02/06/2022
Who was “Typhoid Mary”?
Salmonella Typhi is predominantly shed in the faeces of infected individuals. This shedding usually stops soon after a person’s symptoms resolve, however, some individuals continue to harbour and shed bacteria for several weeks to more than a year after resolution of symptoms. These individuals are known as “carriers”. One such individual was Mary Mallon, a cook who was given the name “Typhoid Mary” after having infected numerous individuals during her years of chronic carriage of Salmonella Typhi in the early 1900’s. Chronic carriers, especially those who work with food, continue to be important sources of infection and are largely responsible for the ongoing spread of typhoid fever within endemic countries.
How is Typhoid Fever spread?
Typhoid fever is an exclusively human infection that is spread via faeco-oral transmission. It is contracted when individuals ingest water or food that has been contaminated with the faeces of infected individuals. Sewage pollution of untreated water supplies remains a primary source of large-scale typhoid fever outbreaks as well as poor sanitation and unhygienic practices, especially within food industries. Typhoid fever is thus considered a disease of poverty as it primarily burdens lower and middle income countries in areas where water quality and sanitation levels are poor.
What are the signs and symptoms?
The symptoms of typhoid fever usually develop 1-2 weeks after initial infection and can last for about 3-4 weeks. These symptoms are fairly nonspecific and often mimic the symptoms of a number of other infectious diseases, including malaria. A sustained, high fever is the most notable symptom but fatigue, headache, nausea, vomiting, abdominal pain and body aches are also commonly experienced by infected individuals. A skin rash (faint and pink “rose spots”) can also occur as well as an enlarged spleen and liver. In severe disease, occurring in 10-15% of patients, additional complications, such as gastrointestinal bleeding, intestinal perforation, pneumonia and septic shock, can occur and could potentially cause death
How is it treated?
Like most bacterial infections, typhoid fever is successfully treated with a number of different antibiotics. In South Africa, ciprofloxacin (an antibiotic that inhibits bacterial DNA synthesis) is the treatment of choice for individuals infected with Salmonella typhi.
If left untreated, there is a 12-30% chance of death in infected patients. However, this death rate can be reduced to less than 1% through effective antimicrobial treatment.
Prevention and control
Considering its mode of transmission, Salmonella typhi can be prevented at an individual level through good hand hygiene, safe food measures and drinking safe, clean water. Good hand hygiene includes washing your hands thoroughly with soap and water before eating or preparing food or after making use of the toilet. Safe food measures include keeping food clean, storing food at safe temperatures and cooking food thoroughly. If you are concerned about the quality of water you are drinking, boiling your water before drinking it can greatly reduce your risk of infection.
Additionally, there are currently three typhoid fever vaccines available. The newest vaccine, the injectable typhoid conjugate, is preferred as it can be used in younger children above 6 months of age, it has improved immunological properties and provides longer lasting immunity.
Enjoy these short videos summarising the key aspects of Typhoid Fever:
Symptoms:
https://youtube.com/clip/UgkxmRPBqj-arRtX_zdGe-YGFCcEXSrKY63M
Treatment:
https://youtube.com/clip/Ugkx2PafLE9LFZ9BAzwTbuz98udj7tjD7G6x
Chronic carriers of S. typhi:
https://youtube.com/clip/UgkxyBEm6Nvl-r9ffmSzp-An7cwD64uLUomo
60 seconds · Clipped by Rebecca Groome · Original video "Osmosis | Salmonella Typhi (typhoid fever)" by drborisplaysdota
