Here’s how management of typhoid fever may be done:
The presumptive diagnosis of typhoid fever is usually made with the knowledge of its history and clinical features. A screening test for typhoid fever called the ‘Widal test’ is commonly done to test for the antibodies against Salmonella typhi. The confirmation of the diagnosis is done with a blood culture or occasionally with a stool or urine culture which shows the growth of Salmonella typhi. Rarely, a bone marrow culture may be needed for the diagnosis. Newer tests to detect DNA of the bacteria in the blood are done in some hospitals.
The mainstay of treatment of typhoid fever is the antibiotic therapy. A fluoroquinolone group of antibiotics like Ciprofloxacin and cephalosporin antibiotics like Ceftriaxone are the common antibiotics used for treatment of typhoid fever. The treatment is usually given for 10-15 days. Ceftriaxone is an injectable drug which is preferred for use in pregnant women and children while the other healthy adults are usually treated with Ciprofloxacin. The antibiotics which were widely used in the past for typhoid fever (like Chloramphenicol, Ampicillin and Co-trimoxazole, etc) are mostly ineffective at present due to the development of resistance by the bacteria.
Patients should also be provided symptomatic relief of the fever with antipyretics like paracetamol. Dehydration is usually corrected with oral fluids but intravenous fluids may be used in severely dehydrated individuals. A healthy calorie-rich diet can help in a speedy recovery.
Improving sanitation and hygiene are essential for prevention of typhoid fever. Measures to prevent the faecal contamination of drinking water and food are the most important aspects of the disease prevention. Exclusive use of safe, clean and treated water for drinking, eating food when it is hot, avoidance of storing food in an open space and thorough washing of the hands in clean warm water before having food are other important measures that can help in prevention of the disease.
Typhoid is preventable by vaccines to a certain extent. Two types of vaccines are currently available for prevention of typhoid fever. One of the vaccines is taken orally while the other is given as an injection. Vaccines are useful for prevention of the disease while travelling to places known to have a high incidence of typhoid fever. Vaccines may also be a public health measure if the individuals at high risk of spreading the disease are vaccinated. The effectiveness of the vaccine decreases with time.