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Paratyphoid fever |
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Typhoid and paratyphoid enteric fevers
Typhoid and paratyphoid fevers are
infections caused by bacteria which are transmitted from faeces to
ingestion. Clean water, hygiene and good sanitation prevent the
spread of typhoid and paratyphoid. Contaminated water is one of
the pathways of transmission of the disease.
The disease and how it
affects people
Typhoid fever is a bacterial infection of the intestinal tract and
bloodstream. Symptoms can be mild or severe and include sustained
fever as high as 39°-40° C, malaise, anorexia, headache,
constipation or diarrhoea, rose-coloured spots on the chest area
and enlarged spleen and liver. Most people show symptoms 1-3 weeks
after exposure. Paratyphoid fever has similar symptoms to typhoid
fever but is generally a milder disease.
The
cause
Typhoid and paratyphoid fevers are caused by the bacteria
Salmonella typhi and Salmonella paratyphi respectively. Typhoid
and paratyphoid germs are passed in the faeces and urine of
infected people. People become infected after eating food or
drinking beverages that have been handled by a person who is
infected or by drinking water that has been contaminated by sewage
containing the bacteria. Once the bacteria enter the person’s body
they multiply and spread from the intestines, into the
bloodstream.
Even after recovery from typhoid or paratyphoid, a small number of
individuals (called carriers) continue to carry the bacteria.
These people can be a source of infection for others. The
transmission of typhoid and paratyphoid in less-industrialized
countries may be due to contaminated food or water. In some
countries, shellfish taken from sewage-contaminated beds is an
important route of infection. Where water quality is high, and
chlorinated water piped into the house is widely available,
transmission is more likely to occur via food contaminated by
carriers handling food.
Distribution
Typhoid and paratyphoid fevers are common in less-industrialized
countries, principally owing to the problem of unsafe
drinking-water, inadequate sewage disposal and flooding.
Interventions
Public health interventions to prevent typhoid and paratyphoid
include:
- health education about personal hygiene,
especially regarding hand-washing after toilet use and before
food preparation; provision of a safe water supply;
- proper sanitation systems;
- excluding disease carriers from food
handling.
Control measures to combat
typhoid include health education and antibiotic treatment. A
vaccine is available, although it is not routinely recommended
except for those who will have prolonged exposure to potentially
contaminated food and water in high-risk areas. The vaccine does
not provide full protection from infection.
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