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A Thing or Two about Typhoid Fever
By Dr. Madan M. Vasandani

When someone in the family or you yourself have a fever you go to a doctor but one of the statements you may hear from the doctor is “the cause of the fever could be Dengue fever, Typhoid fever or some other viral illness.” Many times you are told to come back in 2-3 days for a blood test if the fever persists. You leave the consultation room more confused and concerned then when you first came in.

Fever is a common symptom for many diseases. However, in Jakarta, the most common cause of fever is infectious in origin. The main concern is if the fever is NOT followed by any specific symptoms like a sore throat, ear pain, diarrhea etc. The two main causes of fever of such nature is Dengue Fever and Typhoid Fever. Both these condition could prove to be very dangerous if not properly managed.

I would like to share a few points about Typhoid fever and its management.

Typhoid fever and Paratyphoid fever is a systemic illness characterised by sustained fever and abdominal complaints. It is collectively known as Enteric fever. Enteric fever is infectious in origin and caused by bacteria belonging to the salmonella family. The illness can range from a mild condition without complications to a very severe condition with very serious complications that has a high mortality rate. The severity of the disease depends on many factors, some of them being the immune status of the individual, bacterial load and the bacterial resistance towards antibiotics. Typhoid is endemic in Indonesia.

The risk factors for the development of enteric fever due to typhoid or paratyphoid may differ. In a study from Indonesia, paratyphoid fever was more probable with exposures outside the home (example purchase of food from street vendors) compared with typhoid fever, which frequently resulted from exposure within the household (example sharing utensils, presence of a patient with typhoid, lack of soap or adequate toilet facilities).

Fever is the main symptom of Typhoid fever. The fever is unique in that it follows a ‘step ladder’ pattern. The fever rises everyday as the disease progresses. Other symptoms like abdominal pain, dry cough, skin rash and joint pain are not consistent with typhoid fever. Ensure that you consult a doctor when such a situation arises. Typhoid is condition with multiple complications. The longer you wait before seeking medical advice the higher the chance of developing complications. The complications include Hepatitis, Meningitis and even Bowel Perforation. These complications carry a high mortality rate.

The key to management of any disease is diagnosing it. Typhoid is diagnosed by a blood test. When the bacterium is inside the body, the body reacts by developing antibodies specific to the bacteria. These antibodies are easily detected by a laboratory test. The treatment of typhoid is antibiotics for a minimum of one week and can even extend to two weeks. One of the main concerns with regard to the treatment of Typhoid is the development of antibiotic resistance. In Indonesia this is very evident hence many times doctors may change the antibiotics depending on the response. For this very reason it is essential that a follow up is done every 48 hours.

The old adage “Prevention is better than cure” is very much valid today. Typhoid is preventable. The main cause of Typhoid fever is ingestion of contaminated food or water. Follow this simple rule – Boil it, Cook it or Peel it otherwise Forget it. The other way of preventing this disease is by getting vaccinated against it. The vaccine to prevent typhoid is available and proven to be very effective. The vaccine is delivered as an Intra Muscular Injection and it is given once every two years.

Please contact Global Assitance Medical Centre 24/7 for an appointment, visit of the facilities or corporate agreements;

Cilandak Commercial Estate Unit 111 GC
Jl Raya Cilandak KKO (corner of Jl Ampera & Jl Simatupang)
Jakarta Selatan 12560
Tel: 021 299 78988 Medical Centre
Tel: 021 299 78999 Alarm Centre

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