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Tactics versus typhoid
Typhoid fever attacks up to 33 million people every year, and of these 600,000 die. That’s 600,000 unnecessary deaths—because typhoid fever is completely preventable. Here’s how.
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n 1901, 53 people fell ill in New York with a high fever, diarrhea, vomiting, and a strange skin rash. The strange outbreak was that of typhoid fever, a disease that killed the likes of Louisa May Alcott (author of Little Women) and Charles Darwin. But stranger was the fact that the outbreak seemed to have come from only one person. Her name was Mary Mallon, who worked as a cook. Unknown to her, Typhoid Mary, as she was later known for, was a carrier of Salmonella typhi, the bacteria that caused typhoid fever – and unwittingly killed three people. Typhoid fever facts Salmonella typhi, like all the other members of the Salmonella genus, is transmitted via the mouth. The cycle of transmission usually starts from the feces of an infected person. The feces infect water and sewerage, which can seep into drinking water. Flying insects such as flies also thrive on these infected places and breed. These insects can then transmit the bacteria to food that we can ingest.
A Slice of Orange is a newsletter designed to help clarify basic health information and offer juicy tips on uplifting your health.
Editorial team Alvin Delfin Christine Llenes Voltz Olea, MD
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Detecting typhoid
Some tests can help doctors diagnose typhoid fever. Once the bacteria reach the intestines, they are engulfed by immune cells called macrophages. Inside the macrophages, the bacteria hide and multiply as they evade destruction. As the macrophages circulate in the blood and lymphatic system, they spread the bacteria to different parts of the body. As the bacteria spread, the body reacts to it with the symptoms of typhoid fever: • A high fever that can reach as high as 40 °C • Profuse sweating • Abdominal pain and vomiting • Diarrhea • Sometimes, a flat, rose-colored rash on the torso. Typhoid fever can also cause headache and nose-bleeding, so it can sometimes be mistaken as dengue fever, which is treated differently.
If untreated, typhoid fever can cause several complications, which usually start on the third week: • Intestinal hemorrhage • Intestinal perforation, which is usually fatal • Encephalitis, or brain infection • Multiple abscesses • Bone infection • Gall bladder infection • Endocarditis, or infection of the heart valves. Like Typhoid Mary, approximately 5% of people who contract typhoid continue to carry the disease after they recover and feel completely fine. These people become asymptomatic carriers of typhoid fever, suffering no symptoms, but capable of infecting others.
The first method is called the Widal test. This test detects protein components found on the cell wall of the Salmonella typhi bacteria. This is a quick test, but is sometimes inaccurate and is only suggestive. The second method is the typhidot test, which detects antibodies that the body forms when it gets infected. The test is fairly accurate. However, since it takes 7 to 14 days for the body to form detectable levels of antibodies in the blood, the test may show up as negative in the early stages of disease. The third and best method is through a culture of a blood, urine or stool sample. The bacteria are grown in a culture medium and then identified under the microscope.
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Must-knows about typhoid vaccine
Stopping typhoid in its tracks Because typhoid fever is a bacterial infection, it is usually treated with specific antibiotics. Antibiotics are prescription medications and should not be taken without the advice of a doctor. Antibiotics usually work well for typhoid fever, and results in complete recovery. However, resistance to antibiotics seems to be on the rise. When typhoid fever is antibiotic-resistant, almost half of patients can die. Hence, as with most diseases, an ounce of prevention is better than a pound of cure. Here are practical tips to temper typhoid: • • •
Wash your hands before eating or preparing food. Cook foods thoroughly. Avoid eating raw foods. Ensure the cleanliness of your drinking water. Boil your drinking water if unsure. Make sure water containers are clean. Get yourself vaccinated against typhoid fever!
There are two vaccines to prevent typhoid.
Who should NOT receive the vaccine?
Inactivated (killed) vaccine • Given as an injection • A booster dose is needed every 2 years
Inactivated typhoid vaccine • Children younger than 2 years of age • Anyone who has had a severe reaction to a previous dose
Live, attenuated (weakened) vaccine • Given orally (by mouth) • A booster dose is needed every 5 years Who should receive the vaccine? People at risk of typhoid infection should receive vaccination. This is especially true for Filipinos, where there is a high rate of transmission.
Live typhoid vaccine • Children younger than 6 years of age • Anyone who has had a severe reaction to a previous dose • Anyone whose immune system is weakened (e.g., those taking steroids, or has cancer or HIV/ AIDS)
A slice of trivia Typhoid Mary is the most famous example of a typhoid , a person who continues to harbor the bacteria and is capable of infecting others even though they feel no symptoms. Freshen up on your researching skills, e-mail us the answer at orange@activelink-consult. com and win a prize! From those with the correct answer, 40 people will be randomly chosen to receive gift packs from GlaxoSmithKline.
We’ll include the answer in the next issue of A Slice of Orange. Answer to last issue’s question:
What is the third most common cancer causing HPV strain in the Philippines?
In the Philippines, HPV strain 45 ranks third after strains 16 and 18 as the most common cancer-causing HPV strain. The vaccine that protects against strains 16 and 18 also seems to confer protection against strain 45.
Looking to enhance your corporate healthcare benefits? E-mail us at benefits@activelink-consult.com. The information in this newsletter is not intended as a substitute for professional medical care. Consult a doctor for all matters relating to your health, particularly for symptoms that may require diagnosis or medical attention. © 2009 ActiveLink
Benefits Made Better
ActiveLink 104 VA Rufino Street, Legaspi Village, Makati City, 1229 Philippines T: +632 817 4606 / 817 7900 www.activelink-consult.com
The Orange wants to he ar from you! Dying to ask us your health related questio ns? Itching to share your pe rsonal health tips? Want to sugg est topics for future issues? Feel free to contac t us. You can e-m ail our team at orange@activ elink-consult.c om.