TYPHOID (ENTERIC) FEVER AND PARATYPHOID FEVER
Anaclare Cobb, RN, BS, MSN, FNP
Typhoid fever is a bacterial infection caused by Salmonella typhi and Paratyphoid fever by Salmonella paratyphi. They have similar symptoms and are spread through fecally-contaminated food and water, or by direct contact with an infected person. According to the World Health Organization (WHO), 9 million people were affected by typhoid and paratyphoid illnesses in 2019. The WHO further estimates that 110,000 people die from the illness each year.
Symptoms of typhoid fever include:
- Protracted fever
- Fatigue
- Headache
- Nausea
- Abdominal pain
- Constipation or diarrhea
- A flat rash, often described as “rose spots”
Severe disease is caused by spreading infection, bowel perforation, and bacteremia. Paratyphoid is similar in presentation to typhoid but generally less severe. If left untreated, even if symptoms resolve, the ill person may remain contagious by spreading the bacterium through their feces.
Typhoid fever and paratyphoid fever are treated with antibiotics. The antibiotics most commonly used are:
- Fluoroquinolones such as ciprofloxacin
- Cephalosporins (third generation)
- Macrolides
- Carbapenems
Gastrointestinal precautions must be kept in place until the ill person’s cultures are clear of infection. Additionally, the infected individual should avoid food preparation and practice frequent handwashing until clearance has been given.
Two typhoid conjugate vaccines were prequalified by the WHO. The vaccines are recommended for individuals aged six months to 65 years.
Typhoid and paratyphoid fever are diseases that can generally be treated with prompt care. Recognition of the symptoms and an understanding of the potential dangers of infection are paramount. Remember that children do not tolerate the ravages of typhoid bacteremia and should be cared for promptly.
Sources:
“Typhoid.” World Health Organization, World Health Organization, 30 Mar. 2023, www.who.int/news-room/fact-sheets/detail/typhoid
“Typhoid Fever.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 Jan. 2023, www.mayoclinic.org/diseases-conditions/typhoid-fever/symptoms-causes/syc-20378661.
“Typhoid Fever and Paratyphoid Fever.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Dec. 2022, www.cdc.gov/typhoid-fever/symptoms.html.
Wolf, Catherine, and Dennis Palmer. Handbook of Medicine in Developing Countries, 4th ed., Christian Medical & Dental Associations, Bristol, TN, 2014, pp. 35–37.