of sick leave is normally 6-8 weeks.

Complications of typhoid fever

At present, when treated properly and timely Typhoid Fever is a rare complication formation.Previously, but it was quite common (up to 10% of patients), bleeding from the intestine, due to propagation of the bacteria in its wall, which led to the formation of ulcers. Bleeding from the gut manifests mushy, black tarry stools. Sometimes it may be so weakened intestinal wall proliferat bacteria until it bursts, causing spilling of intestinal contents into the abdominal cavity and peritonitis (peritonitis).

Peritonitis is a serious condition because the bacteria normally found in the intestine invade the bloodstream and cause sepsi- So overall defensive reaction of the organism to their presence.Sepsis leads to the formation of septic shock with multiple organ failure, which is often fatal.

Further, rare complications include inflammation of the bone marrow (osteomyelitis), which is located primarily in the ribs and in the long bones. This inflammation may occur after a longer time since the inception of typhoid fever, rarely occurs immediately after the outbreak of the disease.

Also, when fever may develop inflammation of the heart muscle (myocarditis), which manifests frequency alternating slow heartbeat, seizures quickly. Among its other manifestations include dušnost- Thus, shortness of breath, even at small exertion, chest tightness and anxiety.

Salmonella are capable of also toxic damage the central nervous system that leaves lifelong consequences in the form of typhoid psychosis.

Especially in people with protracted cholecystitis other origin may also develop typhus cholecystitis, which often results in formation bacilonosičství.

After antecedent diseases, especially when he began to treat late may cause hair loss and theformation of baldness (alopecia). This is a temporary hair after looking again grow.

For long-term bedridden, immobile patients can body parts, which are facing the greatest pressure (buttocks, heels), and create pressure sores, or decubitus ulcers. Also, they have an increased risk of developing pneumonia, which greatly complicates the already serious condition.

For paratyphoid risk of having the same complications as typhoid, but they are much less common.

Other names: Paratyphoid, typhoid, typhus, typhus abdominis, abdominal typhus, enteric fever, catarrhal fever, paratyphus, paratyphoid

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