Fight typhoid
http://www.telegraphindia.com/1151130/jsp/knowhow/story_55762.jsp
Your Health - Dr. Gita Mathai
Several infectious diseases such as small pox and polio have been eliminated in India through universal immunisation. Typhoid, which has practically disappeared from industrialised countries, is however endemic in the country. Around 20-25 million people worldwide are affected every year by typhoid and of these around 2,00,000 die. The major burden of typhoid is in India, Pakistan and Bangladesh.
Bacteria belonging to the Salmonella family cause typhoid and its two milder variants of paratyphoid fever. The bacteria are excreted in the stools and urine of infected individuals. Some people (carriers) continue to excrete the organism even after treatment of the disease and apparent recovery. The environment gets contaminated as the bacteria leach into the soil, and eventually enter water and food. The bacteria can survive for weeks as they wait for a host. They survive only in humans.
Defecating in the open is unhealthy and aesthetically repulsive but it is an accepted part of life in India. Our towns and cities also contribute to the problem. They often have open drainage. Untreated sewage (almost 80 per cent of the total generation) is pumped into lakes and rivers. The bacteria seep into the ground and leach into groundwater and drinking supplies.
Once the typhoid bacteria enter the body, symptoms occur after an incubation period of a week or two. During this time the bacteria slowly multiply, invade the intestine and circulate in the blood. They reach the liver, kidney and bone marrow. They then re-enter the blood stream, causing symptoms like tiredness, high fever (103°F, 39.5°C), a mild red rash, abdominal pain and diarrhoea.
Blood counts in typhoid are non-specific. In the early and late stages of the disease the bacteria can be grown in cultures of blood (70 per cent) and stool or bone marrow (90 per cent). There are a number of blood tests. The most commonly used is the Widal test. This is a very non-specific test. A single high value is inconclusive. It confirms typhoid if a repeat test shows a rising titer. There are also “card” tests for typhoid similar to the ones used for pregnancy tests.
Treatment with oral antibiotics needs to be continued for 10-14 days. Supportive therapy in the form of a bland diet, tepid sponging and paracetemol helps. Despite adequate treatment and apparent cure, 3-5 per cent of the infected individuals remain asymptomatic carriers. Those with kidney or gall bladder stones are more likely to become carriers. Removal of the stones or the gall bladder helps recovery.
Good sanitation and proper sewage disposal is the key to the prevention of typhoid. In most of India this does not occur. Nor has the toilet construction scheme been successful.
Single shot vaccines are available for typhoid. They can be given after the age of two. Boosters have to be given every three years. Oral vaccines are also available. They can be given after the age of five. They are not as effective as the injections.
To protect against typhoid:
♦ Drink water that is boiled, bottled or purified.
♦ Do not eat raw vegetables or fruits washed in untreated water
♦ If you eat outside, make sure the food is piping hot.
♦ Immunise yourself and your family. The vaccine is not expensive.
♦ Try to mobilise local government for action on sewage and sanitation.
♦ Do not eat raw vegetables or fruits washed in untreated water
♦ If you eat outside, make sure the food is piping hot.
♦ Immunise yourself and your family. The vaccine is not expensive.
♦ Try to mobilise local government for action on sewage and sanitation.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
