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Introduction
The global medical system is full of examples of diseases people hear of on a regular basis but never pay enough attention to protect themselves from the risk. The innovative society of the 21st century, with its technological advancements, has created the impression of people’s invincibility and ability to combat practically any infectious disease. While some diseases and viruses like COVID-19 are being discovered in the current stage of their development, some illnesses have been serving as a severe health hazard for over a century. In order to combat any outbreaks of the already existing diseases, it is vital to educate people on how to prevent even individual cases of contagion. Hence, in the course of this project, typhoid disease will be examined on the subject of its major development stages, along with symptoms and ways of treatment.
Main body
Being a life-threatening bacterial disease, typhoid fever does not have an impact on people, because the scope of its contagion in developed countries is not as impressive as the one of any infectious disease. People who live in European countries or the US are hardly exposed to the risk of being infected once they do not travel to the states with poorer living standards. As such countries tend to have low food and water quality, the risk of it being contaminated by Salmonella Typhi is extremely high. In order to fully examine the disease, it is necessary to dwell upon the history of its development.
It is quite complicated to trace back the first-ever samples of any infectious disease. However, in the course of meticulous research, some researchers have estimated that illnesses with typhoid symptoms trace back to 430 BC, where one-third of the population died because of some plague unknown to the society of that time. Another location to record the typhoid fever outbreak is believed to be Jamestown, an English colony in Virginia, where the number of deaths calculated approximately six thousand villagers. American Civil War, taken place in 1861-1865, also captured the consequences of Salmonella Typhi, causing death to more than eighty thousand soldiers. Dysentery during the Spanish-American War also led to some considerable losses.
Despite the scholars’ claims to prove the early existence of typhoid, it was the 19th century when the actual case of the new bacterial disease was confirmed. Although the symptoms of the disease were similar to those of typhus, known for quite a long time, the sources of contagion were somehow different. Hence, in 1829, the term “typhoid” was coined with the inflection “oid,” which literally meant “typhus-like.” In the course of further investigations, the causal bacteria Bacillus typhosus was identified. Thus, there was a clear distinction between flea-borne typhus and water-borne typhoid fever.
Mary Mallon, mostly known under the nickname “Typhoid Mary,” became the first American resident to be a Salmonella Typhi carrier who managed to infect more than 50 people. Having emigrated from Ireland to the US, Mary became a perfect carrier for the bacteria existing in food and water, as she worked as a cook for a well-to-do New York banker’s residence. The major mistake made by the medicals was their blind confidence that the root of the issue lay in the infected water, so they allowed Mary to contaminate food and increase fatalness rates. After 26 years spent in isolation, Mary Mallon died in 1938.
The symptoms of typhoid fever are, at first, similar to a common cold with headaches, muscle pain, and high body temperatures. However, the major distinctive feature of the disease is the presence of a small pink rash across the body, especially in the torso zone. Once these symptoms are identified, it is of crucial importance to ask for medical assistance. When treated properly and timely, typhoid can be eliminated within approximately a week. However, in case it is ignored, the complications of the infection may cost a person’s life, depending on the illness period.
The symptoms of typhoid fever may be implicit for about one or two weeks after the contact with bacteria. Once the condition is exposed and treated, the symptoms tend to disappear within three or five days from the start of the treatment. When ignored, patients struggle with the disease for at least a month, having some severe complications on human health. Quite often, these implications are incompatible with human life considering that a person may have some health issues or chronic diseases. Hence, even the slightest symptoms exposure is worth consulting with specialists for the sake of safety.
As it was estimated in the late 19th century, typhoid fever is primarily caused by the waterborne bacteria Salmonella Typhi. The most evident method of disease transmission is an interaction with contaminated water or food. Once a person is infected, the infection may then be spread through the fecal-oral route and direct interaction with healthy people. However, another important and dangerous method of disease transmission is through typhoid carriers. Like in the case of Typhoid Mary, a bacteria carrier has no signs of infection but still exposes others to the disease. Such an implicit way of disease transmission can only be managed by a meticulous investigation of the patient’s communication and nutrition patterns held by a therapist.
Food and water containing Salmonella Typhi presuppose the overall poor sanitation patterns of the area. For this reason, the risk of being infected in industrialized countries like the US is extremely low. The vast majority of people who were infected through the contaminated water or food were the ones who had recently returned from India, Southeast Asia, Africa, South America, and other endemic areas. Another issue is that children are usually more predisposed to typhoid, but they tend to handle the disease easier than adults do. Moreover, lab workers who have close contact with the isolated bacteria are as well at high risk when acting not according to the safety principles.
One of the most efficient ways to prevent typhoid fever is, by all means, immunization. The peculiarities of typhoid vaccination will be discussed later in the discussion, so now it is more crucial to focus on healthy eating habits while traveling abroad. It should be mentioned in the first place that following balanced nutrition patterns is obligatory when visiting another country due to its eating habit traditions. While double-checking the meal, tourists can prevent themselves from other diseases like diarrhea, cholera, and hepatitis A as well.
With an increasing number of militants having typhoid fever in the 19th century, there was a high demand for an efficient vaccine for the disease. Thus, in order to create it as soon as possible, various scientific groups were involved, making it hard to define who was the first one to identify the biological preparation. However, the discussion is primarily focused on the British pathologist Almroth Wright and the German bacteriologist Richard Pfeiffer, whereas the former is more likely to introduce the vaccine back in 1896. The immunization was, by all means, essential and extremely successful in terms of dysentery and sanitation issues in wartime. Its use spread over the whole population over the years, creating a considerable decline in the number of infection cases.
As was mentioned before, people who live in industrialized countries are not implied to vaccinate against Salmonella Typhi bacteria unless they do not travel to other countries. In this case, it is necessary to choose between the two available immunization options. The first option, inactivated typhoid vaccine, is an injection that should be taken two weeks prior to the trip. In the case of regular risk, the vaccination should be repeated every two years. The second immunization type, the live typhoid vaccine, is administered orally with a capsule being taken every other day for four times. The last intake has to be taken at least a week before travel. People who remain at risk should repeat the procedure every five years.
The most efficient way of typhoid fever treatment is taking the course of antibiotics. Prior to the discovery of antibiotics, people did not take any measures to combat the infection and, hence, the fatality rate was more than 20%. The prompt treatment existing nowadays has reduced this number to 1-2% on average. Typhoid fever is usually treated with the help of a 7-14-day antibiotics course. The most common antibiotic is Chloramphenicol, an original drug, which had been used to treat typhoid for years before some complications were identified. However, the current issue concerns the fact that infection mutations have now led to some types of Salmonella Typhi being resistant to the existing antibiotics.
When patients identify typhoid at an early stage, the treatment process usually goes without serious complications, and there is no need for obligatory hospitalization. However, communication with a patient’s GP is essential in order to control the illness flow and make sure the medication is picked properly. While staying at home, it is obligatory to have a rest, drink a lot of fluids, and be provided with a nutritious meal. Although the patient usually starts to feel better within the first three days of treatment, it is better to take the full antibiotics course in order to prevent a relapse.
In the case of typhoid fever, a person is not obliged to stay at home during the whole treatment period. Regarding the outcome that a patient is feeling better while taking the medication without passing, he or she is allowed to return to the workplace or educational establishment. However, in order to secure the safety of others, there are some limitations in terms of one’s environment. In the case when patients’ surroundings include children aged five and younger, older adults, or the ones with poor health, it is crucial to make sure a patient exposes no social threat.
Speaking of typhoid geographical distribution, the chart on the slide depicts the major issue laying behind typhoid fever control and prevention in the 21st century. One may notice how almost all the American continent and Europe do not estimate more than one million fatality cases of typhoid fever. These are the industrialized, developed countries where cases of bacterial meal contamination are not frequent due to established quality criteria. However, some places on the chart like Western Africa or Southern Asia expose an extremely high number of deaths, constituting more than forty million incidents. Such an enormous gap makes it complicated to establish proper control over the issue, as the vast majority of the world population tends to underestimate the scopes dramatically. In order to obtain a better understanding, the scopes of both the US and global infection rates should be analyzed.
Centers for Disease Control and Prevention, being one of the most reliable sources in terms of the US, provides residents with statistical data gathered in the period from 2011 to 2015. The latest data shows that over the past five years, the average number of typhoid fever remains practically the same with not more than 400 cases yearly. In 2015, the highest rates were estimated in the states of California and New York, constituting 56 and 49 cases, respectively. The patients’ diagnosis was mostly related to the fact they had recently come from Asian and African countries. According to the CDC, there were no fatal cases, and the average age of the patients was 23 years. Hence, the current tendency of typhoid fever will be successfully reduced once the issue is resolved on the global level.
When speaking of the global picture, the expansion of typhoid fever does not seem to have a definite average figure. With a yearly estimate of more than 10 million cases of infections, the US constitutes 0,3% of the overall picture. Countries, who cause approximately 80% of the cases, include Bangladesh, China, India, Indonesia, Laos, Nepal, Pakistan, and Vietnam. The tendency of disease spreading is currently increasing in Pakistan, causing an epidemic in 2016. These states have a relatively high ratio of neighborhoods with low living standard rates and, hence, do not obtain satisfying sanitation conditions. As a result, people who travel to such countries without considering the impact of nutrition and the environment bring bacteria to developed countries.
Although both notions of treatment and disease control are crucial in terms of future disease implications, typhoid fever is still more dependent on the issue of control. Its two major aspects concern non-endemic countries’ prevention and safety promotion in the endemic ones. Since the living conditions are beneficial for developing more diseases like typhoid fever, it is of crucial importance to pay much attention to the issue from these people’s perspective. While people in industrialized countries willingly refuse to protect themselves, Indian or Pakistani residents do not even have such an option. Hence, the focus of typhoid fever control has to be shifted towards providing developing states with some basic everyday hygiene items and education.
Conclusion
Taking everything into consideration, it may be concluded that typhoid fever is a seriously undermined problem in the context of today’s society. The major issue lies in the fact that while the disease may be prevented and cured, millions of people struggle with typhoid on an annual basis, and hundreds of thousands of lives are lost. For this reason, it is essential to raise people’s awareness of the subject, giving everyone a chance to make a significant contribution to world well-being.
References
World Health Organization (WHO). (2019). Typhoid. Web.
Smith, Y. (2018). Typhoid fever history. Web.
Brightman, C. (2015). Typhoid fever: yesterday, today and unfortunately still tomorrow. Trends in Urology & Men’s Health. Web.
Marineli, F., Tsoucalas, G., Karamanou, M., & Androutsos, G. (2013). Mary Mallon (1869-1938) and the history of typhoid fever. Annals of Gastroenterology, 26(2), 132-134.
Mandal, A. (2019). Typhoid symptoms. Web.
Typhoid fever. (2018). Web.
Centers for Disease Control and Prevention (CDC). (2018). Web.
Centers for Disease Control and Prevention (CDC). (2019). Typhoid VIS. Web.
National Health Service. (2018). Typhoid fever: Treatment. Web.
Centers for Disease Control and Prevention (CDC). (2015). National typhoid and paratyphoid fever surveillance annual summary. Web.
Brusch, J. L. (2019). What is the global prevalence of typhoid fever (enteric fever)? Web.
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