Kevin Chatham-Stephens discusses drug-resistant typhoid fever, vaccination, and treatment options. Clinical Features Typhoid fever and paratyphoid fever are bacteremic illnesses that have an insidious onset characterized by fever, headache, constipation or diarrhea, malaise, chills, and myalgias, with few clinical features that reliably distinguish them from a variety of other infectious diseases. Diarrhea may occur, and vomiting is not usually severe.
The disease is spread by ingestion of contaminated food or water. Typhoid commonly presents with a sudden onset of fever, headache, abdominal pain, and diarrhea and can quickly progress to a variety of potentially fatal complications, including gastrointestinal hemorrhage, intestinal perforation, and neurological dullness or delirium.
Although infection is often curable with antibiotic treatment, the growing prevalence of resistance makes vaccination of at risk groups an increasingly urgent priority. Global Burden orldwide, there are an estimated million cases of typhoid each year, leading to , deaths.
In addition to endemic disease, outbreaks of typhoid fever have recently occurred in regions such as Tajikistan and Haiti.
The economic burden of typhoid has been calculated by several cost-of-illness surveys. Rapidly rising rates of antibiotic resistance are increasing the duration and expense of treatment. A literary analysis of typhoid fever harvested from polluted regions or raw vegetables fertilized with human manure night soil may also harbor the bacterium.
Diligent hand washing is important to prevent hand to mouth transmission. In addition, flies may passively carry the bacteria to food. Typhoid symptoms generally appear weeks after infection.
The pathogens are then taken up by macrophages and carried to the lymph nodes, spleen, bone marrow, and liver. Instead, the typhoid bacteria are protected from the immune system as they multiply within the macrophage.
Severe neurological symptoms may occur and can persist even after the infection has been cleared. Persistently infected individuals are at risk for a relapse of the disease and may experience billiary tract abnormalities, such as gallstones.
While chronic carriers may not feel sick, they can still spread the disease to others and must be barred from food handling.
In the face of antibiotic resistance, control of typhoid fever is now focused on improved sanitation and expanding vaccine coverage. Safe water, proper food handling, diligent hand washing, and control of flies are particularly important to stem typhoid outbreaks.
Case reporting of the disease is mandatory in most countries. Unfortunately, a diagnosis of typhoid can only be confirmed by analysis of blood or stool in a laboratory. The lack of simple, rapid, point-of-care diagnostics suitable for use in developing countries means that cases often go unreported and the true typhoid burden is underestimated.
Existing Products Drugs In resource-poor settings of the developing world, oral rehydration therapy is the standard of care for diarrheal diseases. While this is sufficient to reduce mortality for many enteric diseases, antibiotics are important for the treatment of typhoid to prevent complications from the infection and to reduce the risk of a person becoming an asymptomatic carrier.
Fluoroquinolones have become the new standard of treatment, but resistance to these drugs is common, especially in Asia. Third-generation cephalosporins are now in use in regions of high multi-drug resistance, but these too are becoming less effective.
Vaccines A typhoid vaccine is recommended for those living in or travelling to endemic regions, those at risk of occupational exposure, and individuals living in the same household as a chronic carrier.
As the vaccines lose their efficacy over time, boosters are recommended every years for those at continued risk. Vaccine protection is not complete, so individuals should also practice good hygiene and avoid potentially unsafe foods. There is no vaccine approved for use in children under 2 years old.
Vi capsular polysaccharide antigen Typhim Vi, Sanofi-Pasteur: The vaccine, which was first licensed inis now in the public domain and is produced by a number of manufacturers.
The vaccine has good heat stability, high yields, and low production costs.Clinical features and outcome of typhoid fever and invasive non-typhoidal salmonellosis in a tertiary hospital in Belgium: analysis and review of the literature. Yombi JC, Martins L, Vandercam B, Rodriguez-Villalobos H, Robert A.
Typhoid fever is a disease transmitted by consuming contaminated food or water. It is rarely fatal, and it is both treatable and preventable.
Outside of the developed world, typhoid is found almost everywhere.
TYPHOID FEVER LITERATURE SEARCH Hwang PH, Deichsel EL, Muni KM, Kwan- Gett TS Identify peer -reviewed and grey literature on global typhoid fever that contribute to improving current scientific knowledge since Typhoid Literature Search | APPROACH TO LITERATURE SEARCH.
Typhoid Fever-Pipeline Review, H2 Summary Global Markets Direct's latest Pharmaceutical and Healthcare disease pipeline guide Typhoid Fever-Pipeline Review, H2 , provides an overview of the Typhoid Fever (Infectious Disease) pipeline landscape.
A Critical Analysis of the Management of Typhoid Fever in a Tertiary care hospital in India caninariojana.com | 9 DISCUSSION Definitive treatment of typhoid fever (enteric fever).
“Typhoid fever is an infection that causes diarrhea and a rash -- most commonly due to a type of bacteria called Salmonella typhi (S. typhi). This bacterium spreads through contaminated food, drink, or water.