Salmonella Typhi is a bacterium

Salmonella Typhi is a bacterium

Salmonella Typhi is a bacterium that caused Typhoid fever. Typhoid fever is an infection that can be life-threatening, according to the World Health Organization (WHO) (“Typhoid”). Contaminated food and water are the major way through which the bacteria can spread. Once Salmonella Typhi is ingested by human beings through the contaminated water or food, the bacteria multiply and start to spread all over the body through the blood (“Typhoid”). Apart from the contaminated water and food, the fever can spread through close contact with an infected person. Typhoid fever is a serious health threat in most of the developing countries. The most affected members of the population are the children since the fever spreads mainly through unhygienic practices. This paper gives an overview of salmonella typhi, its etiology, epidemiology, pathophysiology, its history and evolution, the symptoms and treatment.

Salmonella typhi is a gram-negative bacterium that was first described in the early 1800. However, it was not until the early 1880 when the discovery of the typhoid organism was made by George Gaffky (Barnett). Almroth Wright first introduced a vaccine for this fever, and despite the advancements in medication and research on the fever, typhoid fever is still a health menace to most developing countries. The bacterium is rod-shaped, flagellated, and can only survive in a human body.

Epidemiology

Typhoid fever is an infection that mostly affects children and teenagers. The children and teenagers are the most vulnerable members of society due to the nature in which the bacterium spreads. Unhygienic practices like the consumption of contaminated water and food are common among children and teenagers, especially in the underdeveloped and developing countries. Through these practices, salmonella typhi is ingested into the body. Underdeveloped and the developing countries with citizens with low-income and poor sanitation conditions have typhoid fever very prevalent (Crump et al.). In the year 2000, the number of illnesses associated with salmonella typhi bacteria was estimated to be around 21.7 million all over the world. Of these illnesses, over 216,000 victims died due to typhoid fever (Mogasale et al.).

According to the International Vaccine Institute, the number of typhoid fever cases all over the world was estimated to be at around 12 million in the years 2010. Of these cases, the number of deaths as a result of typhoid fever in low and middle-income countries were over 128,000 (Crump and Stephen). This shows that low and middle-income countries are the most affected by this bacterium. These numbers concerning the typhoid fever related cases in the low and middle-income countries are, however, a misrepresentation of the true casualties of the disease. This is because a large number of salmonella typhi victims get treatment on an outpatient basis in local healthcare. Local healthcare systems are used by most citizens in underdeveloped and developing countries. This means that a large number of typhoid fever victims are not in the record. Due to the conditions of healthcare systems and the income conditions of citizens, a significant number of typhoid fever victims never receive treatment at all in the underdeveloped and the developing countries.

In developed countries like the United States of America, there are minimal cases of illnesses and deaths linked to Salmonella typhi. In the United States, typhoid fever cases each year ranges from approximately 250 to 350 cases. However, over 80 percent of these cases are from people who recently visited the endemic regions (Lynch et al.). The mortality rate of the victims affected by Salmonella typhi is currently at 1%. The advancement in the development of effective antibiotics has contributed a lot to this low rate of mortality of typhoid fever victims. Before the advancements in the development of antibiotics, the mortality rate of the victims of Salmonella typhi was at 15% (Stuart and Roscoe)

Pathophysiology

As mentioned earlier, Salmonella typhi enters the body of an individual through the ingestion of contaminated food or water. The disease can also be transmitted between individuals by close contact with a person carrying the bacteria. When salmonella typhi is ingested by an individual, the bacteria must first survive the gastric pH in the victim’s stomach. If the bacteria survive the pH barrier, the bacteria then move to the victim’s small intestines. Among healthy individuals, a dose enough to infect the individual is between the range of 1000 to a million salmonella typhi organisms. This dose, however, depends on the individual’s immune system (Parry et al.).

Once the organisms are in the human’s small intestines, they penetrate the small intestine’s epithelium. This is where the salmonella typhi gains access to the individual’s lymphoid tissues. From here, salmonella typhi then gets distributed all over the body through the human lymphatic system. The bacterium is also distributed through the bloodstream of the individual. Once the organisms get distributed, the symptoms begin to show. This is because cellular replication of salmonella typhi begins in the individual’s body, and this is when the symptoms of the disease can be seen or detected. After the replication process, the organisms remain in the victim’s liver, spleen, and bone marrow. The bone marrow is the place where the organism can be mostly found in an infected individual (Crump et al.).

Of the individuals infected by the bacterium, an approximate percentage of 1 to 5% become chronic carriers. Chronic carriers are those patients who have salmonella typhi in their system but do not show any signs or symptoms of typhoid fever. These individuals could spread the bacterium to other people, although they themselves are in perfect health (Parry et al.). The most famous of such patients is Mary Mallon, who, in 1906, spread the disease to the various households she served as a cook. During this time, Mary seemed and looked to be in perfect health even though she had the organisms in her system (Barnett).

History and Symptoms

The asymptomatic period of the disease is between 7 and 14 days of initial exposure to salmonella typhi. After this period, the patient will begin to show an illness that resembles influenza. This influenza-like illness is accompanied by a fever (Crump et al.). As the disease progresses and the days go by, the individual begins to have abdominal symptoms that include abdominal pains, vomiting, nausea, and vomiting. These symptoms are followed by continuous constipation by the individual, accompanied by diarrhea (Parry et al.). In serious situations, typhoid fever patients begin to develop confusion and apathetic effect.

Among the typhoid fever patients, all of them do not have the symptom of fever even though this symptom is highly associated with the disease. Fever symptom among the typhoid fever patients could possibly depend on the geographical area from which the infection occurred (Crump et al.). Among all the typhoid fever patients, abdominal pains, and most of the accompanying abdominal symptoms is common. What differs in the abdominal pains among the victims is the severity of the abdominal pains (Crump et al.). In most typhoid fever patients, spots, and rushes at the patient’s back, chest, and abdomen are common. The rashes are 2 to 4 mm in diameter and might also appear in the patient’s neck. These rushes are just a common symptom of typhoid fever and do not appear in every patient.

Treatment and management

The only effective treatment of typhoid fever is with the use of antibiotics. The first antibiotic ever used for the treatment of typhoid fever was chloramphenicol (Parry et al.). After the continuous use of this antibiotic, a resistant strain of salmonella typhi was discovered among some patients (Parry et al.). This called for more research, and soon, a more effective antibiotic for the treatment of typhoid fever was discovered. Ciprofloxacin and ofloxacin are the current and most effective antibiotics to be used for the treatment of typhoid fever (Bhutta). Despite the fact that these antibiotics might be too strong and not recommended for children, they are used in severe cases, and when alternative methods of treatment are not available (Parry et al.). To boost immunity and resistance for the disease among children, there has been a breakthrough in the development of a vaccine. A vaccine is available for the children that give the children a higher resistance to the disease.

Typhoid fever patients are also advised to have a regular and large intake of fluids. Since the disease involves severe diarrhea in some cases, the intake of enough fluids would be ideal for body hydration. Typhoid fever is a disease that could be easily managed and avoided. The major way of avoiding the disease is maintaining a high level of hygiene. High hygiene maintenance includes taking clean and treated water, sufficient cooking of food, and regular cleaning of hands.

Differential Diagnosis

The patients of typhoid fever normally show signs and symptoms that are similar to a number of other diseases or illnesses. These other illnesses include malaria, q fever, yellow fever, and filariasis. In tropical countries, the disease is normally confused with malaria. Patients show symptoms that are very similar to those of malaria, except for the rushes and the abdominal pains. The fever, vomiting, and nausea are also symptoms of malaria and other fevers different from typhoid fever. Before treatment, it is advisable that patients ensure that they undergo thorough testing and give a good and accurate history of their past for efficient diagnosis.

Conclusion

Typhoid fever is a disease that spreads through contaminated water and food. Therefore, the most affected people are those people who live in an unhygienic environment. To avoid the disease, people are encouraged to maintain a high level of hygiene wherever they are. It is important that people take clean water and properly cooked food. Individuals should also ensure that they maintain standard practices for sewage disposal for contaminated waste that could cause infections in the neighborhood. Governments of the affected areas should ensure that clinics and hospitals are equipped with antibiotics to combat the disease. These clinics and hospitals should also be equipped with professional nurses and clinicians. These professionals should get involved in training aimed at raising awareness for the disease and encouraging the locals to maintain hygienic practices.

Works cited

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Mogasale, Vittal et al. “Burden Of Typhoid Fever In Low-Income And Middle-Income Countries: A Systematic, Literature-Based Update With Risk-Factor Adjustment.” The Lancet Global Health, vol 2, no. 10, 2014, pp. e570-e580. Elsevier BV, doi:10.1016/s2214-109x(14)70301-8.

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