Typhoid fever is a life-threatening illness caused by the bacterium Salmonella Typhi transmitted through contaminated water or food by human carrier faeces.

Globally, typhoid fever affects an estimated 20 million people annually, with over 200,000 deaths every year in various parts of the world where poor sanitation and limited access to clean and drinkable water are common. In developing areas of Africa, such as Nigeria, Togo, Sudan, Liberia, South-East Asia, and the South Americas (Colombia, Ecuador), the diseases continue to be a public health issue. Children in these countries are most at risk of developing typhoid fever because their immune system which acts as the body’s natural defense against infection is still growing, but these children tend to have milder symptoms than most adults.

What Causes Typhoid Fever?

Typhoid fever is caused by the bacteria called Salmonella Typhi that enters the bloodstream through the mouth after ingesting food or water contaminated with the excreta of a person carrying the bacteria. This bacterium is thus transmitted from one infected human to another.

In developing countries, typhoid fever is endemic due to poor sanitation practices; human waste contaminates the waters, and people mostly become infected by drinking this contaminated water.

Risk Factors of Typhoid Fever

In endemic areas in Africa, Southeast Asia, and South America, typhoid fever has a peak incidence rate of infection occurring between July to September. People who live in a typhoid-free environment (i.e., developed countries) can also be at risk of contracting the disease if they travel to typhoid fever endemic areas, and;

• consume unhealthy food prepared by carriers of Salmonella typhi
• drink water that the Salmonella Typhi bacteria has contaminated
• eating seafood from a water source contaminated by infected stools
• eating raw vegetables that have been contaminated with human waste containing Salmonella typhi

Recognizing Typhoid Fever

An individual who has a febrile illness and has been exposed to Salmonella typhi bacteria through contaminated food or water has an increased chance of developing typhoid fever.

The symptoms of typhoid fever usually develop 1 or 2 weeks after a person has been infected with the Salmonella typhi bacteria. But with treatment, people infected with typhoid fever tend to quickly improve within 3 to 5 days.

Typhoid fever can be recognized through these common signs and symptoms:

Typhoid Fever Early Signs

Signs and symptoms include:

• Fever that starts low and increases daily, possibly reaching as high as 104.9^F (40.5^C)
• Headache
• Weakness and fatigue
• Muscle aches
• Sweating
• Dry cough
• Loss of appetite and weight
• Stomach pain
• Diarrhea or constipation
• Rash
• Extremely swollen stomach

If typhoid fever isn’t treated, it usually gets worse over the course of a few weeks, and life-threatening complications risk being developed.

Without treatment, a person may:

• Become delirious and sometimes “psychotic” (Typhoid psychology)
• Lie motionless and exhausted with eyes half-closed in what is known as ‘the typhoid state’.

Differences Between Malaria and Typhoid

Malaria and typhoid are the two most common infectious diseases in Nigeria and other Sub-Saharan African countries. Although both have similarities when it comes to some of their symptoms, they are neither the same disease nor caused by one or the other as people imply.

Below are some of the differences between Malaria and Typhoid fever:

• Malaria is an infectious disease that is caused by the plasmodium parasites which are spread through the female Anopheles mosquito’s bite, while Typhoid fever is an acute illness that is caused by Salmonella typhi which is acquired by ingesting contaminated food and water.
• Malaria can also be referred to as the plasmodium infection while typhoid is also called enteric fever.
• Malaria is caused by a protozoan acquired through mosquito bites while typhoid fever is caused by a bacterium acquired through ingestion of contaminated meals (water and food). This is the key difference between the two illnesses.
• For malaria, there is an incubation period of 10 – 21 days before the symptoms begin to manifest. And during this period there is an initial feverish symptom, then malaise, nausea, diarrhea, and vomiting. However, typhoid symptoms begin to manifest after an incubation of 10 – 14 days with symptoms such as headache, fever, abdominal pain, constipation, etc.
• Typhoid fever is a vaccine-preventable disease but malaria is not a vaccine-preventable disease.