Typhoid

Typhoid fever is a serious bacterial infection caused by Salmonella Typhi. It spreads through food and water contaminated with the faeces of an infected person. India has a high burden of typhoid — it remains one of the most common causes of prolonged fever in children and young adults.

Symptoms

Symptoms typically appear 1-3 weeks after exposure and come on gradually:

• High fever (often rising in a step-wise pattern, peaking around 39-40°C)
• Headache
• Stomach pain
• Loss of appetite, nausea
• Constipation (more common in adults) or diarrhoea (more common in children)
• Profound fatigue and weakness
• Dry cough
• Sometimes a faint rash of rose-coloured spots on the trunk
• Enlarged spleen or liver on examination

Without treatment, typhoid can progress to serious complications in the third and fourth weeks — intestinal perforation, gastrointestinal bleeding, encephalopathy (confusion, delirium). Untreated typhoid has a high death rate; with early antibiotic treatment, death is rare.

Diagnosis

• Blood culture — the gold standard; most reliable in the first week of illness
• Widal test — widely used in India but has significant limitations (false positives in endemic areas; often confirms rather than diagnoses). Should not be used alone.
• Typhidot / other rapid tests — variable accuracy
• Bone marrow culture — most sensitive, used in difficult cases

Treatment

Typhoid is treated with antibiotics. The choice depends on local resistance patterns, which matter greatly in India — Salmonella Typhi resistance to older antibiotics is widespread:

Adequate fluid intake, rest, and paracetamol for fever are important supportive measures. Most people feel better within a few days of starting the right antibiotic, but complete the full course.

Prevention

• Typhoid vaccination — a typhoid conjugate vaccine is available in India, both in public immunisation programmes (where offered) and private clinics. Booster doses are recommended.
• Safe water — drink water that has been boiled, filtered, or treated; avoid ice from unknown sources
• Food safety — eat hot, freshly-cooked food; avoid raw salads and peeled fruits prepared by others
• Hand washing — especially before eating and after the toilet
• Sanitation — proper disposal of sewage