The risk of typhoid fever worldwide is especially there in the developing areas of Africa, the Americas and Southeast Asia, where the disease is a serious public health problem. WHO estimates that there are 11-20 million cases of typhoid fever annually, including about 128,000-161,000 deaths.
Generally, poor sanitation, malfunctioning sewage systems and difficult access to potable water are among the main causes of infection, while growth in urbanization and climate change are among the factors that have the potential to increase the epidemiological incidence of typhoid fever.
The countries with the highest number of typhoid fever cases are: China, India, Laos,Nepal, Indonesia, Bangladesh, Pakistan, and Vietnam.
Typhoid fever is a systemic disease. It is characterized by an incubation period of one to two weeks (but can be up to 3 months), which then results in a rise in body temperature to between 39 and 40 degrees. The fever may present with some drops in the morning and may last for about a week. This period is followed by inflammation of the bowel and severe and increasing abdominal pain.
Other symptoms that may occur are:
- Sense of weakness
- Cough
- Enlargement of the spleen
- Liver enlargement
- Abdominal pain
- Headaches
- Weight loss
- The following may also occur: diarrhea and intestinal bleeding or perforation.
Mortality after the introduction of antibiotic therapy is increasingly rare and related to other prior illnesses.
Diagnosis is confirmed after a culture test on blood or stool. Affected patients can call themselves infected as long as the bacterium is present in their stool. The period starts from the first week and varies throughout. 2-5% of patients become chronic healthy carriers.
Like all gold-fecal-transmissible diseases, it is necessary to comply with hygiene and health regulations both at the individual level, when storing or handling food, and at the collective level, by properly disposing of solid and liquid wastes. Although salmonellae exhibit great resistance to the external environment, they are still susceptible to the action of common disinfectants. A quick solution that can be implemented in one's home can be achieved by diluting a tablespoon of bleach inside a liter of water. This solution can be used to disinfect kitchen utensils such as cutlery or dishes, but it is also good for fruits and vegetables to be eaten raw, but these must then be rinsed with drinking water. Several vaccines are commercially available against typhoid fever:
- Injectable vaccine: single dose by intramuscular injection. Recall at intervals of 2 to 3 years
- Oral vaccine: 3 doses taken every other day on an empty stomach. Not recommended for children under 2 years of age. Cannot be taken during antibiotic or antimalarial treatment. Booster dose is given at least one year apart
- Vaccines containing the polysaccharide antigen: single dose by intramuscular injection. Booster at a distance of 2 to 3 years
The vaccine provides protection ranging from 75% to 90%, and has a duration of about 2-3 years. It is advisable to perform it in epidemic situations, for those traveling to countries where typhoid fever is particularly prevalent, or for those performing work where they are in contact with particularly infectious agents. Side effects to the typhoid fever vaccine are very rare, but there is a small chance that they will manifest as: redness, pain at the site of inoculation, or swelling at the site of inoculation. More rarely, fever, migraine or nausea may occur. Vaccination is not recommended for children under 2 years of age and should not be given during antibiotic or antimalarial treatment.