Typhoid Fever

Typhoid fever is a systemic bacterial infection caused by Salmonella enterica serotype Typhi, spread through food and water contaminated with the bacteria. It is common in areas with inadequate sanitation and unsafe water supply.

• Prolonged, stepwise-rising fever
• Headache
• Abdominal pain
• Constipation or diarrhoea
• Malaise and loss of appetite
• In severe cases: rose-coloured spots on the trunk, abdominal distension, and complications such as intestinal bleeding or perforation

• Caused by ingesting food or water contaminated with Salmonella Typhi from an infected person or a carrier.
• Spread is facilitated by poor sanitation, unsafe water supply, and inadequate food hygiene.

• Blood culture is the preferred confirmatory test, especially in the first week of illness.
• The Widal test may support diagnosis but has limited specificity and should be interpreted cautiously.
• Full blood count and other supportive investigations may be used as needed.

Uncomplicated typhoid fever is treated with an appropriate oral antibiotic guided by local resistance patterns, such as a fluoroquinolone (for example ciprofloxacin) where susceptibility allows, azithromycin, or a third-generation cephalosporin such as cefixime, for 7–14 days.

Severe or complicated typhoid — with altered consciousness, perforation, or shock — requires hospital admission for intravenous antibiotics such as ceftriaxone and supportive care, with surgical management if intestinal perforation occurs.

• Drink water from safe sources or boil/treat water before drinking.
• Practise proper sanitation and safe sewage disposal.
• Wash hands with soap, especially before eating and after using the toilet.
• Cook food thoroughly.
• Typhoid vaccination where recommended, particularly for high-risk groups and during outbreaks.