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     Volume 7 Issue 35 | August 29, 2008 |

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The Real Skinny on Typhoid

Shara Azad

Experiencing a combination of high, sustained fever, stomach pains, and a rash of rose-colored spots--or perhaps just one of the above? Bangladesh's favourite bacteria Salmonella typhi may be rearing its ugly head once again. Typhoid fever seems to be back with a vengeance this rainy season, sending hundreds of ailing patients to seek treatment at local hospitals. Therefore, to save yourself, here is what you need to know:

The Salmonella typhi bacteria cause typhoid fever, which begins when S. typhi enters the body through food or drink contaminated by sewage containing the bacteria shed from another person. In the rainy season, oftentimes Bangladesh's sewage systems flood over from the rain, contaminating drinking water. When that water is directly drunk or used to wash and prepare food, the typhoid bacteria is transmitted. In a few rare cases, however, the carrier of S. typhi does not show any symptoms of the disease, and instead just excretes the bacteria, which contaminates water that another ingests, and the cycle continues.

The salmonella typhi (above) enters the body through contaminated food or drink.

Therefore, to prevent typhoid, one must be particularly careful about what one eats or drinks. As everyone knows, drinking boiled water is important, but a less well-known fact is that ice must also be made with boiled water or it too can carry the bacteria. Likewise, food sold by street vendors should be avoided, since mass-produced food is often not prepared in the most hygienic way. And according to the Centers of Disease Control in the United States, only peeled raw fruits and vegetables should be eaten in high-risk countries such as Bangladesh, and one should peel his own food after a thorough hand washing. While there is a vaccine against typhoid, it is not completely effective, so caution in eating and drinking is the best way to act.

Once one exhibits the symptoms of typhoid like sustained fever for a few days, stomach pains, and in some cases, a rash on the stomach, a blood test checking for the presence of S. typhi should be administered. If S. typhi is present, doctors can prescribe antibiotics such as ampicillin and trimethoprim-sulfamethoxazole. Ciprofloxacin was another antibiotic that used to be prescribed, but strains of S. typhi resistant to it have been found in Bangladesh, so it is better to opt for one of the alternative medications. With proper antibiotics though, the patient should feel better within a few days. Going without antibiotic treatment, however, can prove to be fatal, since about thirty percent of untreated typhoid cases result in death.

Typhoid has been almost eradicated in industrialised nations of the world such as the United States, the United Kingdom, and Japan even without an effective vaccine. The few cases that do appear there come from travellers returning from abroad. For a country like Bangladesh, on the other hand, there may be some hope. During summer 2008, scientists from around the world have been working toward mapping the S. typhi genome, which may help them produce a successful vaccine. In the meantime though, the people in this part of the world will just have to do with watching what they eat and drink.


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