An Overview Of Typhoid Fever: Symptoms, Pathogenesis, And Treatment

Typhoid fever is refered one of the world's main causes illness also death. This infectious disease is caused by Gram-negative bacteria called Salmonella. Infection with salmonella in humans can be classified into two wide kinds created by low- virulence serotypes of Salmonella enterica causing food poisoning and high- severity serotypes Salmonella enterica typhi (S. typhi), causing thyphoid, and a group of serovars known as S Parathyphi A, B and C causing Paratyphoid Typhoidal salmonella transmits predominantly through liquid or food polluted with humanoid poop. Moreover talking about typhoid fever, a person called Mary Mallon who born in Ireland immigrated in 1884 to the United States. She is considered to be America’s first famous carrier of thyphoid fever. As a good as Salmonella typhi carrier, her nickname of “Typhoid Mary” became connected with infection spread, as many were infected because of her neglect of the illness. Scholars and researchers have in the previous researched outbreaks and concluded that many of them could have been typhoid diseases. Approximately 430 B. C. A plague believed prior to be an outbreak of typhoid fever murdered some third of this individuals on Athens, some of the most strong towns in ancient Greece at that moment. 


There are several number of symptoms for typhoid fever. Typhoid has elevated fever, chill, nausea, headaches, discomfort and sometimes delirium. Other health issues involve bleeding or prolapse of the intestine, myocarditis, pneumonia, hepatitis meningitis and acute cholecystitis. Early tiny perforation of the intestine and cochleovestibular deficiency were also recorded as unusual complication of typhoid fever. Other signs involve diarrhea, stomach pain, vomiting, chronic fatigue, cough, loss of weight, constipation, tenderness of the abdomen, evident spleen, palpable liver and rose spots. Reviews have also been produced about S. Typhi sepsis and rhabdomyolysis with acute renal failure and also in kids with irregular perforation. Most individuals with enteric disease have a non-specific febrile disease, often with an pernicious start after 7-14 days of incubation. Arthralgia is much less prevalent within typhoid and paratyphoid fever than within rickettsial diseases. In a 'stepladder' pattern, steadily growing fever is rare, although fever tends to worsen as the disease advances. Moreover, the body heat upsurges then the following week can reach of great peak about 39 to 40 ° C. Febricity also skin eruption exist as two primary symptoms. The enteric fever symptoms generally develop 1 or 2 weeks after an individual gets infected with pathogen Salmonella typhosa. With therapy, typhoid fever symptoms should enhance rapidly within 3 to 5 days. 


This infectious disease seems to be a notable nutrition and bacterial disease spread via crustacean and milk products as well as less commonly thru the direction of urine, human waste or such discharges from our body. Typhoid fever isn't really prevalent to countries of adequate wastewater and drainage systems as well as secure access to water. The biochemical mechanisms of typhoid sickness is a complicated method that goes across multiple phases. The illness starts with 7-14 days of asymptomatic incubation, Salmonella enter macrophages at which they disperse throughout the reticuloendothelial system. The consumed bacteria first should withstand its stomach's acidic atmosphere. The recognized enhanced threat of typhoid fever with concomitant Helicobacter pylori infection may be expressed through the hypochlorhydria connected with acute H. pylori disease. Then invading objects move via the intestinal epithelial cells and enter into touch of phagocytic cells well into the intestinal stone parts of the Peyer. The macrophages, however, do not destroy the bacteria. Bacterial replication is therefore mainly intracellular. Salmonella prevents lysosome encapsulation by trying to divert ordinary metabolic processes. The bacteria proliferate and extend through the blood stream to other cells in the reticuloendothelial system in the liver, spleen, bone marrow and gall bladder over the asymptomatic incubation period of 7-14 days. As replication inside phagocytic cells continues, bacteria are shed into the blood stream in sustained but low concentrations and the clinical syndrome of fever, headache and abdominal pain begins. 


There are several treatments to cure the salmonella infected patients. The first of all is intake of antibiotics. This kind of pathogenic disease can be controlled or reduced antibiotics present. The microorganisms itself manufacture the antibiotics and it behave on other bacteria. Moreover simulated antibiotic also has the power to attack the pathogen. There are some antibiotics which have been used so far For example, Cefotaxime, Ampicillin, Chloramphenicol, Co-trimoxazole and more. Eventhough antibiotics attack against this infectious bacteria, they become resistant to this particular bacteria which then leads to multi drug resistant typhoid (MDRST). The main treatment for typhoid fever was antibiotics but some antibiotics rises the resistant level which is like Chloramphenicol, Ampicillin and Co-trimoxazole antibiotics increase the production side effects. Thus, vaccination introduced to this disease to control and fight against it. There are some vaccine which does not have that much of potent but most of it are truly useful. Moreover vaccination also has side effect as well. Example of vaccines are Vi polysaccharide vaccine, Ty21a vaccine, Vi polysaccharide vaccine, Vi-rEPA vaccine. Moreover there is also another treatment which is the herbal drugs treatment. Plants are used for this treatment. This herbal drug treatment is effective eventhough it consumes some time heal and also noticed that it has low rate of side effects. Example are, Syzygium cumini (L.) (Myrtaceae), Unripe Carica papaya fruit, Citrus aurantifolia, Gossypium spp leaves and more, 


As conclusion, there are still people facing problem by this Salmonella bacteria. With the rise and global distribution of Salmonella, morbidity and death attributable to typhoid fever are now also growing. Health officials should now develop methods to use the two presently accessible enhanced typhoid vaccines, parenteral Vi polysaccharide and verbal Ty21a, in wider range in early childhood ages in kindergarten and also organize programs about the specific disease at school. They should also guide the public towards a healthy life style. Public should uphold the health goals like secured drinking water, upgraded the cleaniness and have enough medical care. 

16 December 2021
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