Typhoid fever can be very severe, as seen from the report that 32% of deaths occurred in several regions of the world. Indonesia reported prevalence rate ranges from 1.6% and ranks 15 major causes of death. Until the twentieth century, the disease has spread throughout the world. Future cases of typhoid in developing countries will be much reduced because of improvements in sanitation and hygiene
In endemic areas, the highest incidence of typhoid fever occur in children aged 5 to 19 years, in some cases significantly typhoid causing pain between the ages of 1 to 5 years. In children aged younger than a year, the disease is usually more severe and associated with complications that commonly occur
Typhoid is usually transmitted through consumption of contaminated food or water and certain risk factors including drinking from contaminated water sources, drinks with ice, and fruits and vegetables grown using fertilizer from manure. Transmission connection with contaminated urine can also occur. Transmission from person to person are also possible. Pathogens can survive in water for days and months on frozen eggs and shellfish contaminated.
In general, symptoms of typhoid fever would occur after 7-14 days since the body is infected, but can also range from 3 till 60 days. Patients typically come to the hospital with complaints such as fever, flu symptoms, severe headache, malaise, anorexia, abdominal discomfort, dry cough, and sore muscles.
Gradually, the body temperature will continue to rise and settle at a high temperature in the second week, and even up to 4 weeks if not treated. Then the temperature will return to normal, though a sense of weakness and fatigue will continue to be felt until a few weeks later.
10% to 15% of patients who do not get treatment usually experience a variety of complications such as bleeding and perforation in the small intestine, as well as a few conditions of nerve disorders. Bleeding occurs in conditions of severe infection, and is characterized by lower body temperature rapidly and then rose again in the early occurrence of peritonitis, a dangerous condition in which inflammation occurs in the peritoneum (the thin membrane protects the walls of the abdominal cavity). Small bowel perforation occurs in 1-3% of patients hospitalized with a mortality rate of 40%. This complication usually affects the terminal ileum and need immediate surgery.
Recurrence occurs in 5-10% of cases, usually within a month after the fever was declared cured. Symptoms are generally milder than the previous infection and in cases where the molecular classification of S. typhi has been conducted, showed that relapse is generally caused by isolates of the same type of previous infection. Recurrent infections with isolates of different species can also occur.
The factors that most affect the poor condition of patients with typhoid fever is the delay in providing adequate antibiotic treatment and effective. It is important to ensure the eradication of S. typhi from patients to reduce the likelihood of recurrence or status as carriers of disease. In cases where severe abdominal swelling and vomiting or diarrhea patients should be continuously hospitalized and intravenously. In general, typhoid fever patients to undergo treatment at home with oral antibiotics and outpatient.
Contaminated food and water is known as a medium of transmission of typhoid fever. Currently, prevention of enteric fever is more focused on improving sanitation, water supply and ensure food security, identification and therapy (carrier) and chronic use of typhoid vaccines to reduce human vulnerability to infection
Vaccination is an additional weapon and not a substitute for avoiding the foods and beverages at risk because not 100% protective efficacy; further immunity can be defeated by the number of bacterial inoculum doses. There are two currently used vaccine, namely Ty21 vaccines given per oral and injectable vaccine Vi polysaccharide pure. Both are considered safe and well tolerated
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