Typhoid

Typhoid fever or just typhoid is an infectious bacterial disease that is transmitted by the intake of food or liquids which are contaminated with the bacterium Salmonella enterica serovar Typhi through the mouth. There is also a “similar disease [...] caused by the related organisms S. enterica serovar Paratyphi types A, B, and C”.¹ Salmonella enterica serovar Typhi and S. enterica serovar Paratyphi are distributed worldwide but particularly found in developing countries in Southern and Southeast Asia.²

Common symptoms of typhoid fever are high body temperature, prostration, delirium, small red spots on the chest, and a strong pain in the bowels.³⁴ If not treated properly, the illness can also be lethal. The former symptoms make it difficult to create a clinical diagnosis since they are also common to other diseases. The disease is easily caught by younger children, which is why they are at greater risk.⁵

In many cases, typhoid fever epidemics have been caused by polluted public water supplies or food that was handled by humans that carry the disease, or by flies that were in contact with the feces of an infected person. Shellfish that grow in polluted water or vegetables cleaned with contaminated water might have caused the spreading as well.

The disease lasts up to four weeks. After the incubation period of 10-14 days, the infected person might suffer from a headache, fever, and discomfort and restlessness that could have an impact on one's sleep in the first week. People who are infected may lose their appetite and suffer from nosebleeds, obstipation or from diarrhea. The fever reaches its peak of 39 or 40 °C after 7-10 days.⁶

Still suffering from high fever in the second week that even may cause mental confusion, red small spots start to appear on the upper body that last for a few days before they fade away. The typhoid bacilli multiply in the intestinal wall as well as in the lymph follicles, causing them to inflame and become necrotic. This leaves ulcers in the intestinal wall tissue that further causes abdominal hemorrhage or even leaves holes that allows the bowel's contents to enter the abdominal cavity. Other complications such as heart failure, pneumonia or the inflammation of the gallbladder also may occur among other comorbidities.⁷

Depending on the current state of the patient, the disease is either treated with oral rehydration therapy at first when they suffer from diarrhea or – if the symptoms are worse – they are treated with antibiotics like fluoroquinolones among other types of antibiotics.⁸

Edith Wharton had suffered from typhoid fever as a child which is reflected in “The Lady's Maid's Bell” since the main protagonist, Hartley, has and is still suffering from the illness' aftermaths.

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1 Poland, Gregory A. Vaccinations. (Missouri: Elsevier Health Sciences, 2019, 163-178. Print.), 165.

2 Ibid.

3 Online Etymology Dictionary, “Typhus”, https://www.etymonline.com/word/typhus. Accessed December 7, 2019.

4 Cambridge Dictionary, “Typhoid fever”, https://dictionary.cambridge.org/de/worterbuch/englisch/typhoid-fever. Accessed December 7, 2019.

5 Typhoid and other invasive salmonellosis, https://www.who.int/immunization/monitoring_surveillance/burden/vpd/WHO_SurveillanceVaccinePreventable_21_Typhoid_R1.pdf?ua=1&ua=1. Accessed December 8, 2019.

6 Encyclopedia Britannica, “Typhoid fever”, https://www.britannica.com/science/typhoid-fever. Accessed December 12, 2019.

7 Ibid.

8 Ibid.